The prognostic and predictive value of vascular response parameters measured by dynamic contrast-enhanced-CT, -MRI and -US in patients with metastatic renal cell carcinoma receiving sunitinib

Autor: John M. Hudson, Mostafa Atri, Ross Williams, Alex Kiss, Colleen Bailey, Greg J. Stanisz, Peter N. Burns, Laurent Milot, Georg A. Bjarnason
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Indoles
medicine.medical_treatment
Urology
Contrast Media
Blood volume
Antineoplastic Agents
Kaplan-Meier Estimate
Multimodal Imaging
Disease-Free Survival
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Renal cell carcinoma
Predictive Value of Tests
Sunitinib
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Pyrroles
skin and connective tissue diseases
Carcinoma
Renal Cell
Survival analysis
Neuroradiology
Aged
Ultrasonography
Aged
80 and over
Chemotherapy
Blood Volume
medicine.diagnostic_test
business.industry
Ultrasound
Magnetic resonance imaging
General Medicine
Middle Aged
medicine.disease
Prognosis
Magnetic Resonance Imaging
Kidney Neoplasms
030220 oncology & carcinogenesis
Female
Radiology
Drug Monitoring
business
Tomography
X-Ray Computed
medicine.drug
Zdroj: European radiology. 28(6)
ISSN: 1432-1084
Popis: To identify dynamic contrast-enhanced (DCE) imaging parameters from MRI, CT and US that are prognostic and predictive in patients with metastatic renal cell cancer (mRCC) receiving sunitinib. Thirty-four patients were monitored by DCE imaging on day 0 and 14 of the first course of sunitinib treatment. Additional scans were performed with DCE-US only (day 7 or 28 and 2 weeks after the treatment break). Perfusion parameters that demonstrated a significant correlation (Spearman p < 0.05) with progression-free survival (PFS) and overall survival (OS) were investigated using Cox proportional hazard models/ratios (HR) and Kaplan-Meier survival analysis. A higher baseline and day 14 value for Ktrans (DCE-MRI) and a lower pre-treatment vascular heterogeneity (DCE-US) were significantly associated with a longer PFS (HR, 0.62, 0.37 and 5.5, respectively). A larger per cent decrease in blood volume on day 14 (DCE-US) predicted a longer OS (HR, 1.45). We did not find significant correlations between any of the DCE-CT parameters and PFS/OS, unless a cut-off analysis was used. DCE-MRI, -CT and ultrasound produce complementary parameters that reflect the prognosis of patients receiving sunitinib for mRCC. Blood volume measured by DCE-US was the only parameter whose change during early anti-angiogenic therapy predicted for OS and PFS. • DCE-CT, -MRI and ultrasound are complementary modalities for monitoring anti-angiogenic therapy. • The change in blood volume measured by DCE-US was predictive of OS/PFS. • Baseline vascular heterogeneity by DCE-US has the strongest prognostic value for PFS.
Databáze: OpenAIRE
Externí odkaz: