title: Perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging predict outcomes of hepatocellular carcinoma receiving radiotherapy with or without thalidomide.
abstract: BACKGROUND
  To correlate between signal parameters using dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) and outcomes of hepatocellular carcinoma (HCC) receiving radiotherapy with or without concomitant thalidomide.
  
  
  METHODS
  DCEMRI was performed in advanced HCC patients undergoing radiotherapy with or without concomitant thalidomide. Initial first-pass enhancement slopes (slope) and peak enhancement ratios (peak) were measured over an operator-defined region of interest over tumor and non-tumor liver parenchyma. The perfusion parameters were correlated with clinical outcomes. The study was registered with ClinicalTrials.gov. (identifier NCT00155272).
  
  
  RESULTS
  Forty-three patients were evaluable. There were 18 partial responses (PRs), 5 minimal responses (MRs), 17 stable diseases (SDs), and 3 progressive diseases (PDs). Baseline perfusion parameters as well as slope at 14 days of radiotherapy were higher in patients with PR or MR compared to SD or PD (0.81 ± 0.29 vs. 0.49 ± 0.34, p < 0.01; 0.39 ± 0.15 vs. 0.28 ± 0.16, p = 0.02; 0.97 ± 0.38 vs. 0.46 ± 0.26, p < 0.01; respectively). Multivariate analysis revealed perfusion parameters over liver parenchyma, but not over tumor, and independently predicted progression-free and overall survival (182 ± 33 vs. 105 ± 26 days, p = 0.01; 397 ± 111 vs. 233 ± 19 days, p = 0.001 respectively). For 22 patients receiving concomitant thalidomide, the perfusion parameters were not significantly different from those receiving radiotherapy alone.
  
  
  CONCLUSIONS
  Signal parameters of DCEMRI over tumor and liver parenchyma correlated with tumor response and survival, respectively, in HCC patients receiving radiotherapy.
authors: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors: Po-Chin
authors: PC
authors: Liang
authors: Hui-Ju
authors: HJ
authors: Ch'ang
authors: Chiun
authors: C
authors: Hsu
authors: Li-Tzong
authors: LT
authors: Chen
authors: Tiffany T F
authors: TT
authors: Shih
authors: Tsang Wu
authors: TW
authors: Liu
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000379:methods; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012815:Signal Processing, Computer-Assisted; D015996:Survival Rate; D013792:Thalidomide / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D003287:Contrast Media; D013792:Thalidomide; C064925:gadodiamide; D019786:Gadolinium DTPA