title: Study of Intrapatient Variability and Reproducibility of Quantitative Tumor Perfusion Parameters Evaluated With Dynamic Contrast-Enhanced Ultrasonography.
abstract: Dynamic contrast-enhanced (DCE) ultrasonography (US) is a functional imaging technique enabling quantitative assessment of solid tumor perfusion in metastatic patients treated with antiangiogenic therapies.The objective of this prospective single-center study was to evaluate in real-life conditions (in routine clinical practice) the intrapatient variability and reproducibility of DCE-US parameters.
  
  
  
  Each patient provided written informed consent and had 2 DCE-US examinations (preprandial and postprandial) at baseline, day 15, and 1 month after treatment initiation. Perfusion curves were recorded after Sonovue injections to determine 7 perfusion parameters. Dynamic contrast-enhanced US examinations were analyzed in pairs: preprandial and postprandial. Log transformed values were used to determine the variability of the pairs (within-subject coefficient of variation) and their reproducibility (Spearman correlation coefficient).
  
  
  
  We included 60 patients (23 colon cancers, 36 kidney cancers, and 1 breast cancer) treated with axitinib (26 patients), sunitinib (27 patients), and other antiangiogenic treatments (7 patients). The 60 patients included 38 men (63%) and 22 women (37%) with a median age of 62 (range, 25-82 years). Thirty patients had hepatic and 30 had extrahepatic target lesions. Data were analyzed for 128 pairs of DCE-US: 45 (baseline), 45 (day 15), and 38 (1 month). Preprandial and postprandial values were not significantly different. For area under the curve and area under the washout, the correlation coefficient between preprandial and postprandial values was 0.89; the associated within-subject coefficients of variation were 61% and 64%, respectively. However, the range of individual variations (postprandial value/preprandial value) was less than 2 logs for a range of parameter values of about 4 logs. Variability was independent of the metastatic site.
  
  
  
  This study showed that area under the curve and area under the washout are the 2 most reproducible DCE-US parameters.
authors.affiliation: From the *Gustave Roussy and IR4M, Centre National de la Recherche Scientifique, Université Paris-Sud, Université Paris-Saclay; †Service Biostatistique et Épidémiologie, Gustave Roussy and CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Sud; and ‡Radiology Department, Gustave Roussy, Villejuif, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lassau
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Coiffier
authors.forename: Laura
authors.initials: L
authors.lastname: Faivre
authors.forename: Baya
authors.initials: B
authors.lastname: Benatsou
authors.forename: Sophie
authors.initials: S
authors.lastname: Bidault
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Girard
authors.forename: Bernard
authors.initials: B
authors.lastname: Asselain
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Pitre-Champagnat
authors.forename: Serge
authors.initials: S
authors.lastname: Koscielny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010743:Phospholipids; D011446:Prospective Studies; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
chemical_list: D020533:Angiogenesis Inhibitors; D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride