Quantitative Contrast-Enhanced Ultrasonic Imaging Reflects Microvascularization in Hepatocellular Carcinoma and Prognosis after Resection

Zou, Ru Hai; Lin, Qi; Huang, Wei; Li, Xiao Ling; Cao, Yun; Zhang, Jing; Zhou, Jian; Li, An Hua; Qian, Chao Nan

doi:10.1016/j.ultrasmedbio.2015.06.004

Cited by 7 publications

(3 citation statements)

References 37 publications

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“…Therefore, D-CEUS of the neck lymph nodes was performed at baseline (day 0), day 8 and 15 after famitinib was administered before starting CCRT. The ultrasonography protocol, enhancer agent SonoVue (Bracco, Milan, Italy), and quantitative analysis of D-CEUS data are described in detail in Additional file 1 : Methods [ 37 , 38 ]. Six perfusion parameters sufficient to characterize both blood volume and blood flow were extracted from time-intensity curves: peak intensity (PI), area under the curve (AUC), time to PI (TP), mean transit time (MTT), slope of wash-in (PW) and wash-in perfusion index (WIPI).…”

Section: Methodsmentioning

confidence: 99%

Famitinib in combination with concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 1, open‐label, dose‐escalation Study

Chen

Tang

Liu

et al. 2018

Cancer Communications

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BackgroundFamitinib is a tyrosine kinase inhibitor against multiple targets, including vascular endothelial growth factor receptor 2/3, platelet-derived growth factor receptor, and stem cell factor receptor (c-kit). Previous studies have demonstrated anti-tumour activities of famitinib against a wide variety of advanced-stage solid cancers. We aimed to determine the safety and efficacy of famitinib with concurrent chemoradiotherapy (CCRT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). We also evaluated the feasibility of contrast-enhanced ultrasound (D-CEUS) as a predictor of early tumour response to famitinib and to correlate functional parameters with clinical efficacy.MethodsThe trial was conducted in subjects with stage III or IVa-b NPC using a 3 + 3 design of escalating famitinib doses. Briefly, subjects received 2 weeks of famitinib monotherapy followed by 7 weeks of famitinib plus CCRT. D-CEUS of the neck lymph nodes was performed at day 0, 8 and 15 after famitinib was administered before starting concurrent chemoradiotherapy. End points included safety, tolerability and anti-tumour activity.ResultsTwenty patients were enrolled (six each for 12.5, 16.5 and 20 mg and two for 25 mg). Two patients in the 25 mg cohort developed dose-limiting toxicities, including grade 4 thrombocytopenia and grade 3 hypertension. The most common grade 3/4 adverse events were leukopenia, neutropenia and radiation mucositis. D-CEUS tests showed that more than 60% of patients achieved a perfusion parameter response after 2 weeks taking famitinib alone, and the parameter response was associated with disease improvement. In the famitinib monotherapy stage, three patients (15%) showed partial responses. The complete response rate was 65% at the completion of treatment and 95% 3 months after the treatment ended. After a median follow-up of 44 months, the 3-year progression-free survival (PFS) and distant metastasis-free survival were 70% and 75%, respectively. Subjects with a decrease of perfusion parameter response, such as peak intensity decreased at least 30% after 1 week of famitinib treatment, had higher 3-year PFS (90.9% vs. 44.4%, 95% CI 73.7%–100% vs. 11.9%–76.9%, P < 0.001) than those with an increase or a reduction of less than 30%.ConclusionsThe recommended famitinib dose for phase II trial is 20 mg with CCRT for patients with local advanced NPC. D-CEUS is a reliable and early measure of efficacy for famitinib therapies. Further investigation is required to confirm the effects of famitinib plus chemoradiotherapy.Electronic supplementary materialThe online version of this article (10.1186/s40880-018-0330-z) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Famitinib in combination with concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 1, open‐label, dose‐escalation Study

Chen

Tang

Liu

et al. 2018

Cancer Communications

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“…The inflow blood system, tumor sinusoids, and outflow blood system change drastically during multistep hepatocarcinogenesis, and CEUS has great advantages in visualizing the difference of hemodynamic perfusions in different HCCs [10]. Previous studies revealed that certain quantifiable patterns of CEUS were related to treatment outcomes of RFA or SR [10-12]. Therefore, we hypothesize that the heterogeneity of HCC dynamic behavior is associated with the tumor response to different treatments.…”

