Perfusion CT – A novel quantitative and qualitative imaging biomarker in gastric cancer

Kruk-Bachonko, Joanna; Krupski, Witold; Czechowski, Michał; Kurys-Denis, Ewa; Mądro, Przemysław; Sierocińska-Sawa, Jadwiga; Dabrowski, A; Wallner, Grzegorz; Skoczylas, Tomasz

doi:10.1016/j.ejrad.2017.08.033

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…Proteotoxic stress, caused by accumulation of misfolded proteins and/or proteasome inhibition, has recently been discovered as an additional pathologic trigger for the diabetic heart. The cardiac ubiquitin proteasome system ( Kruk-Bachonko et al, 2017 ) is responsible for the maintenance of protein homeostasis by degrading the misfolded or oxidized proteins ( Gilca et al, 2017 ). UPS dysfunction occurs early on in the onset of diabetic cardiomyopathy and promotes cardiac maladaptive remodeling, whereas increasing UPS activity through PA28α overexpression has been shown to reduce cardiac dysfunction in a STZ-induced diabetes model ( Li et al, 2017 ).…”

Section: The Pathogenesis Of Diabetic Cardiomyopathymentioning

confidence: 99%

Diabetic Cardiomyopathy: Current and Future Therapies. Beyond Glycemic Control

et al. 2018

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Diabetes mellitus and the associated complications represent a global burden on human health and economics. Cardiovascular diseases are the leading cause of death in diabetic patients, who have a 2–5 times higher risk of developing heart failure than age-matched non-diabetic patients, independent of other comorbidities. Diabetic cardiomyopathy is defined as the presence of abnormal cardiac structure and performance in the absence of other cardiac risk factors, such coronary artery disease, hypertension, and significant valvular disease. Hyperglycemia, hyperinsulinemia, and insulin resistance mediate the pathological remodeling of the heart, characterized by left ventricle concentric hypertrophy and perivascular and interstitial fibrosis leading to diastolic dysfunction. A change in the metabolic status, impaired calcium homeostasis and energy production, increased inflammation and oxidative stress, as well as an accumulation of advanced glycation end products are among the mechanisms implicated in the pathogenesis of diabetic cardiomyopathy. Despite a growing interest in the pathophysiology of diabetic cardiomyopathy, there are no specific guidelines for diagnosing patients or structuring a treatment strategy in clinical practice. Anti-hyperglycemic drugs are crucial in the management of diabetes by effectively reducing microvascular complications, preventing renal failure, retinopathy, and nerve damage. Interestingly, several drugs currently in use can improve cardiac health beyond their ability to control glycemia. GLP-1 receptor agonists and sodium-glucose co-transporter 2 inhibitors have been shown to have a beneficial effect on the cardiovascular system through a direct effect on myocardium, beyond their ability to lower blood glucose levels. In recent years, great improvements have been made toward the possibility of modulating the expression of specific cardiac genes or non-coding RNAs in vivo for therapeutic purpose, opening up the possibility to regulate the expression of key players in the development/progression of diabetic cardiomyopathy. This review summarizes the pathogenesis of diabetic cardiomyopathy, with particular focus on structural and molecular abnormalities occurring during its progression, as well as both current and potential future therapies.

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Section: The Pathogenesis Of Diabetic Cardiomyopathymentioning

confidence: 99%

Diabetic Cardiomyopathy: Current and Future Therapies. Beyond Glycemic Control

et al. 2018

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“…They concluded that tumor growth might lead to increase both tissue pressure and capillary compression and subsequently reduce tumor blood flow, as a result, hypoxic environment in tumor tissue might promote oncogenic mutations and finally more aggressive behaviors in tumor. Another paper reported that neoadjuvant therapy was more effective in patients with higher baseline tumor blood flow and patients with a positive treatment response showed decrease tumor blood flow in gastric cancer (30). Previous reports applied PCT for assessing tumor neovascularization and focused on predicting patient prognosis and response to chemotherapy or chemoradiotherapy (23–25).…”

