The prognostic and predictive value of vascular response parameters measured by dynamic contrast-enhanced-CT, -MRI and -US in patients with metastatic renal cell carcinoma receiving sunitinib.
Objectives: To identify dynamic contrast-enhanced (DCE) imaging parameters from MRI, CT and US that are prognostic and predictive in patients with metastatic renal cell cancer (mRCC) receiving sunitinib.Methods: Thirty-four patients were monitored by DCE imaging on day 0 and 14 of the first course o...
| Publicado en: | European Radiology Vol. 28; no. 6; pp. 2281 - 2291 |
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| Autores principales: | , , , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Springer Nature
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129492211&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129492211 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jun2018 vid: 28 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 129492211 129492211 NLM29383520 129492211 10.1007/s00330-017-5220-2 NLM29383520 129492211 ppf: 2281 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The prognostic and predictive value of vascular response parameters measured by dynamic contrast-enhanced-CT, -MRI and -US in patients with metastatic renal cell carcinoma receiving sunitinib. aug: au: Hudson, John M. Bailey, Colleen Atri, Mostafa Stanisz, Greg Milot, Laurent Williams, Ross Kiss, Alex Burns, Peter N. Bjarnason, Georg A. affil: Department of Medical Biophysics, University of Toronto, 2075 Bayview Ave, Room S6-39, M4N 3M5, Toronto, ON, Canada sug: subj: Kidney Neoplasms Carcinoma, Renal Cell Antineoplastic Agents Therapeutic Use Heterocyclic Compounds Therapeutic Use Indoles Therapeutic Use Drug Monitoring Methods Tomography, X-Ray Computed Methods Magnetic Resonance Imaging Methods Female Adult Human Aged, 80 and Over Kidney Neoplasms Drug Therapy Diagnostic Imaging Methods Contrast Media Aged Middle Age Ultrasonography Methods Predictive Value of Tests Carcinoma, Renal Cell Drug Therapy Blood Volume Prognosis Kaplan-Meier Estimator Male Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Adult: 19-44 years Aged, 80 & over Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Objectives: To identify dynamic contrast-enhanced (DCE) imaging parameters from MRI, CT and US that are prognostic and predictive in patients with metastatic renal cell cancer (mRCC) receiving sunitinib.Methods: Thirty-four patients were monitored by DCE imaging on day 0 and 14 of the first course of sunitinib treatment. Additional scans were performed with DCE-US only (day 7 or 28 and 2 weeks after the treatment break). Perfusion parameters that demonstrated a significant correlation (Spearman p < 0.05) with progression-free survival (PFS) and overall survival (OS) were investigated using Cox proportional hazard models/ratios (HR) and Kaplan-Meier survival analysis.Results: A higher baseline and day 14 value for Ktrans (DCE-MRI) and a lower pre-treatment vascular heterogeneity (DCE-US) were significantly associated with a longer PFS (HR, 0.62, 0.37 and 5.5, respectively). A larger per cent decrease in blood volume on day 14 (DCE-US) predicted a longer OS (HR, 1.45). We did not find significant correlations between any of the DCE-CT parameters and PFS/OS, unless a cut-off analysis was used.Conclusions: DCE-MRI, -CT and ultrasound produce complementary parameters that reflect the prognosis of patients receiving sunitinib for mRCC. Blood volume measured by DCE-US was the only parameter whose change during early anti-angiogenic therapy predicted for OS and PFS.Key Points: • DCE-CT, -MRI and ultrasound are complementary modalities for monitoring anti-angiogenic therapy. • The change in blood volume measured by DCE-US was predictive of OS/PFS. • Baseline vascular heterogeneity by DCE-US has the strongest prognostic value for PFS. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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