CT Perfusion Imaging Can Predict Patients' Survival and Early Response to Transarterial Chemo-Lipiodol Infusion for Liver Metastases from Colorectal Cancers.
10.3348/kjr.2015.16.4.810
- Author:
Wei Fu LV
1
;
Jian Kui HAN
;
De Lei CHENG
;
Chun Ze ZHOU
;
Ming NI
;
Dong LU
Author Information
1. PET/CT Center, Qilu Hospital, First Affiliated Hospital of Shandong University, Jinan 250012, China. jiankuihan99@163.com
- Publication Type:Original Article
- Keywords:
Liver;
Metastatic carcinoma;
Colorectal cancer;
Transarterial chemo-lipiodol infusion;
Computed tomography perfusion imaging
- MeSH:
Adult;
Aged;
Colorectal Neoplasms/mortality/*pathology;
Contrast Media/administration & dosage;
Ethiodized Oil/*administration & dosage;
Female;
Hepatic Artery/radiography;
Humans;
Liver Neoplasms/*drug therapy/mortality/*radiography/secondary;
Male;
Middle Aged;
Perfusion Imaging/*methods;
Prospective Studies;
Survival Rate;
Tomography, X-Ray Computed/methods
- From:Korean Journal of Radiology
2015;16(4):810-820
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). MATERIALS AND METHODS: Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified as responders and non-responders based on 4-month CT scans after TACLI. The percentage change of CTPI parameters of target lesions were compared between responders and non-responders at 1 month after TACLI. The optimal parameter and cutoff value were determined. The patients were divided into 2 subgroups according to the cutoff value. The log-rank test was used to compare the survival rates of the 2 subgroups. RESULTS: Four-month images were obtained from 58 patients, of which 39.7% were responders and 60.3% were non-responders. The percentage change in hepatic arterial perfusion (HAP) 1 month after TACLI was the optimal predicting parameter (p = 0.003). The best cut-off value was -21.5% and patients who exhibited a > or = 21.5% decrease in HAP had a significantly higher overall survival rate than those who exhibited a < 21.5% decrease (p < 0.001). CONCLUSION: Computed tomography perfusion imaging can predict the early response to TACLI and survival of patients with CRLM. The percentage change in HAP after TACLI with a cutoff value of -21.5% is the optimal predictor.