Section: Previous Applications Of Pct For Gastrointestinal Cancermentioning

confidence: 99%

Hepatic blood flow by perfusion computed tomography as an imaging biomarker for patients with gastric cancer

et al. 2019

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Perfusion computed tomography (PCT) is a less invasive imaging modality that provides information about tissue hemodynamics at the capillary level. The present study aimed to investigate the correlation between hepatic perfusion and gastric cancer progression. A total of 136 patients with gastric adenocarcinoma were evaluated in the present study. Prior to initial treatment, liver PCT was performed across the hepatic hilar plane and the hepatic blood flow (HBF) was measured using the dual-input deconvolution method. HBF was compared with clinicopathological factors, patient prognosis and circulating serum proangiogenic cytokines. The median HBF was 217 ml/min/100 g tissue. Patients with high HBF had larger tumors (43 mm vs. 71, P<0.001) and more advanced tumor-node stages (P<0.001 for both). When both patient groups of operable and inoperable were compared by their respective median HBF values, each high-HBF group had a significantly worse prognosis (P=0.002 and P=0.024), notably in the inoperable group, with <1-year survival. In 17 postoperative recurrent patients, the high-HBF at recurrence group also had a significantly worse postrecurrent prognosis (P=0.019). HBF was an independent prognostic factor (hazard ratio, 2.019; P=0.048) and was strongly associated with serum vascular endothelial growth factor level (R=0.607, P<0.001). HBF was significantly correlated with gastric cancer progression, and is an easily measured imaging biomarker reflecting patient survival.

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“…Therefore, this more permeable tumor vasculature may provide better access to chemotherapeutic agents, which in turn may lead to a more favorable response to systemic chemotherapy (1228). In fact, according to a recent article by Kruk-Bachonko et al (22), neoadjuvant therapy was shown to be more effective in gastric cancer patients with higher PS values. Our study findings also correlate well with this recent result.…”

Section: Discussionmentioning

confidence: 99%

“…All PCT examinations were performed using an MDCT scanner (Definition; Siemens Healthineers, Erlangen, Germany). All participating patients fasted for at least 6 hours before PCT acquisition, and each patient drank 500–1000 mL of water before the PCT examination to distend the stomach for better delineation of the gastric cancer lesion(s) (12172022). Hyoscine butylbromide (10 mg; Buscopan, Boehringer Ingelheim Korea, Seoul, Korea) was also injected intravenously 5 minutes before PCT acquisition if not contraindicated so as to minimize gastric movement during the examination, which could cause motion-related artifacts (1221).…”

Section: Methodsmentioning

confidence: 99%

Prediction of Treatment Outcome of Chemotherapy Using Perfusion Computed Tomography in Patients with Unresectable Advanced Gastric Cancer

et al. 2019

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ObjectiveTo evaluate whether data acquired from perfusion computed tomography (PCT) parameters can aid in the prediction of treatment outcome after palliative chemotherapy in patients with unresectable advanced gastric cancer (AGC).Materials and MethodsTwenty-one patients with unresectable AGCs, who underwent both PCT and palliative chemotherapy, were prospectively included. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (i.e., patients who achieved complete or partial response were classified as responders). The relationship between tumor response and PCT parameters was evaluated using the Mann-Whitney test and receiver operating characteristic analysis. One-year survival was estimated using the Kaplan-Meier method.ResultsAfter chemotherapy, six patients exhibited partial response and were allocated to the responder group while the remaining 15 patients were allocated to the non-responder group. Permeability surface (PS) value was shown to be significantly different between the responder and non-responder groups (51.0 mL/100 g/min vs. 23.4 mL/100 g/min, respectively; p = 0.002), whereas other PCT parameters did not demonstrate a significant difference. The area under the curve for prediction in responders was 0.911 (p = 0.004) for PS value, with a sensitivity of 100% (6/6) and specificity of 80% (12/15) at a cut-off value of 29.7 mL/100 g/min. One-year survival in nine patients with PS value > 29.7 mL/100 g/min was 66.7%, which was significantly higher than that in the 12 patients (33.3%) with PS value ≤ 29.7 mL/100 g/min (p = 0.019).ConclusionPerfusion parameter data acquired from PCT demonstrated predictive value for treatment outcome after palliative chemotherapy, reflected by the significantly higher PS value in the responder group compared with the non-responder group.

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Perfusion CT – A novel quantitative and qualitative imaging biomarker in gastric cancer

Cited by 9 publications

References 22 publications

Diabetic Cardiomyopathy: Current and Future Therapies. Beyond Glycemic Control

Diabetic Cardiomyopathy: Current and Future Therapies. Beyond Glycemic Control

Hepatic blood flow by perfusion computed tomography as an imaging biomarker for patients with gastric cancer

Prediction of Treatment Outcome of Chemotherapy Using Perfusion Computed Tomography in Patients with Unresectable Advanced Gastric Cancer

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