Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, D-69120, Germany.
Cancer Imaging. 2013 Jul 22;13(3):306-13. doi: 10.1102/1470-7330.2013.0031.
Supplementary functional information can contribute to assess response in targeted therapies. The aim of this study was to evaluate semi-automatic RECIST plus iodine uptake (IU) determination in melanoma metastases under BRAF inhibitor (vemurafenib) therapy using dual-energy computed tomography (DECT).
Nine patients with stage IV melanoma treated with a BRAF inhibitor were included. Contrast-enhanced DECT was performed before and twice after treatment onset. Changes in tumor size were assessed according to RECIST. Quantification of IU (absolute value for total IU (mg) and volume-normalized IU (mg/ml)) was based on semi-automatic tumor volume segmentation. The decrease compared with baseline was calculated.
The mean change of RECIST diameter sum per patient was -47% at the first follow-up (FU), -56% at the second FU (P < 0.01). The mean normalized IU per patient was -21% at the first FU (P < 0.2) and -45% at the second FU (P < 0.01). Total IU per patient, combining both normalized IU and volume, showed the most pronounced decrease: -89% at the first FU and -90% at the second FU (P < 0.01).
Semi-automatic RECIST plus IU quantification in DECT enables objective, easy and fast parameterization of tumor size and contrast medium uptake, thus providing 2 complementary pieces of information for response monitoring applicable in daily routine.
补充功能信息有助于评估靶向治疗的反应。本研究旨在评估黑色素瘤转移患者在 BRAF 抑制剂（vemurafenib）治疗下使用双能 CT（DECT）的 RECIST 联合碘摄取（IU）的半自动测定。
纳入 9 例接受 BRAF 抑制剂治疗的 IV 期黑色素瘤患者。在治疗开始前和开始后两次进行增强 DECT。根据 RECIST 评估肿瘤大小的变化。IU 的定量（总 IU（mg）和体积归一化 IU（mg/ml）的绝对值）基于半自动肿瘤体积分割。与基线相比计算下降值。
每位患者的 RECIST 直径总和的平均变化在第一次随访（FU）时为-47%，在第二次 FU 时为-56%（P<0.01）。每位患者的平均归一化 IU 在第一次 FU 时为-21%（P<0.2），在第二次 FU 时为-45%（P<0.01）。每位患者的总 IU，结合归一化 IU 和体积，显示出最明显的下降：第一次 FU 时为-89%，第二次 FU 时为-90%（P<0.01）。
DECT 中 RECIST 联合 IU 定量的半自动分析能够客观、简便、快速地对肿瘤大小和对比剂摄取进行参数化，从而为适用于日常实践的反应监测提供 2 种互补的信息。
