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Lee DH, Kim SH, Lee SM, Han JK. Prediction of Treatment Outcome of Chemotherapy Using Perfusion Computed Tomography in Patients with Unresectable Advanced Gastric Cancer. Korean J Radiol 2019; 20:589-598. [PMID: 30887741 PMCID: PMC6424833 DOI: 10.3348/kjr.2018.0306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/03/2018] [Indexed: 02/06/2023] Open
Abstract
Objective To evaluate whether data acquired from perfusion computed tomography (PCT) parameters can aid in the prediction of treatment outcome after palliative chemotherapy in patients with unresectable advanced gastric cancer (AGC). Materials and Methods Twenty-one patients with unresectable AGCs, who underwent both PCT and palliative chemotherapy, were prospectively included. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (i.e., patients who achieved complete or partial response were classified as responders). The relationship between tumor response and PCT parameters was evaluated using the Mann-Whitney test and receiver operating characteristic analysis. One-year survival was estimated using the Kaplan-Meier method. Results After chemotherapy, six patients exhibited partial response and were allocated to the responder group while the remaining 15 patients were allocated to the non-responder group. Permeability surface (PS) value was shown to be significantly different between the responder and non-responder groups (51.0 mL/100 g/min vs. 23.4 mL/100 g/min, respectively; p = 0.002), whereas other PCT parameters did not demonstrate a significant difference. The area under the curve for prediction in responders was 0.911 (p = 0.004) for PS value, with a sensitivity of 100% (6/6) and specificity of 80% (12/15) at a cut-off value of 29.7 mL/100 g/min. One-year survival in nine patients with PS value > 29.7 mL/100 g/min was 66.7%, which was significantly higher than that in the 12 patients (33.3%) with PS value ≤ 29.7 mL/100 g/min (p = 0.019). Conclusion Perfusion parameter data acquired from PCT demonstrated predictive value for treatment outcome after palliative chemotherapy, reflected by the significantly higher PS value in the responder group compared with the non-responder group.
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Affiliation(s)
- Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
| | - Sang Min Lee
- Department of Radiology, Hallym University Sacred Heart Hospital, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
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Assessing Microcirculation in Resectable Oesophageal Squamous Cell Carcinoma with Dynamic Contrast-enhanced MRI for Identifying Primary tumour and Lymphatic Metastasis. Sci Rep 2019; 9:124. [PMID: 30644415 PMCID: PMC6333778 DOI: 10.1038/s41598-018-36929-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 11/27/2018] [Indexed: 12/26/2022] Open
Abstract
This study aimed to determine whether dynamic contrast-enhanced MRI (DCE-MRI) derived parameters can identify oesophageal squamous cell carcinoma (SCC) and lymphatic metastasis. Thirty-nine oesophageal SCC patients underwent DCE-MRI. Quantitative parameters including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume and fractional plasma volume, and semi-quantitative parameters including time to peak (TTP), max concentration, Max Slope and area under concentration-time curve of both oesophageal SCC and normal oesophagus were measured. Mann-Whitney U test revealed that Ktrans and Kep of oesophageal SCC were higher while TTP was shorter when compared to normal oesophagus (all P-values < 0.05); and areas under receiver operating characteristic [ROC] curves displayed that Kep was superior to TTP or Ktrans for identifying oesophageal SCC (0.903 vs. 0.832 or 0.713). Mann-Whitney U test also demonstrated that Kep was higher and TTP was shorter in patients with lymphatic metastasis when compared to non-metastatic cancer patients (both P-values < 0.05), and area under ROC curve also showed that TTP was superior to Kep for predicting lymphatic metastasis (0.696 vs. 0.659). In conclusion, the combination of quantitative and semi-quantitative parameters derived from DCE-MRI can aid in the identification of oesophageal SCC and lymphatic metastasis.
