Assessing Early Vascular Changes and Treatment Response After Laser-Induced Thermotherapy of Pulmonary Metastases With Perfusion CT: Initial Experience

Hegenscheid, Katrin; Behrendt, Nicole; Rosenberg, Christian; Kuehn, Jens-Peter; Ewert, Ralf; Hosten, Norbert; Puls, Ralf

doi:10.2214/ajr.09.2810

Cited by 29 publications

(20 citation statements)

References 35 publications

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“…Routine enhanced CT usually can not reflect the change in tumour vascular physiology and even provides an incorrect evaluation because that the lesion sometimes has great enhancement that results from radiotherapy. However, perfusion CT technique provides a new method of reflecting the vascular characteristics such as micro-vessel density (MVD) and vascular permeability [15][16][17]. If the short-time effect of the tumour can be predicted before therapy in the light of vascular characteristics discerned by perfusion CT, it becomes possible to select those patients who are sensitive to synchronous radiochemotherapy before treatment, which is very helpful for the choice of treatment regimens and improvement of prognosis.…”

Section: Discussionmentioning

confidence: 99%

The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer

Fan

Zhu

et al. 2011

Eur Radiol

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Section: Discussionmentioning

confidence: 99%

The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer

Fan

Zhu

et al. 2011

Eur Radiol

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“…Our data acquisition period was nearly 10 minutes, but it appeared to be insufficient to attain stabilization in PS with high confidence. Further studies extending (7,(9)(10)(11)(13)(14)(15)(16)(17)19,21,22,28). Although these studies did not all include the specific organ and tissues we used, some of these studies may not have characterized the CT perfusion parameters adequately.…”

Section: Gastrointestinal Imaging: Metastases To the Liver From Neuromentioning

confidence: 99%

Metastases to the Liver from Neuroendocrine Tumors: Effect of Duration of Scan Acquisition on CT Perfusion Values

Ng¹,

Hobbs²,

Chandler³

et al. 2013

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Purpose:To assess the effects of acquisition duration on computed tomographic (CT) perfusion parameter values in neuroendocrine liver metastases and normal liver tissue. Materials and Methods:This retrospective study was institutional review board approved, with waiver of informed consent. CT perfusion studies in 16 patients (median age, 57.5 years; range, 42.0-69.7 years), including six men (median, 54.1 years; range, 42.0-69.7), and 10 women (median, 59.3 years; range 43.6-66.3), with neuroendocrine liver metastases were analyzed by means of distributed parametric modeling to determine tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction for tumors and normal liver tissue. Analyses were undertaken with acquisition time of 12-590 seconds. Nonparameteric regression analyses were used to evaluate the functional relationships between CT perfusion parameters and acquisition duration. Evidence for time invariance was evaluated for each parameter at multiple time points by inferring the fitted derivative to assess its proximity to zero as a function of acquisition time by using equivalence tests with three levels of confidence (20%, 70%, and 90%). Results:CT perfusion parameter values varied, approaching stable values with increasing acquisition duration. Acquisition duration greater than 160 seconds was required to obtain at least low confidence stability in any of the CT perfusion parameters. At 160 seconds of acquisition, all five CT perfusion parameters stabilized with low confidence in tumor and normal tissues, with the exception of hepatic arterial fraction in tumors. After 220 seconds of acquisition, there was stabilization with moderate confidence for blood flow, blood volume, and hepatic arterial fraction in tumors and normal tissue, and for mean transit time in tumors; however, permeability values did not satisfy the moderate stabilization criteria in both tumors and normal tissue until 360 seconds of acquisition. Blood flow, mean transit time, permeability, and hepatic arterial fraction were significantly different between tumor and normal tissue at 360 seconds (P , .001). Conclusion:CT perfusion parameter values are affected by acquisition duration and approach progressively stable values with increasing acquisition times.q RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup /suppl

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“…No. of patientsDiameter (cm)TreatmentTiming (H: hours, D: day, W: week, M: month)Imaging biomarkers b Results in respondersHarvey, 2002 [ 64 ] 3n.a.FRTD0, W1, W2, W6, W12Perfusion, CP↑ perfusion, ↑ CP at W1–W2Wang, 2009 [ 63 ] 35≥3CHEMO (19)D0, cycle2, end RTBV, BF, CP, MTT↑ BF at D0RT (7)↓ BV, BF, CP post RT ± CHEMOCHEMORT (9)(no changes with chemo only)Ng, 2007 [ 66 ] 164.9–11.8FRTD0, 2–4-6 fractionsBV, CP↑ BV at fraction 2–4 (not 6)Ng, 2007 [ 65 ] 84.9–11.8RT + VDAD0,2 fractionsBV, CP↑ BV, ↑ CP at fraction 2H4, H72 post VDA↓ BV at H4–H72Hegenscheid, 2010 [ 68 ] a 220.8–5.4LITTD0, D1, W4, W6BV, BF, CP, MTT↓ BV, BF, CP at D1, W4, W6Correlation with RECIST at M12Yabuuchi, 2011 [ 67 ] 282.3–9CHEMOD0, W3,W4TTP, WashOut MaxEnh ratioNo change at W3,W4…”

Section: Lung Metastasesmentioning

confidence: 99%

Functional imaging biomarkers for assessing response to treatment in liver and lung metastases

Bernardin¹,

O’Flynn²,

deSouza³

2013

Cancer Imaging

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Management of patients with metastatic cancer and development of new treatments rely on imaging to provide non-invasive biomarkers of tumour response and progression. The widely used size-based criteria have increasingly become inadequate where early measures of response are required to avoid toxicity of ineffective treatments, as biological, physiologic, and molecular modifications in tumours occur before changes in gross tumour size. A multiparametric approach with the current range of imaging techniques allows functional aspects of tumours to be simultaneously interrogated. Appropriate use of these imaging techniques and their timing in relation to the treatment schedule, particularly in the context of clinical trials, is fundamental. There is a lack of consensus regarding which imaging parameters are most informative for a particular disease site and the best time to image so that, despite an increasing body of literature, open questions on these aspects remain. In addition, standardization of these new parameters is required. This review summarizes the published literature over the last decade on functional and molecular imaging techniques in assessing treatment response in liver and lung metastases.

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Assessing Early Vascular Changes and Treatment Response After Laser-Induced Thermotherapy of Pulmonary Metastases With Perfusion CT: Initial Experience

Abstract: Perfusion CT of pulmonary metastases has potential in the assessment of early vascular changes that result from LITT and predicting technical success immediately after treatment. Tumors with perfusion measurements that had not changed after therapy indicated progressive disease.

Cited by 29 publications

References 35 publications

The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer

The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer

Metastases to the Liver from Neuroendocrine Tumors: Effect of Duration of Scan Acquisition on CT Perfusion Values

Functional imaging biomarkers for assessing response to treatment in liver and lung metastases

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