Quantitative measurements of enhancement on preprocedure triphasic ct can predict response of colorectal liver metastases to radioembolization Journal Article

   

Authors:	Boas, F. E.; Brody, L. A.; Erinjeri, J. P.; Yarmohammadi, H.; Shady, W.; Kishore, S.; Sofocleous, C. T.
Article Title:	Quantitative measurements of enhancement on preprocedure triphasic ct can predict response of colorectal liver metastases to radioembolization
Abstract:	OBJECTIVE. Colorectal liver metastases (CLM) have a variable response to radioembolization. This may be due at least partly to differences in tumor arterial perfusion. The present study examines whether quantitative measurements of enhancement on preprocedure triphasic CT can be used to predict the response of CLM to radioembolization. MATERIALS AND METHODS. We retrospectively reviewed patients with CLM treated with radioembolization who underwent pretreatment PET/CT and triphasic CT examinations and posttreatment PET/CT examinations. A total of 31 consecutive patients with 60 target tumors were included in the present study. For each tumor, we calculated the hepatic artery coefficient (HAC), portal vein coefficient (PVC), and arterial enhancement fraction (AEF) based on enhancement measurements on pretreatment triphasic CT. HAC and PVC are estimates of the hepatic artery and portal vein blood supply. AEF, which is the arterial phase enhancement divided by the portal phase enhancement, provides an estimate of the hepatic artery blood supply as a fraction of the total blood supply. For each tumor, the metabolic response to radioembolization was based on findings from the initial follow-up PET/CT scan obtained at 4-8 weeks after treatment. RESULTS. A total of 55% of CLM had a complete or partial metabolic response. Arterial phase enhancement, the HAC, and the PVC did not predict which tumors responded to radioembolization. However, the AEF was statistically significantly greater in tumors with a complete or partial metabolic response than in tumors with no metabolic response (i.e., those with stable disease or disease progression) (p = 0.038). An AEF of less than 0.4 was associated with a 40% response rate, whereas an AEF greater than 0.75 was associated with a 78% response rate. CONCLUSION. Response to radioembolization can be predicted using the AEF calculated from the preprocedure triphasic CT. © American Roentgen Ray Society.
Keywords:	colorectal cancer; liver metastasis; perfusion; enhancement; yttrium-90
Journal Title:	American Journal of Roentgenology
Volume:	207
Issue:	3
ISSN:	0361-803X
Publisher:	American Roentgen Ray Society
Date Published:	2016-09-01
Start Page:	671
End Page:	675
Language:	English
DOI:	10.2214/ajr.15.15767
PROVIDER:	scopus
PMCID:	PMC5003600
PUBMED:	27248430
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-84983372016&partnerID=40&md5=479b001a7e5934bf5262bfffe594d5b2
Notes:	Article -- Export Date: 1 September 2016 -- Source: Scopus

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