Dataset Information

Feasibility of 4D perfusion CT imaging for the assessment of liver treatment response following SBRT and sorafenib.

ABSTRACT:

Objectives

To evaluate the feasibility of 4-dimensional perfusion computed tomography (CT) as an imaging biomarker for patients with hepatocellular carcinoma and metastatic liver disease.

Methods and materials

Patients underwent volumetric dynamic contrast-enhanced CT on a 320-slice scanner before and during stereotactic body radiation therapy and sorafenib, and at 1 and 3 months after treatment. Quiet free breathing was used in the CT acquisition and multiple techniques (rigid or deformable registration as well as outlier removal) were applied to account for residual liver motion. Kinetic modeling was performed on a voxel-by-voxel basis in the gross tumor volume and normal liver resulting in 3-dimensional parameter maps of blood perfusion, capillary permeability, blood volume, and mean transit time. Perfusion characteristics in the tumor and adjacent liver were correlated with radiation dose distributions to evaluate dose-response. Paired t tests assessed change in spatial and histogram parameters from baseline to different time points during and after treatment. Technique reproducibility as well as the impact of arterial and portal vein input functions was also investigated using intra- and inter-subject variance and Bland-Altman analysis.

Results

Quantitative perfusion parameters were reproducible (±5.7%; range, 2%-10%) depending on tumor/normal liver type and kinetic parameter. Statistically significant reductions in tumor perfusion were measurable over the course of treatment and as early as 1 week after sorafenib administration (P < .05). Marked liver parenchyma perfusion reduction was seen with a strong dose-response effect (R² = 0.95) that increased significantly over the course treatment.

Conclusions

The proposed methodology demonstrated feasibility of evaluating spatiotemporal changes in liver tumor perfusion and normal liver function following antiangiogenic therapy and radiation treatment warranting further evaluation of biomarker prognostication.

SUBMITTER: Coolens C

PROVIDER: S-EPMC5514015 | biostudies-literature | 2016 Jul-Sep

REPOSITORIES: biostudies-literature

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Publications

Feasibility of 4D perfusion CT imaging for the assessment of liver treatment response following SBRT and sorafenib.

Coolens Catherine C Driscoll Brandon B Moseley Joanne J Brock Kristy K KK Dawson Laura A LA

Advances in radiation oncology 20160701 3

<h4>Objectives</h4>To evaluate the feasibility of 4-dimensional perfusion computed tomography (CT) as an imaging biomarker for patients with hepatocellular carcinoma and metastatic liver disease.<h4>Methods and materials</h4>Patients underwent volumetric dynamic contrast-enhanced CT on a 320-slice scanner before and during stereotactic body radiation therapy and sorafenib, and at 1 and 3 months after treatment. Quiet free breathing was used in the CT acquisition and multiple techniques (rigid or ...[more]

PMID: 28740888

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Project description:To investigate the effects of increasing doses of angiotensin II on hepatic hemodynamics in the normal rabbit liver and in hepatic VX2 tumors by using dynamic contrast material-enhanced perfusion computed tomography (CT).This study was approved by the institutional animal care and use committee. Solitary hepatic VX2 tumors were implanted into 12 rabbits. In each animal, perfusion CT of the liver was performed before (at baseline) and after hepatic arterial infusion of varying doses (0.1-50.0 μg/mL) of angiotensin II. Images were acquired continuously for 80 seconds after the start of the intravenous contrast material administration. Blood flow (BF), blood volume (BV), mean transit time (MTT), and capillary permeability-surface area product were calculated for the tumor and the adjacent and distant normal liver tissue. Generalized linear mixed models were used to estimate the effects of angiotensin II dose on outcome measures.Angiotensin II infusion increased contrast enhancement of the tumor and distal liver vessels. Tumor BF increased in a dose-dependent manner after administration of 0.5-25.0 μg/mL angiotensin II, but only the 2.5 μg/mL dose induced a significant increase in tumor BF compared with BF in the adjacent (68.0 vs 26.3 mL/min/100 g, P < .0001) and distant (68.0 vs 28.3 mL/min/100 g, P = .02) normal liver tissue. Tumor BV varied with angiotensin II dose but was greater than the BV of the adjacent and distant liver tissue at only the 2.5 μg/mL (4.8 vs 3.5 mL/100 g for adjacent liver [P < .0001], 4.8 vs 3.3 mL/100 g for distant liver [P = .0006]) and 10.0 μg/mL (4.9 vs 4.4 mL/100 g for adjacent liver [P = .007], 4.9 vs 4.3 mL/100 g for distant liver [P = .04]) doses. Tumor MTT was significantly shorter than the adjacent liver tissue MTT at angiotensin II doses of 2.5 μg/mL (9.7 vs 15.8 sec, P = .001) and 10.0 μg/mL (5.1 vs 13.2 sec, P = .007) and significantly shorter than the distant liver tissue MTT at 2.5 μg/mL only (9.7 vs 15.3 sec, P = .0006). The capillary permeability-surface area product for the tumor was higher than that for the adjacent liver tissue at the 2.5 μg/mL angiotensin II dose only (11.5 vs 8.1 mL/min/100 g, P = .01).Perfusion CT enables a mechanistic understanding of angiotensin II infusion in the liver and derivation of the optimal effective dose. The 2.5 μg/mL angiotensin II dose increases perfusion in hepatic VX2 tumors versus that in adjacent and distant normal liver tissue primarily by constricting normal distal liver vessels and in turn increasing tumor BF and BV.

Dataset Information

Feasibility of 4D perfusion CT imaging for the assessment of liver treatment response following SBRT and sorafenib.

Objectives

Methods and materials

Results

Conclusions

Publications

Feasibility of 4D perfusion CT imaging for the assessment of liver treatment response following SBRT and sorafenib.

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