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Düzgün F, Tarhan S, Ovalı GY, Eskiizmir G, Pabuşçu Y. Is computed tomography perfusion a useful method for distinguishing between benign and malignant neck masses? EAR, NOSE & THROAT JOURNAL 2018. [PMID: 28636734 DOI: 10.1177/014556131709600601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Evaluation of neck masses is frequent in ear, nose, and throat clinics. Successful outcomes associated with neck mass are directly related to rapid diagnosis and accurate treatment for each patient. Late diagnosis of a malignant mass increases the magnitude of morbidity and the rate of mortality of the disease. Although magnetic resonance imaging and computed tomography (CT) examinations are important tools for evaluating head and neck pathologies, they do not allow functional evaluation. For this reason, CT perfusion (CTP) as a method of functional evaluation for distinguishing benign from malignant masses is gaining attention. The utility of CTP for distinguishing between benign and malignant mass lesions was investigated in 35 patients with masses in the neck (11 benign, 24 malignant). CTP was shown to be a useful method for identifying head and neck tumors and blood volume values to enable the differential diagnosis of benign and malignant head and neck tumors.
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Affiliation(s)
- Fatih Düzgün
- Department of Radiology, Celal Bayar University Faculty of Medicine, 45030 Manisa, Turkey.
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Huang YC, Chen TW, Zhang XM, Zeng NL, Li R, Tang YL, Chen F, Chen YL. Intravoxel incoherent motion diffusion-weighted imaging of resectable oesophageal squamous cell carcinoma: association with tumour stage. Br J Radiol 2018; 91:20170421. [PMID: 29308923 DOI: 10.1259/bjr.20170421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To determine whether intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) derived parameters can be associated with tumour stage of oesophageal squamous cell carcinoma (SCC). METHODS 60 patients with resectable oesophageal SCC and 20 healthy individuals underwent oesophageal DWI-using multi b-values with a 3.0 T MR system. Pure diffusion coefficient (D), perfusion-related incoherent microcirculation (D*), microvascular volume fraction (f) and apparent diffusion coefficient (ADC) were measured on DWI. Statistical analyses were performed to determine associations of DWI-derived parameters with T-stage. RESULTS ADC (r = -0.842), D (r = -0.729), D* (r = -0.301) and f (r = -0.817) were negatively correlated with T-stage of oesophageal SCC (all p < 0.01), and the multinominal regression analyses revealed that IVIM-derived parameters including D (p = 0.038; odds ratio <1) and f (p < 0.001; odds ratio <1) were associated with T-stage. The Mann-Whitney U tests with Bonferroni correction showed that D, f and ADC could discriminate oesophageal SCC, especially T1-staged tumour, from normal oesophagus (all p < 0.05) while D* could not (p > 0.05). By receiver operating characteristic analyses, f could be the best indicator for detecting oesophageal SCC with an area under receiver operating characteristic (AUC) of 0.964, especially T1-staged cancer with an AUC of 0.984, and for discriminating T1-stages between T0-1 and T2-3 with an AUC of 0.957, and between T0-2 and T3 with an AUC of 0.945 in comparison with any other DWI-derived parameter. CONCLUSIONS IVIM derived parameters can be associated with T-stage of oesophageal SCC. Advances in knowledge (1) IVIM-derived parameters are negatively correlated with stage of oesophageal SCC. (2) Among IVIM-derived parameters, microvascular volume fraction helps detect and stage oesophageal SCC.
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Affiliation(s)
- Yu-Cheng Huang
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China.,2 Department of Radiology, Dazhou Central Hospital , Dazhou, Sichuan , China
| | - Tian-Wu Chen
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Xiao-Ming Zhang
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Nan-Lin Zeng
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Rui Li
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Yu-Lian Tang
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Fan Chen
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
| | - Yan-Li Chen
- 1 Department of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College , Nanchong, Sichuan , China
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CT Perfusion evaluation of gastric cancer: correlation with histologic type. Eur Radiol 2017; 28:487-495. [PMID: 28779403 DOI: 10.1007/s00330-017-4979-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 04/07/2017] [Accepted: 07/06/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To prospectively evaluate if the perfusion parameters of gastric cancer can provide information on histologic subtypes of gastric cancer. METHODS We performed preoperative perfusion CT (PCT) and curative gastrectomy in 46 patients. PCT data were analysed using a dedicated software program. Perfusion parameters were obtained by two independent radiologists and were compared according to histologic type using Kruskal-Wallis, Mann-Whitney U test and receiver operating characteristic analysis. To assess inter-reader agreement, we used intraclass correlation coefficient (ICC). RESULTS Inter-reader agreement for perfusion parameters was moderate to substantial (ICC = 0.585-0.678). Permeability surface value of poorly cohesive carcinoma (PCC) was significantly higher than other histologic types (47.3 ml/100 g/min in PCC vs 26.5 ml/100 g/min in non-PCC, P < 0.001). Mean transit time (MTT) of PCC was also significantly longer than non-PCC (13.0 s in PCC vs 10.3 s in non-PCC, P = 0.032). The area under the curve to predict PCC was 0.891 (P < 0.001) for permeability surface and 0.697 (P = 0.015) for MTT. CONCLUSION Obtaining perfusion parameters from PCT was feasible in gastric cancer patients and can aid in the preoperative imaging diagnosis of PCC-type gastric cancer as the permeability surface and MTT value of PCC type gastric cancer were significantly higher than those of non-PCC. KEY POINTS • Obtaining perfusion parameters from PCT was feasible in patients with gastric cancer. • Permeability surface and MTT were significantly higher in poorly cohesive carcinoma (PCC). • Permeability surface, MTT can aid in the preoperative imaging diagnosis of PCC.