Section: Introductionmentioning

confidence: 99%

Deep Learning Radiomics Based on Contrast-Enhanced Ultrasound Might Optimize Curative Treatments for Very-Early or Early-Stage Hepatocellular Carcinoma Patients

et al. 2020

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Background: We aimed to evaluate the performance of a deep learning (DL)-based Radiomics strategy designed for analyzing contrast-enhanced ultrasound (CEUS) to not only predict the progression-free survival (PFS) of radiofrequency ablation (RFA) and surgical resection (SR) but also optimize the treatment selection between them for patients with very-early or earlystage hepatocellular carcinoma (HCC). Methods: We retrospectively enrolled 419 patients examined by CEUS within 1 week before receiving RFA or SR (RFA: 214, SR: 205) from January 2008 to 2016. Two Radiomics signatures were constructed by the Radiomics model R-RFA and R-SR to stratify PFS of different treatment groups. Then, RFA and SR nomograms were built by incorporating Radiomics signatures and significant clinical variables to achieve individualized 2-year PFS prediction. Finally, we applied both Radiomics models and both nomograms to each enrolled patient to investigate whether there were space for treatment optimization and how much prognostic improvement could be expected.

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“…e microbubbles of a contrast agent called Sonazoid can be phagocytosed by Kupffer cells, which rarely exist in tumors, and then Sonazoid-enhanced US (SEUS) provides a special phase called the Kupffer phase or the post-vascular phase [12,13]. Previous studies have reported that the degree of the contrast defect in the Kupffer phase are related to histological grading of HCC, and certain quantifiable patterns of CEUS were associated with treatment outcomes [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Kupffer Phase Radiomics Signature in Sonazoid-Enhanced Ultrasound is an Independent and Effective Predictor of the Pathologic Grade of Hepatocellular Carcinoma

Liu

et al. 2022

Journal of Oncology

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We conduct this study to investigate the value of Kupffer phase radiomics signature of Sonazoid-enhanced ultrasound images (SEUS) for the preoperative prediction of hepatocellular carcinoma (HCC) grade. From November 2019 to October 2021, 68 pathologically confirmed HCC nodules from 54 patients were included. Quantitative radiomic features were extracted from grayscale images and arterial and Kupffer phases of SEUS of HCC lesions. Univariate logistic regression and the maximum relevance minimum redundancy (MRMR) method were applied to select radiomic features best corresponding to pathological results. Prediction radiomic signature was calculated using each of the image types. A predictive model was validated using internal leave-one-out cross validation (LOOCV). For discrimination between poorly differentiated HCC (p-HCC) and well-differentiated HCC/moderately differentiated HCC (w/m-HCC), the Kupffer phase radiomic score (KPRS) achieved an excellent area under the curve (AUC = 0.937), significantly higher than the other two radiomic signatures. KPRS was the best radiomic score based on the highest AUC (AUC = 0.878), which is prior to gray and arterial RS for differentiation between w-HCC and m/p-HCC. Univariate and multivariate analysis incorporating all radiomic signatures and serological variables showed that KPRS was the only independent predictor in both predictions of HCC lesions (p-HCC vs. w/m-HCC, log OR 15.869, P < 0.001 , m/p-HCC vs. w-HCC, log OR 12.520, P < 0.05 ). We conclude that radiomics signature based on the Kupffer phase imaging may be useful for identifying the histological grade of HCC. The Kupffer phase radiomic signature may be an independent and effective predictor in discriminating w-HCC and p-HCC.

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Quantitative Contrast-Enhanced Ultrasonic Imaging Reflects Microvascularization in Hepatocellular Carcinoma and Prognosis after Resection

Cited by 7 publications

References 37 publications

Famitinib in combination with concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 1, open‐label, dose‐escalation Study

Famitinib in combination with concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 1, open‐label, dose‐escalation Study

Deep Learning Radiomics Based on Contrast-Enhanced Ultrasound Might Optimize Curative Treatments for Very-Early or Early-Stage Hepatocellular Carcinoma Patients

Kupffer Phase Radiomics Signature in Sonazoid-Enhanced Ultrasound is an Independent and Effective Predictor of the Pathologic Grade of Hepatocellular Carcinoma

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