依维莫司治疗期间胰腺神经内分泌肿瘤肝转移灶的灌注CT变化

Perfusion CT Changes in Liver Metastases from Pancreatic Neuroendocrine Tumors During Everolimus Treatment.

作者信息

D'Onofrio Mirko, Cingarlini Sara, Ortolani Silvia, Crosara Stefano, DE Robertis Riccardo, Vallerio Paola, Grego Elisabetta, Ciaravino Valentina, Ruzzenente Andrea, Landoni Luca, Scarpa Aldo, Bassi Claudio, Tortora Giampaolo

机构信息

Department of Diagnostic and Public Health, Institute of Radiology, G.B. Rossi Hospital, University of Verona, Verona, Italy

Department of Oncology, G.B. Rossi Hospital, University of Verona, Verona, Italy.

出版信息

Anticancer Res. 2017 Mar;37(3):1305-1311. doi: 10.21873/anticanres.11448.

DOI:10.21873/anticanres.11448

PMID:28314296

Abstract

AIM

To evaluate modifications of perfusional parameters assessed by perfusion computed tomography (P-CT) of liver metastases (LM) from pancreatic neuroendocrine tumors (PanNETs) during everolimus treatment.

PATIENTS AND METHODS

All patients with LMs from G1-2 PanNETs undergoing everolimus treatment between January 2013 and January 2015 were prospectively evaluated with P-CT at baseline, and after 2 and 4 months of therapy. Size, perfusion, blood volume (BV), peak enhancement intensity (PEI) and time to peak for each lesion were calculated.

RESULTS

A total of 33 LMs in nine patients with G1-2 PanNETs were prospectively evaluated: 23/33 (69.7%) were responders, 10/33 (30.3%) were non-responders. Among perfusional parameters, only numerical peak enhancement intensity values significantly differed between the two groups at baseline (p=0.043). BV increase was the most significant perfusional modification identifying responding lesions, even at an early stage of treatment, with a high positive predictive value (89.47%).

CONCLUSION

P-CT seems to be useful for prediction of response to everolimus of LMs from PanNETs.

摘要

目的

评估依维莫司治疗期间，胰腺神经内分泌肿瘤（PanNETs）肝转移灶（LM）的灌注计算机断层扫描（P-CT）所评估的灌注参数变化。

患者与方法

对2013年1月至2015年1月期间接受依维莫司治疗的所有G1-2级PanNETs肝转移患者，在基线时以及治疗2个月和4个月后进行前瞻性P-CT评估。计算每个病灶的大小、灌注、血容量（BV）、峰值强化强度（PEI）和达峰时间。

结果

对9例G1-2级PanNETs患者的33个肝转移灶进行了前瞻性评估：23/33（69.7%）为反应者，10/33（30.3%）为无反应者。在灌注参数中，仅基线时两组间的峰值强化强度数值有显著差异（p=0.043）。血容量增加是识别反应性病灶最显著的灌注变化，即使在治疗早期也是如此，具有较高的阳性预测值（89.47%）。