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Eur J Radiol. 2018 Sep;106:62-68. doi: 10.1016/j.ejrad.2018.07.012. Epub 2018 Jul 20.

Dynamic contrast enhanced perfusion CT imaging: A diagnostic biomarker tool for survival prediction of tumour response to antiangiogenetic treatment in patients with advanced HCC lesions.

Author information

1
School of Medicine, University of Milano-Bicocca, Milan, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza MB, Italy. Electronic address: davide.atena@tiscalinet.it.
2
School of Medicine, University of Milano-Bicocca, Milan, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza MB, Italy.
3
School of Medicine, University of Milano-Bicocca, Milan, Italy; Department of Surgery and Interdisciplinary Medicine, University of Milano-Bicocca, Milan, Italy.
4
School of Medicine, University of Milano-Bicocca, Milan, Italy; Department of Diagnostic Radiology, H. Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo BG, Italy.
5
School of Medicine, University of Milano-Bicocca, Milan, Italy; Department of Surgery and Interdisciplinary Medicine, University of Milano-Bicocca, Milan, Italy; Liver Center Section of Digestive Diseases, Yale University, New Haven, CT, USA.

Abstract

PURPOSE:

To investigate whether perfusion-CT (p-CT) imaging could depict the inhibition of tumor neoangiogenesis induced by Sorafenib in advanced hepatocellular carcinoma (HCC), and whether it could be useful in predicting survival during treatment.

MATERIALS AND METHODS:

Ninety-eight p-CT examinations were performed among 29 cirrhotic patients, with advanced HCC, before and every 2 months after Sorafenib administration, on a 256-slice MDCT scanner. Perfusion parameters were considered and statistically compared, at baseline and follow-up, between non-progressor (complete response, stable disease or partial response) and progressor (progressive disease) group. Kaplan-Meier analyses estimated the time-to-survival in overall population, after stratifying patients according to mRECIST.

RESULTS:

The group that responded to Sorafenib showed a significant reduction of values in HCC target lesions after anti-angiogenic therapy (p < 0.01), in comparison with progressor group that demonstrated an increase or no significant variation. When patients were stratified into mRECIST, higher survival rate was observed in the non-progressor group compared to the progressor (48.6% vs 28.6%), and statistically significant correlation (p=0.01) was found between percentage variation of perfusion parameters, from baseline to follow-up, and overall survival rate.

CONCLUSION:

Quantitative analysis of perfusion parameters, represents prognostic indicators useful in assessment of response to anti-angiogenic therapy, allowing for optimization of individualized treatment.

KEYWORDS:

Antiangiogenic treatment; Computed Tomography; Hepatocellular carcinoma; Perfusion imaging; Survival rate

PMID:
30150052
DOI:
10.1016/j.ejrad.2018.07.012
[Indexed for MEDLINE]

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