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Genc B, Kantarci M, Sade R, Orsal E, Ogul H, Okur A, Aydin Y, Karaca L, Eroğlu A. The Comparison of Computed Tomography Perfusion, Contrast-Enhanced Computed Tomography and Positron-Emission Tomography/Computed Tomography for the Detection of Primary Esophageal Carcinoma. Med Princ Pract 2016; 25:254-9. [PMID: 26784024 PMCID: PMC5588388 DOI: 10.1159/000444086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 01/18/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the efficiency of computed tomography perfusion (CTP), contrast-enhanced computed tomography (CECT) and 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron-emission tomography (PET/CT) in the diagnosis of esophageal cancer. SUBJECTS AND METHODS This prospective study consisted of 33 patients with pathologically confirmed esophageal cancer, 2 of whom had an esophageal abscess. All the patients underwent CTP, CECT and PET/CT imaging and the imaging findings were evaluated. Sensitivity, specificity and positive and negative predictive values were calculated for each of the 3 imaging modalities relative to the histological diagnosis. RESULTS Thirty-three tumors were visualized on CTP, 29 on CECT and 27 on PET/CT. Six tumors were stage 1, and 2 and 4 of these tumors were missed on CECT and PET/CT, respectively. Significant differences between CTP and CECT (p = 0.02), and between CTP and PET/CT (p = 0.04) were found for stage 1 tumors. Values for the sensitivity, specificity and positive and negative predictive values on CTP were 100, 100, 100 and 100%, respectively. Corresponding values on CECT were 93.94, 0, 93.94 and 0%, respectively, and those on PET/CT were 87.88, 0, 93.55 and 0%, respectively. Hence, the sensitivity, specificity and positive and negative predictive values of CTP were better than those of CECT and PET/CT. CONCLUSION CTP had an advantage over CECT and PET/CT in detecting small lesions. CTP was valuable, especially in detecting stage 1 tumors.
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Affiliation(s)
- Berhan Genc
- Department of Radiology, School of Medicine, Sifa University, Izmir, Departments of, Yozgat, Turkey
- Department of Radiology, School of Medicine, Radiology, Yozgat, Turkey
| | - Mecit Kantarci
- Department of Radiology, School of Medicine, Radiology, Yozgat, Turkey
- *Mecit Kantarci MD, PhD, Department of Radiology, School of Medicine, Ataturk University, TR-25040 Erzurum (Turkey), E-Mail
| | - Recep Sade
- Department of Radiology, School of Medicine, Radiology, Yozgat, Turkey
| | - Ebru Orsal
- Department of Radiology, School of Medicine, Nuclear Medicine, Yozgat, Turkey
| | - Hayri Ogul
- Department of Radiology, School of Medicine, Radiology, Yozgat, Turkey
| | - Aylin Okur
- Department of Radiology, School of Medicine, Bozok University, Yozgat, Turkey
| | - Yener Aydin
- Department of Radiology, School of Medicine, Thoracic Surgery, School of Medicine, Ataturk University, Erzurum, Yozgat, Turkey
| | - Leyla Karaca
- Department of Radiology, School of Medicine, Radiology, Yozgat, Turkey
| | - Atilla Eroğlu
- Department of Radiology, School of Medicine, Thoracic Surgery, School of Medicine, Ataturk University, Erzurum, Yozgat, Turkey
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Karmazanovsky GG, Buryakina SA, Kondratiev EV, Yang Q, Ruchkin DV, Kalinin DV. Value of two-phase dynamic multidetector computed tomography in differential diagnosis of post-inflammatory strictures from esophageal cancer. World J Gastroenterol 2015; 21:8878-8887. [PMID: 26269677 PMCID: PMC4528030 DOI: 10.3748/wjg.v21.i29.8878] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/25/2015] [Accepted: 05/07/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To characterize the computed tomography (CT) findings in patients with post-inflammatory esophageal strictures (corrosive and peptic) and reveal the optimal scanning phase protocols for distinguishing post-inflammatory esophageal stricture and esophageal cancer.
