Department of Thoracic Imaging, Hospital Calmette (EA 2694), University of Lille Nord de France, 59000, Lille, France.
Eur Radiol. 2013 Aug;23(8):2127-36. doi: 10.1007/s00330-013-2821-2. Epub 2013 Apr 4.
To determine whether CT can depict early perfusion changes in lung cancer treated by anti-angiogenic drugs, allowing prediction of response.
Patients with non-small cell lung cancer, treated by conventional chemotherapy with (Group 1; n = 17) or without (Group 2; n = 23) anti-vascular endothelial growth factor (anti-VEGF) drug (bevacizumab) underwent CT perfusion before (TIME 0) and after 1 (TIME 1), 3 (TIME 2) and 6 (TIME 3) cycles of chemotherapy. The CT parameters evaluated included: (1) total tumour vascular volume (TVV) and total tumour extravascular flow (TEF); (2) RECIST (Response Evaluation Criteria in Solid Tumours) measurements. Tumour response was also assessed on the basis of the clinicians' overall evaluation.
In Group 1, significant reduction in perfusion was identified between baseline and: (1) TIME 1 (TVV, P = 0.0395; TEF, P = 0.015); (2) TIME 2 (TVV, P = 0.0043; TEF, P < 0.0001); (3) TIME 3 (TVV, P = 0.0034; TEF, P = 0.0005) without any significant change in Group 2. In Group 1: (1) the reduction in TVV at TIME 1 was significantly higher in responders versus non-responders at TIME 2 according to RECIST (P = 0.0128) and overall clinicians' evaluation (P = 0.0079); (2) all responders at TIME 2 had a concurrent decrease in TVV and TEF at TIME 1.
Perfusion CT demonstrates early changes in lung cancer vascularity under anti-angiogenic chemotherapy that may help predict therapeutic response.
• Perfusion CT has the potential of providing in vivo information about tumour vasculature. • CT depicts early and specific perfusion changes in NSCLC under anti-angiogenic drugs. • Specific therapeutic effects of anti-angiogenic drugs can be detected before tumour shrinkage. • Early perfusion changes can help predict therapeutic response to anti-angiogenic treatment. • Perfusion CT could be a non-invasive tool to monitor anti-angiogenic treatment.
确定 CT 是否可以描绘接受抗血管生成药物治疗的肺癌的早期灌注变化，从而预测其反应。
对接受常规化疗的非小细胞肺癌患者（第 1 组，n=17）或未接受（第 2 组，n=23）抗血管内皮生长因子（抗-VEGF）药物（贝伐单抗）治疗的患者，在化疗前（TIME0）和第 1（TIME1）、3（TIME2）和 6（TIME3）个周期后进行 CT 灌注。评估的 CT 参数包括：（1）肿瘤总血管容积（TVV）和总肿瘤细胞外血流（TEF）；（2）实体瘤反应评价标准（RECIST）测量。还根据临床医生的总体评估评估肿瘤反应。
在第 1 组中，与基线相比，灌注在以下时间点显著降低：（1）TIME1（TVV，P=0.0395；TEF，P=0.015）；（2）TIME2（TVV，P=0.0043；TEF，P<0.0001）；（3）TIME3（TVV，P=0.0034；TEF，P=0.0005），而第 2 组无明显变化。在第 1 组中：（1）根据 RECIST（P=0.0128）和临床医生的总体评估（P=0.0079），在 TIME1 时 TVV 的降低在 responders 与 non-responders 之间差异有统计学意义；（2）所有在 TIME2 时的 responders 在 TIME1 时 TVV 和 TEF 均有同步下降。
灌注 CT 显示抗血管生成化疗后肺癌血管早期变化，可能有助于预测治疗反应。
灌注 CT 具有提供肿瘤血管生成的活体信息的潜力。
CT 描绘了 NSCLC 接受抗血管生成药物治疗后的早期和特定的灌注变化。
可以在肿瘤缩小之前检测到抗血管生成药物的特定治疗效果。
早期灌注变化有助于预测抗血管生成治疗的反应。
灌注 CT 可能成为监测抗血管生成治疗的非侵入性工具。
