Potential role of doppler perfusion index in selection of patients with colorectal cancer for adjuvant chemotherapy

Leen, Edward; Goldberg, J. A.; Angerson, Wilson J.; McArdle, C. S.

doi:10.1016/s0140-6736(99)06322-9

Cited by 73 publications

(51 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This hypothesis was proven on both a global basis with Doppler US and a regional basis with perfusion CT. Leen et al (67) showed that the 5-year survival of patients after curative surgery for colorectal cancer was 91% in patients with normal hepatic Doppler perfusion index (defined as the ratio of the hepatic arterial to the sum of hepatic arterial blood flow and portal venous blood flow) and 29% in patients with abnormal hepatic Doppler perfusion index ( 0.3). Hepatic arterial and portal venous blood flows were calculated from the product of velocity averaged over time and cross-sectional area of the vessel, which were measured at common hepatic artery and intrahepatic portal vein, respectively.…”

Section: Early Detection Of Liver Tumorsmentioning

confidence: 99%

CT Perfusion of the Liver: Principles and Applications in Oncology

Kim¹,

Kamaya²,

Willmann³

2014

Radiology

171

135

View full text Add to dashboard Cite

With the introduction of molecularly targeted chemotherapeutics, there is an increasing need for defining new response criteria for therapeutic success because use of morphologic imaging alone may not fully assess tumor response. Computed tomographic (CT) perfusion imaging of the liver provides functional information about the microcirculation of normal parenchyma and focal liver lesions and is a promising technique for assessing the efficacy of various anticancer treatments. CT perfusion also shows promising results for diagnosing primary or metastatic tumors, for predicting early response to anticancer treatments, and for monitoring tumor recurrence after therapy. Many of the limitations of early CT perfusion studies performed in the liver, such as limited coverage, motion artifacts, and high radiation dose of CT, are being addressed by recent technical advances. These include a wide area detector with or without volumetric spiral or shuttle modes, motion correction algorithms, and new CT reconstruction technologies such as iterative algorithms. Although several issues related to perfusion imagingsuch as paucity of large multicenter trials, limited accessibility of perfusion software, and lack of standardization in methods-remain unsolved, CT perfusion has now reached technical maturity, allowing for its use in assessing tumor vascularity in larger-scale prospective clinical trials. In this review, basic principles, current acquisition protocols, and pharmacokinetic models used for CT perfusion imaging of the liver are described. Various oncologic applications of CT perfusion of the liver are discussed and current challenges, as well as possible solutions, for CT perfusion are presented.q RSNA, 2014

show abstract

Section: Early Detection Of Liver Tumorsmentioning

confidence: 99%

CT Perfusion of the Liver: Principles and Applications in Oncology

Kim¹,

Kamaya²,

Willmann³

2014

Radiology

171

135

View full text Add to dashboard Cite

show abstract

“…It was concluded that patients who had a DVI > 15% at the primary site had worse overall survival compared to patients with DVI < 15% [80] . A similar parameter is the Doppler hepatic perfusion index (DHPI) (ratio of hepatic arterial flow/total liver flow), which appeared to be increased even in patients with occult micrometastases and is predictive of metastatic liver tumour recurrence [81] . The association between angiogenesis at the primary CRC site and in the hepatic metastases is further supported by imaging techniques, such as dynamic contrast-enhanced magnetic resonance imaging and contrast-enhanced computed tomography [82] .…”

Section: Angiogenesis In the Large Intestinementioning

confidence: 99%

Natural history of hepatic metastases from colorectal cancer - pathobiological pathways with clinical significance

Paschos

Majeed

Bird

2014

WJG

View full text Add to dashboard Cite

Colorectal cancer hepatic metastases represent the final stage of a multi-step biological process. This process starts with a series of mutations in colonic epithelial cells, continues with their detachment from the large intestine, dissemination through the blood and/or lymphatic circulation, attachment to the hepatic sinusoids and interactions with the sinusoidal cells, such as sinusoidal endothelial cells, Kupffer cells, stellate cells and pit cells. The metastatic sequence terminates with colorectal cancer cell invasion, adaptation and colonisation of the hepatic parenchyma. All these events, termed the colorectal cancer invasion-metastasis cascade, include multiple molecular pathways, intercellular interactions and expression of a plethora of chemokines and growth factors, and adhesion molecules, such as the selectins, the integrins or the cadherins, as well as enzymes including matrix metalloproteinases. This review aims to present recent advances that provide insights into these cell-biological events and emphasizes those that may be amenable to therapeutic targeting. Paschos KA, Majeed AW, Bird NC. Natural history of hepatic metastases from colorectal cancer -pathobiological pathways with clinical significance.

