title: Response evaluation of chemotherapy in metastatic colorectal cancer by contrast enhanced ultrasound.
abstract: OBJECTIVE
  To evaluate whether contrast enhanced ultrasound (CEUS) might also be used for response prediction and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.
  
  
  METHODS
  Thirty consecutive patients with non primary resectable liver metastases from colorectal cancer underwent CEUS before treatment (CEUS date 1) and before the second (CEUS date 2) and fourth (CEUS date 3) cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak (TTP) and RISE RATE]were correlated with radiological response.
  
  
  RESULTS
  For neoadjuvant purpose a reduction of tumour mass was required to assume clinical response. Based on these response criteria there was a significant (P < 0.001) correlation in TTP between metastases of responders (9.08 s) and non-responders (14.76 s) archived on CEUS date 1. By calculating a standardized quotient (metastases divided by normal liver tissue) we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting TTP was also significantly (P < 0.01) different between responders and non-responders. In contrast, Peak and Rise rate did not show any significant difference between responder and non-responder.
  
  
  CONCLUSIONS
  CEUS might serve as a surrogate marker to predict treatment response in patients with metastasized colorectal cancer who receive antiangiogenic therapy.
authors.affiliation: Department of Medicine III, University Hospital Aachen (RWTH), Aachen 52074, Germany.
authors.forename: Ramin
authors.initials: R
authors.lastname: Schirin-Sokhan
authors.forename: Ron
authors.initials: R
authors.lastname: Winograd
authors.forename: Christoph
authors.initials: C
authors.lastname: Roderburg
authors.forename: Jhenee
authors.initials: J
authors.lastname: Bubenzer
authors.forename: Nicole Cabral
authors.initials: NC
authors.lastname: do Ó
authors.forename: Dorothee
authors.initials: D
authors.lastname: Guggenberger
authors.forename: Hartmut
authors.initials: H
authors.lastname: Hecker
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.forename: Jens J W
authors.initials: JJ
authors.lastname: Tischendorf
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D003287:Contrast Media / Q000378:metabolism; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D014463:Ultrasonography
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D003287:Contrast Media; D000068258:Bevacizumab