title: Current status and guidelines for the assessment of tumour vascular support with dynamic contrast-enhanced computed tomography.
abstract: Dynamic contrast-enhanced computed tomography (DCE-CT) assesses the vascular support of tumours through analysis of temporal changes in attenuation in blood vessels and tissues during a rapid series of images acquired with intravenous administration of iodinated contrast material. Commercial software for DCE-CT analysis allows pixel-by-pixel calculation of a range of validated physiological parameters and depiction as parametric maps. Clinical studies support the use of DCE-CT parameters as surrogates for physiological and molecular processes underlying tumour angiogenesis. DCE-CT has been used to provide biomarkers of drug action in early phase trials for the treatment of a range of cancers. DCE-CT can be appended to current imaging assessments of tumour response with the benefits of wide availability and low cost. This paper sets out guidelines for the use of DCE-CT in assessing tumour vascular support that were developed using a Delphi process. Recommendations encompass CT system requirements and quality assurance, radiation dosimetry, patient preparation, administration of contrast material, CT acquisition parameters, terminology and units, data processing and reporting. DCE-CT has reached technical maturity for use in therapeutic trials in oncology. The development of these consensus guidelines may promote broader application of DCE-CT for the evaluation of tumour vascularity.                         Key Points                      • DCE-CT can robustly assess tumour vascular support                      • DCE-CT has reached technical maturity for use in therapeutic trials in oncology                      • This paper presents consensus guidelines for using DCE-CT in assessing tumour vascularity.
authors.affiliation: Clinical Imaging Sciences Centre, Brighton & Sussex Medical School, University of Sussex, Falmer, BN1 9RR, UK. k.a.miles@bsms.ac.uk
authors.forename: K A
authors.initials: KA
authors.lastname: Miles
authors.forename: T-Y
authors.initials: TY
authors.lastname: Lee
authors.forename: V
authors.initials: V
authors.lastname: Goh
authors.forename: E
authors.initials: E
authors.lastname: Klotz
authors.forename: C
authors.initials: C
authors.lastname: Cuenod
authors.forename: S
authors.initials: S
authors.lastname: Bisdas
authors.forename: A M
authors.initials: AM
authors.lastname: Groves
authors.forename: M P
authors.initials: MP
authors.lastname: Hayball
authors.forename: R
authors.initials: R
authors.lastname: Alonzi
authors.forename: T
authors.initials: T
authors.lastname: Brunner
mesh_terms: D003287:Contrast Media / Q000592:standards*; D005544:Forecasting; D006801:Humans; D009369:Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D012015:Reference Standards; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000639:trends*
chemical_list: D003287:Contrast Media