title: Dynamic contrast-enhanced magnetic resonance imaging in the early evaluation of anti-angiogenic therapy in metastatic renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the efficacy of dynamic contrast-enhanced magnetic resonance (DCE-MR) in the response to anti-angiogenic-targeted agents in patients with metastatic renal cell cancer (mRCC).
  
  
  METHODS
  Twenty-eight consecutive patients with sub-diaphragmatic metastases from mRCC were included in the protocol after signed informed consent. Baseline characteristics were collected and patients were first evaluated with a baseline computed tomography (CT) and DCE-MR, subsequently with a new DCE-MRI after 28 days of therapy and followed-up with CT until progression. Treatments were administered at standard doses. The changes of peak enhancement (ΔPE) and of the sum of longest tumor diameters (ΔLTD) were related to progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  The median PFS was 11.4 months [95% Confidence Interval (CI): 7.9-14.7 months) and the parametric two-tailed Pearson's test showed a positive correlation between the median ΔPE and the median PFS (rp=0.809; p=0.015); no significant correlation was found between the median ΔLTD and the median PFS (rp=-0.446; p=0.27). The median OS was 23.3 months (95% CI: 13.6-33.0 months) and no significant correlation was found with the median ΔPE (rp=0.218; p=0.60) or with the median ΔLTD (rp=0.012; p=0.98).
  
  
  CONCLUSIONS
  The ΔPE but not the ΔLTD was found to be significantly related to PFS; these preliminary results suggest extending the number of patients and investigating the possible relationship with other tumor characteristics and MRI parameters.
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy, valeria.panebianco@gmail.com.
authors: Valeria
authors: V
authors: Panebianco
authors: Roberto
authors: R
authors: Iacovelli
authors: Flavio
authors: F
authors: Barchetti
authors: Amelia
authors: A
authors: Altavilla
authors: Valerio
authors: V
authors: Forte
authors: Alessandro
authors: A
authors: Sciarra
authors: Enrico
authors: E
authors: Cortesi
authors: Carlo
authors: C
authors: Catalano
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis
keywords: MRI; Metastatic renal cell carcinoma; angiogenesis; peak enhancement; targeted therapies