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European Radiology
Published in: European Radiology 7/2018

01-07-2018 | Oncology

Dynamic contrast-enhanced ultrasonography (D-CEUS) for the early prediction of bevacizumab efficacy in patients with metastatic colorectal cancer

Authors: Michele Amadori, Domenico Barone, Emanuela Scarpi, Devil Oboldi, Elena Amadori, Gianfranco Bandi, Alice Rossi, Fabio Ferroni, Angela Ragazzini, Andrea Casadei Gardini, Giovanni Luca Frassineti, Giampaolo Gavelli, Alessandro Passardi

Published in: European Radiology | Issue 7/2018

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Abstract

Objectives

To investigate early changes in tumour perfusion parameters by dynamic contrast-enhanced ultrasonography (D-CEUS) and to identify any correlation with survival and tumour response in patients with metastatic colorectal cancer (CRC) treated with bevacizumab (B).

Methods

Thirty-seven patients randomized to either chemotherapy (C) plus B or C alone were considered for this study. D-CEUS was performed at baseline and after the first treatment cycle (day 15). Four D-CEUS perfusion parameters were considered: derived peak intensity (DPI), area under the curve (AUC), slope of wash-in (A) and time to peak intensity (TPI).

Results

In patients treated with C plus B, a ≥22.5 % reduction in DPI, ≥20 % increase in TPI and ≥10 % reduction in AUC were correlated with higher progression-free survival in the C+B arm (p = 0.048, 0.024 and 0.010, respectively) but not in the C arm. None of the evaluated parameter modifications had a correlation with tumour response or overall survival.

Conclusions

D-CEUS could be useful for detecting and quantifying dynamic changes in tumour vascularity as early as 15 days after the start of B-based therapy. Although these changes may be predictive of progression-free survival, no correlation with response or overall survival was found.

Key Points

• D-CEUS showed early changes in liver metastasis perfusion in colorectal cancer.
• A decrease in tumour perfusion was associated with longer progression-free survival.
• The decrease in perfusion was not correlated with higher overall survival.
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Metadata
Title
Dynamic contrast-enhanced ultrasonography (D-CEUS) for the early prediction of bevacizumab efficacy in patients with metastatic colorectal cancer
Authors
Michele Amadori
Domenico Barone
Emanuela Scarpi
Devil Oboldi
Elena Amadori
Gianfranco Bandi
Alice Rossi
Fabio Ferroni
Angela Ragazzini
Andrea Casadei Gardini
Giovanni Luca Frassineti
Giampaolo Gavelli
Alessandro Passardi
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5254-5

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