METHODS: Sixty-five patients with esophageal strictures of different etiology were included in this study: 24 patients with 27 histopathologically confirmed corrosive strictures, 10 patients with 12 peptic strictures and 31 patients with esophageal cancer were evaluated with a two-phase dynamic contrast-enhanced MDCT. Arterial and venous phases at 10 and 35 s after the attenuation of 200 HU were obtained at the descending aorta, with a delayed phase at 6-8 min after the start of injection of contrast media. For qualitative analysis, CT scans of benign strictures were reviewed for the presence/absence of the following features: “target sign”, luminal mass, homogeneity of contrast medium uptake, concentric wall thickening, conically shaped suprastenotic dilatation, smooth boundaries of stenosis and smooth mucous membrane at the transition to stenosis, which were compared with a control group of 31 patients who had esophageal cancer. The quantitative analysis included densitometric parameter acquisition using regions-of-interest measurement of the zone of stenosis and normal esophageal wall and the difference between those measurements (ΔCT) at all phases of bolus contrast enhancement. Esophageal wall thickening, length of esophageal wall thickening and size of the regional lymph nodes were also evaluated.
RESULTS: The presence of a concentric esophageal wall, conically shaped suprastenotic dilatation, smooth upper and lower boundaries, “target sign” and smooth mucous membrane at the transition to stenosis were suggestive of a benign cause, with sensitivities of 92.31%, 87.17%, 94.87%, 76.92% and 82.05%, respectively, and specificities of 70.96%, 89.66%, 80.65%, 96.77% and 93.55%, respectively. The features that were most suggestive of a malignant cause were eccentric esophageal wall thickening, tuberous upper and lower boundaries of stenosis, absence of mucous membrane visualization, rupture of the mucous membrane at the upper boundary of stenosis, cup-shaped suprastenotic dilatation, luminal mass and enlarged regional lymph nodes with specificities of 92.31% 94.87%, 67.86%, 100%, 97.44%, 94.87% and 82.86%, respectively and sensitivities of 70.97%, 80.65%, 96.77%, 80.65%, 54.84%, 87.10% and 60%, respectively. The highest tumor attenuation occurred in the arterial phase (mean attenuation 74.13 ± 17.42 HU), and the mean attenuation difference between the tumor and the normal esophageal wall (mean ΔCT) in the arterial phase was 23.86 ± 19.31 HU. Here, 11.5 HU of ΔCT in the arterial phase was the cut-off value used to differentiate esophageal cancer from post-inflammatory stricture (P = 0.000). The highest attenuation of post-inflammatory strictures occurred in the delayed phase (mean attenuation 71.66 ± 14.28 HU), and the mean ΔCT in delayed phase was 34.03 ± 15.94 HU. Here, 18.5 HU of ΔCT in delayed phase was the cut-off value used to differentiate post-inflammatory stricture from esophageal cancer (P < 0.0001).
CONCLUSION: The described imaging findings reveal high diagnostic significance in the differentiation of benign strictures from esophageal cancer.
