Perfusion CT best predicts outcome after radioembolization of liver metastases: a comparison of radionuclide and CT imaging techniques.

Details

Serval ID
serval:BIB_930E3E7CC002
Type
Article: article from journal or magazin.
Collection
Publications
Title
Perfusion CT best predicts outcome after radioembolization of liver metastases: a comparison of radionuclide and CT imaging techniques.
Journal
European Radiology
Author(s)
Morsbach F., Sah B.R., Spring L., Puippe G., Gordic S., Seifert B., Schaefer N., Pfammatter T., Alkadhi H., Reiner C.S.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
24
Number
7
Pages
1455-1465
Language
english
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: To determine the best predictor for the response to and survival with transarterial radioembolisation (RE) with (90)yttrium microspheres in patients with liver metastases.
METHODS: Forty consecutive patients with liver metastases undergoing RE were evaluated with multiphase CT, perfusion CT and (99m)Tc-MAA SPECT. Arterial perfusion (AP) from perfusion CT, HU values from the arterial (aHU) and portal venous phase (pvHU) CT, and (99m)Tc-MAA uptake ratio of metastases were determined. Morphologic response was evaluated after 4 months and available in 30 patients. One-year survival was calculated with Kaplan-Meier curves.
RESULTS: We found significant differences between responders and non-responders for AP (P < 0.001) and aHU (P = 0.001) of metastases, while no differences were found for pvHU (P = 0.07) and the (99m)Tc-MAA uptake ratio (P = 0.40). AP had a significantly higher specificity than aHU (P = 0.003) for determining responders to RE. Patients with an AP >20 ml/100 ml/min had a significantly (P = 0.01) higher 1-year survival, whereas an aHU value >55 HU did not discriminate survival (P = 0.12). The Cox proportional hazard model revealed AP as the only significant (P = 0.02) independent predictor of survival.
CONCLUSION: Compared to arterial and portal venous enhancement and the (99m)Tc-MAA uptake ratio of liver metastases, the AP from perfusion CT is the best predictor of morphologic response to and 1-year survival with RE.
KEY POINTS: ? Perfusion CT allows for calculation of the liver arterial perfusion. ? Arterial perfusion of liver metastases differs between responders and non-responders to RE. ? Arterial perfusion can be used to select patients responding to RE.
Keywords
Adult, Aged, Aged, 80 and over, Angiography, Embolization, Therapeutic/methods, Female, Follow-Up Studies, Humans, Injections, Intra-Arterial, Liver Neoplasms/diagnosis, Liver Neoplasms/radiotherapy, Male, Microspheres, Middle Aged, Perfusion Imaging/methods, Predictive Value of Tests, Prospective Studies, ROC Curve, Radiopharmaceuticals/administration & dosage, Radiopharmaceuticals/therapeutic use, Tomography, Emission-Computed, Single-Photon/methods, Tomography, X-Ray Computed/methods, Treatment Outcome, Yttrium Radioisotopes/administration & dosage, Yttrium Radioisotopes/therapeutic use
Pubmed
Create date
17/06/2015 14:38
Last modification date
20/08/2019 14:55
Usage data