Preoperative hepatic CT perfusion as an early predictor for the recurrence of esophageal squamous cell carcinoma: initial clinical results.
Reports suggest that hepatic blood flow may have an association with cancer progression. The aim of the present study was to evaluate whether the hepatic blood flow measured by CT perfusion (CTP) may identify patients at high‑risk for postoperative recurrence of esophageal squamous cell carcinoma (ESCC). Prior to surgery, hepatic CTP images were obtained using a 320-row area detector CT. The data were analyzed by a commercially available software based on the dual input maximum slope method, and arterial blood flow (AF, ml/min/100 ml tissue), portal blood flow (PF, ml/min/100 ml tissue) and perfusion index [PI (%) = AF/AF + PF x 100] were measured. These parameters were compared with the pathological stage and outcome of the ESCC patients. Forty-five patients with ESCC were eligible for this study. The median follow-up period was 17 months, and recurrences were observed in 9 patients (20%). The preoperative PI values of the 9 patients with recurrence were significantly higher than those of the 36 patients without recurrence (23.9 vs. 15.9, P=0.0022). Patients were categorized into the following two groups; high PI (>20) and low PI (<20). The recurrence-free survival of the low PI group was significantly better than that of the high PI group (P<0.0001). A multivariate analysis showed that a high PI was an independent risk factor for recurrence (odds ratio, 19.1; P=0.0369).Therefore, the preoperative PI of the liver may be a useful imaging biomarker for predicting the recurrence of patients with esophageal cancer.
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Takeshi
T
Fujishiro
Department of Surgery, Teikyo University Medical Center, Ichihara, Chiba 299-0111, Japan.
Kiyohiko
K
Shuto
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Koichi
K
Hayano
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Asami
A
Satoh
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Tsuguaki
T
Kono
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Gaku
G
Ohira
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Takayuki
T
Tohma
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Hisashi
H
Gunji
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Kazuo
K
Narushima
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Toru
T
Tochigi
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Toshiharu
T
Hanaoka
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Sayaka
S
Ishii
Department of Radiological Technology, Chiba University Hospital, Chuo-ku, Chiba, Chiba 260-8677, Japan.
Noriyuki
N
Yanagawa
Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan.
Hisahiro
H
Matsubara
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D000077277:Esophageal Squamous Cell Carcinoma; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control; D057234:Preoperative Period; D011446:Prospective Studies; D012372:ROC Curve; D012039:Regional Blood Flow; D014057:Tomography, X-Ray Computed