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http://dx.doi.org/10.3348/kjr.2015.16.4.810

CT Perfusion Imaging Can Predict Patients' Survival and Early Response to Transarterial Chemo-Lipiodol Infusion for Liver Metastases from Colorectal Cancers  

Lv, Wei-Fu (PET/CT Center, Qilu Hospital, First Affiliated Hospital of Shandong University)
Han, Jian-Kui (Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University)
Cheng, De-Lei (Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University)
Zhou, Chun-Ze (Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University)
Ni, Ming (Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University)
Lu, Dong (Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University)
Publication Information
Korean Journal of Radiology / v.16, no.4, 2015 , pp. 810-820 More about this Journal
Abstract
Objective: To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). Materials and Methods: Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified as responders and non-responders based on 4-month CT scans after TACLI. The percentage change of CTPI parameters of target lesions were compared between responders and non-responders at 1 month after TACLI. The optimal parameter and cutoff value were determined. The patients were divided into 2 subgroups according to the cutoff value. The log-rank test was used to compare the survival rates of the 2 subgroups. Results: Four-month images were obtained from 58 patients, of which 39.7% were responders and 60.3% were non-responders. The percentage change in hepatic arterial perfusion (HAP) 1 month after TACLI was the optimal predicting parameter (p = 0.003). The best cut-off value was -21.5% and patients who exhibited a ${\geq}21.5%$ decrease in HAP had a significantly higher overall survival rate than those who exhibited a < 21.5% decrease (p < 0.001). Conclusion: Computed tomography perfusion imaging can predict the early response to TACLI and survival of patients with CRLM. The percentage change in HAP after TACLI with a cutoff value of -21.5% is the optimal predictor.
Keywords
Liver; Metastatic carcinoma; Colorectal cancer; Transarterial chemo-lipiodol infusion; Computed tomography perfusion imaging;
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