Value of DCE-MRI and FDG-PET/CT in the prediction of response to preoperative chemotherapy with bevacizumab for colorectal liver metastases

被引：98

作者：

De Bruyne, S. ^{[2
]}

Van Damme, N. ^{[3
]}

Smeets, P. ^{[4
]}

Ferdinande, L. ^{[5
]}

Ceelen, W. ^{[3
]}

Mertens, J. ^{[6
]}

Van de Wiele, C. ^{[6
]}

Troisi, R. ^{[7
]}

Libbrecht, L. ^{[5
]}

Laurent, S. ^{[1
]}

Geboes, K. ^{[1
]}

Peeters, M. ^{[1
,8
]}

机构：

[1] Ghent Univ Hosp, Dept Gastroenterol, Ghent, Belgium

[2] Ghent Univ Hosp, Dept Resp Med, Ghent, Belgium

[3] Ghent Univ Hosp, Dept Surg, Ghent, Belgium

[4] Ghent Univ Hosp, Dept Radiol, Ghent, Belgium

[5] Ghent Univ Hosp, Dept Pathol, Ghent, Belgium

[6] Ghent Univ Hosp, Dept Nucl Med, Ghent, Belgium

[7] Ghent Univ Hosp, Dept Gen & Hepatobiliary Surg, Ghent, Belgium

[8] Univ Antwerp Hosp, Dept Oncol, Edegem, Belgium

来源：

BRITISH JOURNAL OF CANCER | 2012年 / 106卷 / 12期

关键词：

bevacizumab; colorectal cancer; DCE-MRI; FDG-PET/CT; immunohistochemistry; liver metastases; POSITRON-EMISSION-TOMOGRAPHY; INDUCED MICROVASCULAR CHANGES; 2-STAGE HEPATECTOMY; F-18-FDG PET; PERIOPERATIVE CHEMOTHERAPY; PHARMACOKINETIC ANALYSIS; ANGIOGENESIS INHIBITOR; SYSTEMIC CHEMOTHERAPY; HEPATIC METASTASES; PLUS IRINOTECAN;

D O I：

10.1038/bjc.2012.184

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BACKGROUND: The purpose of this study was to assess the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and F-18-fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) for evaluation of response to chemotherapy and bevacizumab and for prediction of progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) with potentially resectable liver lesions. METHODS: A total of 19 mCRC patients were treated with FOLFOX/FOLFIRI and bevacizumab followed by surgery. Dynamic contrast-enhanced magnetic resonance imaging and FDG-PET/CT were performed before treatment and after cycle 5. PET results were quantified by calculating maximum standardised uptake value (SUVmax) whereas area under the enhancement curve (AUC), initial AUC (iAUC) and the endothelial transfer constant (K-trans) were used to quantify DCE-MRI. Pathological analysis of the resection specimen was performed, including measurement of microvessel density (MVD) and proliferation index. RESULTS: Both AUC and iAUC were significantly decreased following bevacizumab therapy (median change of 22% (P = 0.002) and 40% (P = 0.001) for AUC and iAUC, respectively). Progression-free survival benefit was shown for patients with >40% reduction in K-trans (P = 0.019). In the group of radiological responders, the median baseline SUVmax was 3.77 (IQR: 2.88-5.60) compared with 7.20 (IQR: 4.67-8.73) in nonresponders (P = 0.021). A higher follow-up SUVmax was correlated with worse PFS (P = 0.012). Median MVD was 10.9. Progression-free survival was significantly shorter in patients with an MVD greater than 10, compared with patients with lower MVD (10 months compared with 16 months, P = 0.016). CONCLUSION: High relative decrease in K-trans, low follow-up SUVmax and low MVD are favourable prognostic factors for mCRC patients treated with bevacizumab before surgery. British Journal of Cancer (2012) 106, 1926-1933. doi:10.1038/bjc.2012.184 www.bjcancer.com Published online 17 May 2012 (C) 2012 Cancer Research UK

引用

页码：1926 / 1933

页数：8

共 49 条

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