Olivier Pellerin1,2,3, Helena Pereira4,5, Nadia Moussa6,7, Costantino Del Giudice8,6,7, Simon Pernot6,9, Carole Dean7, Gilles Chatellier6,4,5, Marc Sapoval8,6,7. 1. INSERM U970, Paris, France. olivier.pellerin@aphp.fr. 2. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. olivier.pellerin@aphp.fr. 3. Department of Interventional Radiology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, 20 rue Leblanc, 75015, Paris, France. olivier.pellerin@aphp.fr. 4. Clinical Research Unit, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France. 5. INSERM U1418, Paris, France. 6. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 7. Department of Interventional Radiology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, 20 rue Leblanc, 75015, Paris, France. 8. INSERM U970, Paris, France. 9. Department of Digestive Oncology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France.
Abstract
PURPOSE: To determine whether intraprocedural C-arm cone-beam CT (CBCT) parenchymal blood volume (PBV) can predict the response of colorectal cancer liver metastases (CRCLM) 2 months after irinotecan drug-eluting bead (DEBIRI) chemoembolization. MATERIALS AND METHODS: This single-center observational study was compliant with the Helsinki Declaration and approved by our institutional review board. Thirty-four consecutive CRCLM patients referred for DEBIRI chemoembolization were enrolled between March 2015 and December 2016. Tumor size was assessed at baseline and 2 months after DEBIRI chemoembolization by multidetector CT (Response Evaluation Criteria in Solid Tumors RECIST 1.0), and PBV was measured before and after DEBIRI chemoembolization. Two independent readers reviewed all data. We determined the potential correlation (Spearman's rank correlation) between intraprocedural PBV values and tumor response at 2 months. The relationship between tumor response and PBV was studied using a mixed model. A logistic regression model was applied to study the relationship between patient "Responder/Non-responder" and PBV. RESULTS: There was a strong correlation between baseline PBV or the percent change of PBV and the 2-month tumor response (rho = - 0.8587 (p = 0.00001) and rho = 0.8027 (p = 0.00001), respectively). The mixed model showed that an increase of 1 ml/1000 ml in PBV of a tumor before DEBIRI chemoembolization led to a 0.54 mm decrease in diameter (p < 0.005). A 1% decrease in PBV after DEBIRI chemoembolization resulted in tumor shrinkage of 0.75 mm (p < 0.005). The logistic regression model showed that patients with a 1% smaller mean decrease of PBV after DEBIRI chemoembolization had a 10% lower likelihood of achieving disease control (OR = 0.9, 95% confidence interval (CI) = 0.81-1; p = 0.0493). CONCLUSION: Intraprocedural PBV may predict tumor response to DEBIRI chemoembolization. KEY POINTS: • There is a strong relationship between the parenchymal blood volume (PBV) of colorectal liver metastases before DEBIRI chemoembolization and tumor response at 2 months. • Higher PBV values before DEBIRI chemoembolization correlate with greater tumor shrinkage, but only if the PBV decreases by more than 70% after DEBIRI chemoembolization. • Each increase of 1% in the mean decrease of PBV after DEBIRI chemoembolization resulted in a 10% lower likelihood of achieving disease control (OR = 0.9, 95% confidence interval (CI) = 0.81-1; p = 0.0493).
PURPOSE: To determine whether intraprocedural C-arm cone-beam CT (CBCT) parenchymal blood volume (PBV) can predict the response of colorectal cancer liver metastases (CRCLM) 2 months after irinotecan drug-eluting bead (DEBIRI) chemoembolization. MATERIALS AND METHODS: This single-center observational study was compliant with the Helsinki Declaration and approved by our institutional review board. Thirty-four consecutive CRCLM patients referred for DEBIRI chemoembolization were enrolled between March 2015 and December 2016. Tumor size was assessed at baseline and 2 months after DEBIRI chemoembolization by multidetector CT (Response Evaluation Criteria in Solid Tumors RECIST 1.0), and PBV was measured before and after DEBIRI chemoembolization. Two independent readers reviewed all data. We determined the potential correlation (Spearman's rank correlation) between intraprocedural PBV values and tumor response at 2 months. The relationship between tumor response and PBV was studied using a mixed model. A logistic regression model was applied to study the relationship between patient "Responder/Non-responder" and PBV. RESULTS: There was a strong correlation between baseline PBV or the percent change of PBV and the 2-month tumor response (rho = - 0.8587 (p = 0.00001) and rho = 0.8027 (p = 0.00001), respectively). The mixed model showed that an increase of 1 ml/1000 ml in PBV of a tumor before DEBIRI chemoembolization led to a 0.54 mm decrease in diameter (p < 0.005). A 1% decrease in PBV after DEBIRI chemoembolization resulted in tumor shrinkage of 0.75 mm (p < 0.005). The logistic regression model showed that patients with a 1% smaller mean decrease of PBV after DEBIRI chemoembolization had a 10% lower likelihood of achieving disease control (OR = 0.9, 95% confidence interval (CI) = 0.81-1; p = 0.0493). CONCLUSION: Intraprocedural PBV may predict tumor response to DEBIRI chemoembolization. KEY POINTS: • There is a strong relationship between the parenchymal blood volume (PBV) of colorectal liver metastases before DEBIRI chemoembolization and tumor response at 2 months. • Higher PBV values before DEBIRI chemoembolization correlate with greater tumor shrinkage, but only if the PBV decreases by more than 70% after DEBIRI chemoembolization. • Each increase of 1% in the mean decrease of PBV after DEBIRI chemoembolization resulted in a 10% lower likelihood of achieving disease control (OR = 0.9, 95% confidence interval (CI) = 0.81-1; p = 0.0493).
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: A Ganguly; A Fieselmann; M Marks; J Rosenberg; J Boese; Y Deuerling-Zheng; M Straka; G Zaharchuk; R Bammer; R Fahrig Journal: AJNR Am J Neuroradiol Date: 2011-07-14 Impact factor: 3.825
Authors: T Struffert; Y Deuerling-Zheng; S Kloska; T Engelhorn; C M Strother; W A Kalender; M Köhrmann; S Schwab; A Doerfler Journal: AJNR Am J Neuroradiol Date: 2010-04-08 Impact factor: 3.825
Authors: Marissa Albert; Matthew V Kiefer; Weijing Sun; Daniel Haller; Douglas L Fraker; Catherine M Tuite; S William Stavropoulos; Jeffrey I Mondschein; Michael C Soulen Journal: Cancer Date: 2010-09-09 Impact factor: 6.860
Authors: Thomas J Vogl; Tatjana Gruber; Jörn O Balzer; Katrin Eichler; Renate Hammerstingl; Stefan Zangos Journal: Radiology Date: 2009-01 Impact factor: 11.105
Authors: Marco Pandolfi; Alessandro Liguori; Martina Gurgitano; Antonio Arrichiello; Letizia Di Meglio; Giovanni Maria Rodà; Alice Guadagni; Salvatore Alessio Angileri; Anna Maria Ierardi; Giorgio Buccimazza; Daniela Donat; Aldo Paolucci; Gianpaolo Carrafiello Journal: Acta Biomed Date: 2020-09-23