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Li MH, Shang DP, Chen C, Xu L, Huang Y, Kong L, Yu JM. Perfusion Computed Tomography in Predicting Treatment Response of Advanced Esophageal Squamous Cell Carcinomas. Asian Pac J Cancer Prev 2015; 16:797-802. [DOI: 10.7314/apjcp.2015.16.2.797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Computed tomography (CT) perfusion as an early predictive marker for treatment response to neoadjuvant chemotherapy in gastroesophageal junction cancer and gastric cancer--a prospective study. PLoS One 2014; 9:e97605. [PMID: 24845062 PMCID: PMC4028233 DOI: 10.1371/journal.pone.0097605] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 04/20/2014] [Indexed: 12/23/2022] Open
Abstract
Objectives To evaluate whether early reductions in CT perfusion parameters predict response to pre-operative chemotherapy prior to surgery for gastroesophageal junction (GEJ) and gastric cancer. Materials and Methods Twenty-eight patients with adenocarcinoma of the gastro-esophageal junction (GEJ) and stomach were included. Patients received three series of chemotherapy before surgery, each consisting of a 3-week cycle of intravenous epirubicin, cisplatin or oxaliplatin, concomitant with capecitabine peroral. The patients were evaluated with a CT perfusion scan prior to, after the first series of, and after three series of chemotherapy. The CT perfusion scans were performed using a 320-detector row scanner. Tumour volume and perfusion parameters (arterial flow, blood volume and permeability) were computed on a dedicated workstation with a consensus between two radiologists. Response to chemotherapy was evaluated by two measures. Clinical response was defined as a tumour size reduction of more than 50%. Histological response was evaluated based on residual tumour cells in the surgical specimen using the standardized Mandard Score 1 to 5, in which values of 1 and 2 were classified as responders, and 3 to 5 were classified as nonresponders. Results A decrease in tumour permeability after one series of chemotherapy was positively correlated with clinical response after three series of chemotherapy. Significant changes in permeability and tumour volume were apparent after three series of chemotherapy in both clinical and histological responders. A cut-off value of more than 25% reduction in tumour permeability yielded a sensitivity of 69% and a specificity of 58% for predicting clinical response. Conclusion Early decrease in permeability is correlated with the likelihood of clinical response to pre-operative chemotherapy in GEJ and gastric cancer. As a single diagnostic test, CT Perfusion only has moderate sensitivity and specificity in response assessment of pre-operative chemotherapy making it insufficient for clinical decision purposes.
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Liu YTY, Zhou H, Liu JK. CT perfusion imaging in the diagnosis of esophageal cancer. Shijie Huaren Xiaohua Zazhi 2012; 20:3494-3498. [DOI: 10.11569/wcjd.v20.i35.3494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Esophageal cancer is one of the most common malignant tumors in China. The symptoms of early esophageal cancer often tend to be unspecific and are easily ignored. Diagnosis of esophageal cancer at early stage can improve its therapy and prognosis. Currently, there are still limitations for the application of digestive barium meal examination and endoscopic pathological biopsy in diagnosis of esophageal cancer. CT perfusion imaging, a technique developed in recent years, can assess tissue microcirculation quickly, conveniently, and non-invasively. These unique advantages have led to its gradual application to tumor diagnosis and prognosis evaluation. In this article, we review the application of CT perfusion imaging in the diagnosis of esophageal cancer.
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Aguila Rodríguez Y, Vicente Sánchez BM, Llaguno Pérez GA, Sánchez Pedraza JF, Costa Cruz M. Effect of physical exercise on metabolic control and risk factors in patients with type 2 diabetes mellitus: a quasi-experimental study. Medwave 2012. [DOI: 10.5867/medwave.2012.10.5547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Esophageal squamous cell carcinoma: assessing tumor angiogenesis using multi-slice CT perfusion imaging. Dig Dis Sci 2012; 80:284-91. [PMID: 22476585 DOI: 10.1016/j.ejrad.2010.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Accepted: 07/07/2010] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the correlation between multi-slice computed tomographic perfusion imaging (CTPI) parameters and immunohistologic markers of angiogenesis in esophageal squamous cell carcinoma (ESCC). METHODS Fifty patients with histologically proven esophageal squamous cell carcinoma were enrolled in this study. All subjects underwent multi-slice CT perfusion scan. The hemodynamic parameters of vascular tumor, including blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS) were generated. All the ESCC specimens were stained immunohistochemically to identify CD31 for quantification of microvessel density (MVD). CTPI parameters were correlated with MVD by using Pearson correlation analysis. RESULTS The value of CT perfusion parameters of ESCC were as follows: BF 116.71 ± 47.59 ml/100 g/min, BV 6.74 ± 2.70 ml/100 g, MTT 6.42 ± 2.84 s, PS 13.82 ± 6.25 ml/100 g/min. The mean MVD of all 50 tumor specimens was 34.44 ± 19.75. The PS values were significantly higher in ESCC patients with involvement of lymph node than those without involvement of lymph node (p < 0.01). Blood volume and permeability surface were positively correlated with MVD (p < 0.01), whereas no significant correlation was observed between MVD and BF or between MVD and MTT. CONCLUSIONS Blood volume and permeability surface were positively correlated with MVD. CTPI could reflect the angiogenesis in ESCC.
