Fan Alice C, Sundaram Vandana, Kino Aya, Schmiedeskamp Heiko, Metzner Thomas J, Kamaya Aya
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA.
Cancers (Basel). 2019 Apr 30;11(5):608. doi: 10.3390/cancers11050608.
Computed tomography (CT) perfusion is a novel imaging method to determine tumor perfusion using a low-dose CT technique to measure iodine concentration at multiple time points. We determined if early changes in perfusion differ between primary renal tumors and metastatic tumor sites in patients with renal cell carcinoma (RCC) receiving targeted anti-angiogenic therapy. A total of 10 patients with advanced RCC underwent a CT perfusion scan at treatment baseline and at one week after initiating treatment. Perfusion measurements included blood volume (BV), blood flow (BF), and flow extraction product (FEP) in a total of 13 lesions (six primary RCC tumors, seven RCC metastases). Changes between baseline and week 1 were compared between tumor locations: primary kidney tumors vs metastases. Metastatic lesions had a greater decrease in BF (average BF difference ± standard deviation (SD): -75.0 mL/100 mL/min ± 81) compared to primary kidney masses (-25.5 mL/100 mL/min ± 35). Metastatic tumors had a wider variation of change in BF, BV and FEP measures compared to primary renal tumors. Tumor diameters showed little change after one week, but early perfusion changes are evident, especially in metastatic lesions compared to primary lesions. Future studies are needed to determine if these changes can predict which patients are benefiting from targeted therapy.
计算机断层扫描（CT）灌注成像术是一种新型成像方法，它利用低剂量CT技术在多个时间点测量碘浓度来确定肿瘤灌注情况。我们研究了接受靶向抗血管生成治疗的肾细胞癌（RCC）患者的原发性肾肿瘤与转移瘤部位之间灌注的早期变化是否存在差异。共有10例晚期RCC患者在治疗基线期和开始治疗一周后接受了CT灌注扫描。灌注测量包括总共13个病灶（6个原发性RCC肿瘤、7个RCC转移灶）的血容量（BV）、血流量（BF）和血流提取产物（FEP）。比较了肿瘤部位（原发性肾肿瘤与转移灶）在基线期和第1周之间的变化。与原发性肾肿块（-25.5 mL/100 mL/min±35）相比，转移灶的BF下降幅度更大（平均BF差异±标准差（SD）：-75.0 mL/100 mL/min±81）。与原发性肾肿瘤相比，转移瘤在BF、BV和FEP测量值的变化方面差异更大。肿瘤直径在一周后变化不大，但早期灌注变化明显, 尤其是转移灶与原发性病灶相比。需要进一步研究来确定这些变化是否可以预测哪些患者能从靶向治疗中获益。
