CT perfusion proves useful for monitoring hepatocellular carcinoma treatment

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CT perfusion is a non-invasive and reproducible technique for assessing perfusion changes due to TACE (transarterial chemoembolization) therapy for locally advanced hepatocellular carcinoma (HCC), according to an article published Oct. 7 in the World Journal of Gastroenterology. However, there are little data on the application of the technique in evaluating the efficacy of TACE based on quantitative analysis of perfusion parameters.

A research team, led by Wen He, MD, department of radiology at the Beijing Friendship Hospital, affiliated with Capital Medical University, used 64-slice CT to prospectively assess the changes in parameters of CT perfusion pre- and post-TACE treatment of HCC in different response groups, and to correlate the changes with various responses to TACE. CT perfusion scan for patients with HCC allows assessment of perfusion changes due to TACE therapy. Researchers further investigated the correlation between changes in CT perfusion parameters pre- and post-TACE treatment of HCC and various responses to TACE.

Thirty-nine HCC patients underwent CT perfusion exams pre- and post-treatment. The response evaluation criteria for solid tumors (RECIST) were referred to when treatment responses were distributed. Wilcoxon-signed ranks test was used to compare the differences in CT perfusion parameters pre- and post-TACE for different response groups, the researchers said.

According to the results, only one case had treatment response to CR and the CT perfusion maps of post-treatment lesion displayed complete absence of signals. In the PR treatment response group, hepatic artery perfusion (HAP), hepatic arterial fracture (HAF) and hepatic blood volume of viable tumors post-TACE were reduced compared with pre-TACE.

In the SD group, all CT perfusion parameters were not significantly different pre- and post-TACE. In the PD group, HAP, HAF, portal vein perfusion and hepatic blood flow of viable tumors post-TACE were significantly increased compared with pre-TACE, the researchers said.

He and colleagues concluded that changes in CT perfusion parameters of viable tumors are correlated with different responses of HCC to TACE. Therefore, “CT perfusion imaging is a feasible technique for monitoring response of HCC to TACE,” the authors wrote.