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Li R, Chen TW, Wang LY, Zhou L, Li H, Chen XL, Li CP, Zhang XM, Xiao RH. Quantitative measurement of contrast enhancement of esophageal squamous cell carcinoma on clinical MDCT. World J Radiol 2012; 4:179-85. [PMID: 22590673 PMCID: PMC3351687 DOI: 10.4329/wjr.v4.i4.179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate contrast-enhanced computed tomography (CECT) for discriminating esophageal squamous cell carcinoma (ESCC) from normal esophagus and evaluating outcomes within tumors after chemoradiotherapy (CRT). METHODS Sixty-four patients with surgical ESCC served as group A, and underwent thoracic contrast-enhanced scan with 16-section multidetector row CT 1 wk before surgery. Thirty-five patients with advanced ESCC receiving 4-wk CRT and showing response to CRT served as group B, and underwent CT scans similar with group A 4 wk after completion of CRT. In group A, differences in CT attenuation values (in HU) between the preoperative ESCC and background normal esophageal wall (delta CT(1)), or between different background normal esophageal walls (delta CT(2)) were compared. Furthermore, delta CT(1) between group A and B was also compared. RESULTS In group A, mean delta CT(1) was higher than delta CT(2) (23.86 ± 10.59 HU vs 6.24 ± 3.06 HU, P < 0.05). When a delta CT(1) of 10.025 HU was employed at a cut-off value to discriminate ESCC from normal esophagus, a sensitivity of 89.1% and specificity of 90.6% were achieved. Mean delta CT(1) was lower in group B than in group A (9.25 ± 10.86 vs 23.86 ± 10.59, P < 0.05), and a delta CT(1) of 15.45 HU was obtained at a cut-off value to assess the CRT changes with a sensitivity of 76.6% and specificity of 77.1%. CONCLUSION CECT might be a clinical technique for discriminating ESCC from normal esophagus, and evaluating outcome in the tumors treated with CRT.
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Affiliation(s)
- Rui Li
- Rui Li, Tian-Wu Chen, Li-Ying Wang, Li Zhou, Hang Li, Xiao-Li Chen, Chun-Ping Li, Xiao-Ming Zhang, Ru-Hui Xiao, Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Chen TW, Yang ZG, Chen HJ, Li Y, Tang SS, Yao J, Dong ZH, He D. Quantitative assessment of first-pass perfusion using a low-dose method at multidetector CT in oesophageal squamous cell carcinoma: correlation with VEGF expression. Clin Radiol 2012; 67:746-53. [PMID: 22341184 DOI: 10.1016/j.crad.2011.07.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/13/2011] [Accepted: 07/05/2011] [Indexed: 02/05/2023]
Abstract
AIM To investigate the correlation between vascular endothelial cell growth factor (VEGF) expression and first-pass perfusion parameters at multidetector computed tomography (MDCT) using a low-dose technique, and to determine how to discriminate VEGF positivity from VEGF negativity by perfusion CT in oesophageal squamous cell carcinomas. MATERIALS AND METHODS Thirty-two patients with oesophageal squamous cell carcinomas underwent first-pass perfusion with 64-section MDCT at 50 mAs. Perfusion parameters, including perfusion, peak enhanced density (PED), time to peak (TTP), and blood volume (BV), were measured. Postoperative specimens were assessed for VEGF expression. Correlation tests were performed to determine the associations between each CT perfusion parameter and VEGF expression. The cut-off values of perfusion parameters were obtained statistically to discriminate VEGF positivity from VEGF negativity. RESULTS Mean perfusion, PED, TTP, and BV were 38.47 ± 30.26 ml/min/ml, 24.68 ± 9.65 HU, 28.35 ± 9.03 s, and 11.82 ± 6.06 ml/100 g, respectively. PED or BV were significantly higher in the VEGF-positive group than in the VEGF-negative group (all p < 0.05), but no significant difference in perfusion or TTP was found between the VEGF-positive and VEGF-negative groups (all p > 0.05). In VEGF positivity, PED and BV were correlated with VEGF expression (r = 0.576 and 0.765, respectively; all p < 0.05), whereas perfusion and TTP were not (r = 0.361 and 0.239, respectively; all p > 0.05). A threshold of BV (10.23 ml/100 g) achieved a sensitivity of 94.4%, and a specificity of 92.9% for discriminating VEGF positivity from VEGF negativity. CONCLUSION BV could reflect tumour VEGF expression, and could be an indicator for evaluating angiogenesis in oesophageal tumours.
