title: Perfusion computed tomography in predicting treatment response of advanced esophageal squamous cell carcinomas.
abstract: BACKGROUND
  The purpose of this study was to prospectively evaluate the predictive value of perfusion computed tomography (CT) for response of local advanced esophageal carcinoma to radiotherapy and chemotherapy.
  
  
  METHODS
  Before any treatment, forty-three local advanced esophageal squamous cell carcinomas were prospectively evaluated by perfusion scan with 16-row CT from June 2009 to January 2012. Perfusion parameters, including perfusion (BF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Seventeen cases received definitive radiotherapy and 26 received concurrent chemo-radiotherapy. The response was evaluated by CT scan and esophagography. Differences in perfusion parameters between responders and non-responders were analyzed, and ROCs were used to assess predictive value of the baseline parameters for treatment response.
  
  
  RESULTS
  There were 25 responders (R) and 18 non-responders (NR). Responders showed significantly higher BF (R:34.1 ml/100 g/min vs NR: 25.0 ml/100 g/min, p=0.001), BV (23.2 ml/100g vs 18.3 ml/100g, p=0.009) and PED (32.5 HU vs 28.32 HU, P=0.003) than non-responders. But the baseline TTP (R: 38.2 s vs NR: 44.10 s, p=0.172) had no difference in the two groups. For baseline BF, a threshold of 36.1 ml/100 g/min achieved a sensitivity of 56%, and a specificity of 94.4% for detection of clinical responders from non-responders.
  
  
  CONCLUSIONS
  The results suggest that the perfusion CT can provide some helpful information for identifying tumors that may respond to radio-chemotherapy.
authors: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, China E-mail : sdyujinming@126.com.
authors: Ming-Huan
authors: MH
authors: Li
authors: Dong-Ping
authors: DP
authors: Shang
authors: Chen
authors: C
authors: Chen
authors: Liang
authors: L
authors: Xu
authors: Yong
authors: Y
authors: Huang
authors: Li
authors: L
authors: Kong
authors: Jin-Ming
authors: JM
authors: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D055420:Perfusion Imaging; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D002945:Cisplatin; D005472:Fluorouracil