Rofo 2017; 189(S 01): S1-S124
DOI: 10.1055/s-0037-1600416
Vortrag (Wissenschaft)
Onkologische Bildgebung/Onkologie
Georg Thieme Verlag KG Stuttgart · New York

Prognostic value of perfusion CT in HCC treatment with sorafenib

S Kaufmann
1   Universität Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
,
W Thaiss
1   Universität Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
,
C Kloth
1   Universität Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
,
K Nikolaou
1   Universität Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
,
M Bitzer
2   Universität Tübingen, Gastroenterologie und Hepatologie, Tübingen
,
M Horger
1   Universität Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
› Author Affiliations
Further Information

Publication History

Publication Date:
23 March 2017 (online)

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Zielsetzung:

To investigate the impact of sorafenib-treatment on intralesional perfusion using volume perfusion computed tomografy (VPCT) in hepatocellular carcinoma (HCC), correlate the observed changes to mRECIST at mid-term for identification of their prognostic value and document potential correlations with the course of serum alpha-fetoprotein (AFP).

Material und Methodik:

VPCT was performed before (baseline) and after 2 months (follow-up) of sorafenib therapy in 28 consecutive HCC patients. AFP levels were registered at baseline and follow-up. Changes in tumor perfusion measurements [(blood flow (BF), blood volume (BV), mean transit time (MTT), k-trans, arterial liver perfusion (ALP) and hepatic perfusion index (HPI)) were registered in the target lesion. mRECIST measurements were performed at baseline, follow-up and every 2 months during sorafenib treatment. The receiver operating characteristic (ROC) curve analysis was performed to identify cut-off values for changes in HPI and BF as predictors of disease stabilization.

Ergebnisse:

According to mRECIST after 2 month of treatment all patients showed stable disease, whereas after 4 month 13 patients (46%) showed stable disease (SD) and 15 patients (54%) showed progressive disease (PD). According to VPCT a significant decrease was found in BF, BV, k-trans, ALP and HPI in patients with SD as well as a significant increase in MTT (p < 0.05). In patients with PD a significant increase in HPI, BF and BV was observed (p < 0.05). There was no correlation between AFP and mRECIST or perfusion measurements, respectively. Reduction of 5.9% in HPI and 21.1% in BF after 2 month of treatment heralded disease stabilization with a sensitivity and specificity of 84.6% and 92.3% (HPI) and 100% and 92.3% (BF), respectively.

Schlussfolgerungen:

Decreased intralesional perfusion after 2 months of therapy predicts disease stabilisation at mid-term (after 4 month) better than mRECIST, since non decreased intralesional perfusion indicates progressive disease at mid-term. AFP dynamics proved unreliable.