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Affiliation(s)
- T-w Chen
- Department of Radiology, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China
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Zhuang H, Yang ZG, Chen HJ, Peng YL, Li L. Time-intensity curve parameters in colorectal tumours measured using double contrast-enhanced ultrasound: correlations with tumour angiogenesis. Colorectal Dis 2012; 14:181-7. [PMID: 21689263 DOI: 10.1111/j.1463-1318.2011.02546.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM The aim of the study was to assess the correlation between time-intensity curve (TIC) parameters and colorectal tumour angiogenesis using double contrast-enhanced ultrasound (DCEUS), in which an intraluminal contrast agent was used in combination with an intravascular contrast agent. METHOD Thirty nine patients with colorectal tumours were examined preoperatively. During hydrocolonal examination with the intraluminal contrast agent, an intravascular contrast agent, SonoVue, was used to perform the DCEUS. The parameter arrival time (AT), time to peak (TTP), peak intensity (PI) and area under the curve (AUC) were measured. Postoperative specimens were assessed for microvessel density (MVD) and vascular endothelial growth factor (VEGF). The correlation between TIC parameters and the expression of VEGF or MVD was studied. RESULTS The mean values of AT, TTP, PI and AUC of the colorectal tumours were 14.32 ± 11.36 s, 30.61 ± 18.65 s, 20.38 ± 17.45 dB and 221.10 ± 156.09 dB.s, respectively. Both AUC and MVD were significantly higher in colorectal adenocarcinomas than in adenomas (all P < 0.05). A positive linear correlation was found between the AUC and MVD in colorectal tumours (r = 0.686, P = 0.0019). No correlation was found between VEGF and any TIC parameter. CONCLUSION DCEUS is a valuable method for evaluating angiogenesis in colorectal tumours in vivo. The AUC has a positive linear correlation with MVD and could form a new index for assessing angiogenesis and the biological behaviour of colorectal tumours.
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Affiliation(s)
- H Zhuang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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16
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Montemezzi S, Cenzi D, Motton M, Re TJ. Preoperative Work-up: Conventional Radiology, Ultrasonography, CT Scan, and MRI. Updates Surg 2012. [DOI: 10.1007/978-88-470-2330-7_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zhuang H, Yang ZG, Wang ZQ, Wang XD, Chen HJ, Zhang YC, Luo Y. Features of time-intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: initial observation. Eur J Radiol 2011; 81:677-82. [PMID: 21316889 DOI: 10.1016/j.ejrad.2011.01.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/16/2011] [Accepted: 01/17/2011] [Indexed: 02/05/2023]
Abstract
PURPOSE This study is to investigate the value of double contrast-enhanced ultrasonography (DCEU) in assessing microcirculation of colorectal adenocarcinomas and to describe the perfusion features of the tumours. MATERIAL AND METHODS DCEUS was performed in 42 patients with adenocarcinoma. The time-intensity curve parameters (arrival time (AT), time-to-peak (TTP), peak intensity (PI) and area under the curve (AUC)) within the tumours were extracted. The parameters were compared among the tumours with different CEUS features and stages. RESULTS The mean values of AT, TTP, PI and AUC of the colorectal adenocarcinomas were 13.68±13.36s, 32.61±19.56s, 19.82±16.54dB and 271.10±159.19dBs, respectively. In the adenocarcinomas with necrosis, the mean values of AUC was significantly lower than that of the adenocarcinomas without (231.10±219.27dBs, 278.10±123.20dBs, p=0.004). In the adenocarcinomas with necrosis, the AUC and PI of the non-necrotic part were significantly higher than that of the necrotic part (p=0.007, 0.0025, respectively). AUC increased progressively in the subgroups of T2, T3 and T4 and the difference of AUC between T2 and T4 subgroup was significant (p=0.008). CONCLUSIONS Double contrast-enhanced ultrasonography is a valuable technique for quantifying tumour vascularity of colorectal adenocarcinomas. AUC was significantly different in the subgroups of different T stage. AUC and PI could reflect the different perfusion status of tumours with or without necrosis.
