title: Quantitative mapping of hepatic perfusion index using MR imaging: a potential reproducible tool for assessing tumour response to treatment with the antiangiogenic compound BIBF 1120, a potent triple angiokinase inhibitor.
abstract: Hepatic metastases are arterially supplied, resulting in an elevated hepatic perfusion index (HPI). The purpose of this study was to use dynamic contrast-enhanced (DCE) MR imaging to quantify the HPI of metastases and the liver before and after treatment with a novel antiangiogenic drug. Ten patients with known metastatic liver disease underwent DCE-MR studies. HPIs of metastases and whole liver were derived using regions of interest (ROIs) and calculated on a pixel-by-pixel basis from quantified changes in gadopentetate dimeglumine (Gd-DTPA) concentration. The HPI measurement error prior to treatment was derived by the Bland-Altman analysis. The median HPI before and after treatment with antiangiogenic drug BIBF 1120 were compared using the Wilcoxon signed rank test. Prior to treatment, the median HPI of metastases, 0.75 +/- 0.14, was significantly higher than that of the whole liver, 0.66 +/- 0.16 (p < 0.01). Bland-Altman reproducibility coefficients of the median HPI from metastases and whole liver were 13.0 and 5.1% respectively. The median HPI of metastases decreased significantly at 28 days after treatment with BIBF 1120 (p < 0.05). This pilot study demonstrates that HPI determined using quantified Gd-DTPA concentration is reproducible and may be useful for monitoring antiangiogenic treatment response of hepatic metastases.
authors: CRUK Clinical Magnetic Resonance Research Group, The Institute of Cancer Research, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK. Keiko.Miyazaki@icr.ac.uk
authors: Keiko
authors: K
authors: Miyazaki
authors: David J
authors: DJ
authors: Collins
authors: Simon
authors: S
authors: Walker-Samuel
authors: Jane N
authors: JN
authors: Taylor
authors: Anwar R
authors: AR
authors: Padhani
authors: Martin O
authors: MO
authors: Leach
authors: Dow-Mu
authors: DM
authors: Koh
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007211:Indoles / Q000627:therapeutic use*; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D003287:Contrast Media; D007211:Indoles; C530716:nintedanib; D019786:Gadolinium DTPA