The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients.
The purpose of this study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (CTP) in evaluating the hemodynamic response of tumors in the chest and abdomen treated with a combination of AZD2171 and gefitinib. Thirteen patients were examined just before and every 4-6 weeks after starting therapy. Following intravenous injection of a contrast agent, dynamic image acquisition was obtained at the level of a selected tumor location. To calculate perfusion, the maximum-slope method was used. Pre-treatment average perfusion for extra-hepatic masses was 84 ml/min/100 g, for liver masses arterial perfusion was 25 ml/min/100 g, and a portal perfusion of 30 ml/min/100 g was found. After the administration of AZD2171 and gefitinib, in extra-hepatic masses an initial decrease in perfusion of 18% was followed by a plateau and in liver masses an initial decrease of 39% within the lesions and of 36% within a rim region surrounding the lesions was followed by a tendency to recovery of hepatic artery flow. In conclusion, CTP is feasible in showing changes of perfusion induced by anti-angiogenic therapy.
Meijerink
Martijn R
MR
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands. mr.meijerink@vumc.nl
van Cruijsen
Hester
H
Hoekman
Klaas
K
Kater
Matthijs
M
van Schaik
Cors
C
van Waesberghe
Jan Hein T M
JH
Giaccone
Giuseppe
G
Manoliu
Radu A
RA
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003287:Contrast Media / Q000008:administration & dosage; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D000077156:Gefitinib; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011379:Prognosis; D011799:Quinazolines / Q000008:administration & dosage* / Q000009:adverse effects; D036542:Tomography, Spiral Computed; D007211:Indoles
D003287:Contrast Media; D000077156:Gefitinib; D011799:Quinazolines; C500926:cediranib; D007211:Indoles