show abstract

“…Beyond diagnostic capability, abnormal DPI values were also reported to predict clinical outcome, lymph node and liver metastases (Cooke et al, 1987;Leen et al, 1997bLeen et al, , 2000Warren et al, 1998;Oppo et al, 2000;Fuentes et al, 2002;Miles et al, 2011). The method used in this study to measure hepatic arterial blood flow differs from that originally described.…”

Section: Discussionmentioning

confidence: 98%

Interrelationship between Liver Hemodynamics and Tumor Metabolism in Liver Metastases: Diagnostic Value of Doppler Perfusion Index Revisited

2013

View full text Add to dashboard Cite

Key words: Liver neoplasms -Neoplasm metastasis -Positron emission tomography -Ultrasonography -DopplerAbstract: It should be expected that the hepatic blood flow increase in the cases with liver metastasis. We aimed to find out if there is a correlation between Doppler parameters and hepatic metabolic activity in oncology patients. 35 patients with hepatic metastases who were identified by 18F-fluorodeoxyglucose positron emission tomography scan and assessed with Doppler ultrasound were included in this prospective study. Patients with hepatic disease, cardiac dysfunction, dehydration, history of alcoholism, intake of antihypertensive or vasoactive medication were excluded. Volume flow of the proper hepatic artery and the portal vein were measured in the hepatoduodenal ligament by Doppler sonography. Doppler perfusion index (the ratio of the hepatic artery flow to the total liver blood flow) and flow volumes of 31 age matched subjects were compared. Both flow of the proper hepatic artery and portal vein were found to be significantly higher in patients with liver metastasis. The mean Doppler perfusion index value was 0.2 ± 0.13 in hepatic metastases whereas 0.13 ± 0.05 in control group. Doppler perfusion index was significantly higher in liver metastases (p=0.008). A positive correlation was found between the maximum standardized uptake value of the liver and flow volume of the proper hepatic artery (r=0.774, p=0). Blood flow of the proper hepatic artery and Doppler perfusion index correlates with hepatic standardized uptake value. Flow measurements of the liver may become an important parameter for selecting patients for further positron emission tomography scan and following-up the response after systemic and local therapeutic procedures. IntroductionLiver metastasis is a common consequence of many carcinomas. The detection of hepatic metastases is necessary for exact staging and planning of the treatment. The recent technological improvements have enabled quantitative imaging of hepatic parenchymal and tumoral blood flow. The demonstration of the altered hepatic hemodynamics during the tumoral angiogenesis within the liver metastases may subsequently indicate the presence of metastases even in the absence of manifest tumours. The functional changes are generally detectable before any structural abnormality is apparent, as it is the degree of physiological change rather than its size that determines whether an abnormality is detected (Fuentes et al., 2002). Quantitative perfusion measures may be used for the characterization of hepatic tumours and their biologic aggressiveness and also monitoring the therapeutic response. Increase in tumoral vascularity and glucose metabolism are prominently important factors in the growth and also detection of many tumours (Miles and Williams, 2008;Haider et al., 2010). For correct staging and treatment optimization, the resolving capacity of imaging modalities needs to be improved. However the use of these imaging tools are not common because of their high cost, lower avail...

show abstract

Potential role of doppler perfusion index in selection of patients with colorectal cancer for adjuvant chemotherapy

Cited by 73 publications

References 16 publications

CT Perfusion of the Liver: Principles and Applications in Oncology

CT Perfusion of the Liver: Principles and Applications in Oncology

Natural history of hepatic metastases from colorectal cancer - pathobiological pathways with clinical significance

Interrelationship between Liver Hemodynamics and Tumor Metabolism in Liver Metastases: Diagnostic Value of Doppler Perfusion Index Revisited

Contact Info

Product

Resources

About