Hongying He MD, PhD, Presenter: Nothing to Disclose

Chusilp Charnsangavej MD, Abstract Co-Author: Consultant, Novartis AG

Richard L. Theriault DO, Abstract Co-Author: Nothing to Disclose

Marjorie Green, Abstract Co-Author: Nothing to Disclose

Mohammad A. Quraishi, Abstract Co-Author: Nothing to Disclose

Wei Tse Yang MD, Abstract Co-Author: Consultant, Naviscan, Inc

To evaluate size versus CT density change of hepatic metastases pre- and post-chemotherapy (TX), targeted therapy (TT) or combination (CX) in breast cancer patients.

A database search in a single institution identified 158 breast cancer patients who had hepatic metastases treated with systemic therapy from October 1997 to December 2009. A total of 76 patients had contrast-enhanced CT (CECT) of the abdomen at baseline and after 2 cycles of systemic therapy. CTs during the portal venous phase were retrospectively evaluated by two radiologists and up to 2 index lesions in each patient were identified. The size (cm) of each lesion was measured according to RECIST, and CT density (Hounsfield unit) was measured by drawing a region of interest around the margin of the entire lesion. The percentage change in size and CT density on pre-and post-treatment scans were computed for each lesion. Statistical analysis of the changes was performed using the Student’s paired t-test and Spearman’s rank correlation coefficients test.

39 patients with 68 lesions had TX only, 9 patients with 15 lesions had TT only, and 28 patients with 46 lesions had CX. The mean percentage changes in size of the TX, TT and CX groups were -29% (SD=25%), -12% (SD=44%) and -34% (SD=19%) respectively. The difference in size change was significant between the TX vs TT, (p=0.04), and CX vs TT (p=0.03). The mean percentage changes in density of the TX, TT, and CX groups were not statistically different (-7%, -5%, and -12%, respectively). There was no correlation between size and CT density change in the TX, TT, and CX groups.

TX and CX resulted in higher mean percentage decrease in size of hepatic metastases when compared to TT. No difference in mean percentage density change is noted with all three types of therapy. A prospective study may provide more information on the correlation between size and density change of hepatic metastases for response evaluation.

Size change of hepatic metastases in breast cancer patients can be used for monitoring TX and CX but may not define a response in TT, suggesting a need for alternate method to assess response.

He, H, Charnsangavej, C, Theriault, R, Green, M, Quraishi, M, Yang, W, Contrast-enhanced CT Evaluation of Hepatic Metastases in Breast Cancer Patients Undergoing Chemotherapy, Targeted Therapy, or Combination.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034390.html