Diagnostic value of dynamic contrast-enhanced CT with perfusion imaging in the quantitative assessment of tumor response to Sorafenib in patients with advanced hepatocellular carcinoma: A feasibility study

• Published in: European journal of radiology 2017-05, Vol.90, p.34-41
• Main Authors: Ippolito, Davide, MD, Querques, Giulia, MD, Okolicsanyi, Stefano, MD, Franzesi, Cammillo Talei, MD, Strazzabosco, Mario, Prof, Sironi, Sandro, Prof
• Format: Article
• Language: English
• Subjects: Anti-angiogenic treatment; Blood Volume - physiology; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Cirrhosis; Computed tomography; Feasibility Studies; Hepatocellular carcinoma; Humans; Liver Neoplasms - diagnostic imaging; Niacinamide - analogs & derivatives; Niacinamide - pharmacology; Perfusion imaging; Perfusion Imaging - methods; Phenylurea Compounds - pharmacology; Quantitative imaging; Radiology; Tomography, Spiral Computed - methods
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2017.02.027

Highlights • Perfusion computed tomography is a well recognized technique that enables depiction of tumor vascular physiology having the ability to detect regional and global alterations in organ blood flow, in addition to being non-invasive and fast. • The quantitative measurement of hepatic perfusion has the potential to provide important information in the assessment and management of advanced HCC lesion and in the determination of their outcome. • After treatment with Sorafenib in the group that responded to therapy we observed a significant decrease of all perfusion parameters, indirectly reflecting the angiogenic factor's expression. Moreover, a 33% reduction of HP in HCC lesions was associated with an increased rate of response to treatment. • Considering the different mRECIST categories, a significantly reduction of perfusion parameters was obtained in the group with complete response (79%) compared to the group with partial response or stable disease (16%), demonstrating the prognostic significance of perfusion value. While in patients that did not respond to Sorafenib, p-CT parameters showed, as expected, a trend towards an increase of the values related to arterial vascularization. • Perfusion CT could be integrated into the current computed tomographic protocols, offering useful information for the optimization of individualized treatment.