Objectives: Malignant angiogenesis affects tumor growth, local expansion and metastasis. Antiangiogenic
chemotherapies act to reduce tumoral cell growth acting as angiogenesis inhibitor
for endothelial cells. Objective tumor response is a common endpoint to evaluate the
efficacy of anticancer agents. World Health Organization (WHO) or Response Evaluation
Criteria in Solid Tumors Group (RECIST) criteria are not appropriate for the evaluation
of targeted therapy because tumoral hypoxia is independent from tumor volume. The
purpose of this study was to evaluate whether CEUS could be used to evaluate tumor
response to antiangiogenic therapy in Patients with hepatic breast cancer metastases.
Methods: 15 Patients with advanced breast cancers with hepatic localization were evaluated
for morphological and functional parameters with CEUS and perfusion CT. Both CEUS
and perfusion CT examinations were obtained at baseline and after 1 and 3 months on
antiangiogenic therapy. The sum of the maximum diameters of individual hepatic target
lesions and the tumoral vascular index (percentage of contrast uptake) were assessed
with CEUS and perfusion CT.
Results: CEUS showed a reduction of tumor vascularization before a reduction in tumor size
in all cases. CEUS accurately measured the size of the lesions and allowed the detection
of microvascularization to confirm the absence of residual neovessels.
Conclusions: CEUS is an effective tool for evaluating the biological response to chemotherapy
of metastatic breast cancer as it allows both an eccellent evaluation of the lesion
size, in particular for small metastasis in steatosic livers and a good assessment
of vascular patterns of the lesions.