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Affiliation(s)
- Hua Zhuang
- Department of Ultrasound, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China
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18
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Chen TW, Yang ZG, Wang QL, Li Y, Qian LL, Chen HJ. Whole tumour quantitative measurement of first-pass perfusion of oesophageal squamous cell carcinoma using 64-row multidetector computed tomography: correlation with microvessel density. Eur J Radiol 2010; 79:218-23. [PMID: 20399055 DOI: 10.1016/j.ejrad.2010.03.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 03/19/2010] [Indexed: 02/05/2023]
Abstract
PURPOSE To assess correlations between whole tumour first-pass perfusion parameters obtained with 64-row multidetector computed tomography (MDCT), and microvessel density (MVD) in oesophageal squamous cell carcinoma. MATERIALS AND METHODS Thirty-one consecutive patients with surgically confirmed oesophageal squamous cell carcinomas were enrolled into our study. All the patients underwent whole tumour first-pass perfusion scan with 64-row MDCT. Perfusion parameters, including perfusion (PF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Postoperative tumour specimens were assessed for MVD. Pearson correlation coefficient tests were performed to determine correlations between each perfusion parameter and MVD. RESULTS Mean values for PF, PED, BV and TTP of the whole tumour were 28.85 ± 20.29 ml/min/ml, 23.16 ± 8.09 HU, 12.13 ± 5.21 ml/100g, and 35.05 ± 13.85 s, respectively. Mean MVD in whole tumour at magnification (×200) was 15.75 ± 4.34 microvessel/tumour sample (vessels/0.723 mm(2)). PED and BV were correlated with MVD (r=0.651 and r=0.977, respectively, all p<0.05). However, PF and TTP were not correlated with MVD (r=0.070 and r=0.100, respectively, all p>0.05). CONCLUSION The BV value of first-pass perfusion CT could reflect MVD in oesophageal squamous cell carcinoma, and can be an indicator for evaluating the tumour angiogenesis.
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Affiliation(s)
- Tian-Wu Chen
- Department of Radiology, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
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Gastric adenocarcinoma: can perfusion CT help to noninvasively evaluate tumor angiogenesis? ACTA ACUST UNITED AC 2010; 36:15-21. [DOI: 10.1007/s00261-010-9609-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Perfusion changes in gastric adenocarcinoma: evaluation with 64-section MDCT. ACTA ACUST UNITED AC 2009; 35:195-202. [PMID: 19259725 DOI: 10.1007/s00261-009-9503-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 01/14/2009] [Accepted: 02/08/2009] [Indexed: 02/05/2023]
Abstract
BACKGROUND Perfusion CT has been applied in many clinical areas, but few studies have addressed gastric cancer. This study is to investigate the feasibility of first-pass perfusion CT with volume-based technique to assess microcirculation of gastric adenocarcinoma. METHODS Perfusion CT of gastric adenocarcinoma was performed with 64-section MDCT in 58 patients, which were subdivided into three subgroups according to the location of the tumor. Perfusion, peak enhancement, time to peak, and blood volume were computed in the tumor and in normal gastric wall. Mean values of perfusion parameters were compared between the tumor and normal stomach, between tumors with and without lymph node metastases, and between different stages. RESULTS Blood volume was significantly increased in gastric adenocarcinoma compared with normal stomach (19.75 +/- 14.74 vs. 13.59 +/- 11.46 mL/100 g, in total stomach, P = 0.004). A total of 10.55 mL/100 g of blood volume was employed as the cut-off value to discriminate the microcirculation of the tumor from that of the normal stomach. There were no significant differences of any perfusion parameters between the subgroups with and without lymph node metastases, or between early and advanced cancer. CONCLUSIONS The first-pass perfusion CT with whole tumor acquisition technique is a feasible technique for quantifying tumor vascularity and angiogenesis in gastric adenocarcinoma.
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