Introduction: Criteria other than RECIST are not validated for evaluation of response during treatment in pancreatic neuroendocrine tumors (pNETs). Preliminary evidence favors antiangiogenic proper- ties of E. Aim(s): To evaluate in a prospective study P-CT changes in pNET liver metastasis (LM) during E. Materials and Methods: We evaluated eight LM from three patients with G1-2 pNETs. P-CT was performed at baseline (T0), after two (T1) and four (T2) months of E on a 64-row multidetector CT scan. A single ROI was drawn within each LM on the main axial slice. Perfusion (PF), Time to Peak (TTP), Peak Enhancement Intensity (PEI) and Blood Volume (BV) were cal- culated. Results: All LM remained dimensionally stable, except for one LM with a reduction >30% at T1. At T0, all LM had high PF and PEI, consistent with hypervascularization of G1-2 pNETs. BV discriminated among two different patterns of perfusional changes in response to E: significant progressive increase (T2 v. T0 +58.2±5.5 ml/100 g; n = 3 LM) v. initial increase (T1 vs T0; +64.28±11.64 ml/100 g; n = 5 LM) and subsequent reduction (T2 v. T1; –73.58±3.3 ml/100 g). No clear patterns were identified for PF, TTP and PEI. Conclusion: BV changes seem to be the earliest, more significant modifications among P-CT values during E treatment in pNETs. BV could reflect early vascular changes in tumor circulation. Longer follow-up is needed to evaluate the role of BV as an early predictive parameter and further studies are claimed to understand physiopathol- ogy of vascular response to E
Tumor Perfusion Changes During Everolimus (E) Treatment: Preliminary Results from Perfusion-CT (P-CT) Study
Ortolani, Silvia;DE ROBERTIS LOMBARDI, Riccardo;CINGARLINI, Sara;D'ONOFRIO, Mirko;Crosara, Stefano;DAVI', Maria Vittoria;Capelli, Paola;SCARPA, Aldo;VALLERIO, Paola;BUTTURINI, Giovanni;POZZI MUCELLI, Roberto;TORTORA, GIAMPAOLO
2014-01-01
Abstract
Introduction: Criteria other than RECIST are not validated for evaluation of response during treatment in pancreatic neuroendocrine tumors (pNETs). Preliminary evidence favors antiangiogenic proper- ties of E. Aim(s): To evaluate in a prospective study P-CT changes in pNET liver metastasis (LM) during E. Materials and Methods: We evaluated eight LM from three patients with G1-2 pNETs. P-CT was performed at baseline (T0), after two (T1) and four (T2) months of E on a 64-row multidetector CT scan. A single ROI was drawn within each LM on the main axial slice. Perfusion (PF), Time to Peak (TTP), Peak Enhancement Intensity (PEI) and Blood Volume (BV) were cal- culated. Results: All LM remained dimensionally stable, except for one LM with a reduction >30% at T1. At T0, all LM had high PF and PEI, consistent with hypervascularization of G1-2 pNETs. BV discriminated among two different patterns of perfusional changes in response to E: significant progressive increase (T2 v. T0 +58.2±5.5 ml/100 g; n = 3 LM) v. initial increase (T1 vs T0; +64.28±11.64 ml/100 g; n = 5 LM) and subsequent reduction (T2 v. T1; –73.58±3.3 ml/100 g). No clear patterns were identified for PF, TTP and PEI. Conclusion: BV changes seem to be the earliest, more significant modifications among P-CT values during E treatment in pNETs. BV could reflect early vascular changes in tumor circulation. Longer follow-up is needed to evaluate the role of BV as an early predictive parameter and further studies are claimed to understand physiopathol- ogy of vascular response to E
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