Nathalie Brigitte Lassau MD, PhD, Presenter: Speaker, Toshiba Corporation Speaker, Bracco Group Speaker, Novartis AG Speaker, Pfizer Inc Speaker, F. Hoffmann-La Roche Ltd

Mohamed Chebil MD, Abstract Co-Author: Nothing to Disclose

Serge Koscielny, Abstract Co-Author: Nothing to Disclose

Linda Chami MD, Abstract Co-Author: Nothing to Disclose

Riad Bendjilali MD, Abstract Co-Author: Nothing to Disclose

Alain Joel Roche MD, Abstract Co-Author: Nothing to Disclose

To determine the best quantitative parameters of DCE-US at D3, D7, D14 for predicting the response at 2 months to bevacizumab in patients with HCC

Forty eight patients with HCC, treated with bevacizumab every 2 weeks were prospectively followed by DCE-US. DCE-US was performed before treatment and at day 3, 7, 14, 2 months and every 2 cycles. Contrast uptake was acquired using VRI®perfusion software after SonoVue®(Bracco) bolus injection. Time-intensity curves (TIC) were determined using linear raw-data from CHI-Q®(Toshiba) software. Seven parameters were extracted from the modelized TICs(Patent PCT/IB2006/003742): peak intensity (PI), areas under the curve (AUC), under the wash-in (AUWI), under the wash-out (AUWO), (corresponding all to the blood volume), time to peak intensity (TPI), slope of the wash-in (SWI) (both corresponding to the blood flow), mean transit time. CT-scan were performed before treatment and every 2 months. Patients were separate in good and bad responders according to the clinical benefit after 2 months according the RECIST criteria (good responders = PR+SD). The variation of each functional parameter of DCE-US was calculated between D0 and D3, 7, D14.

To date, 42 patients have been followed-up at least 2 months with a maximum of 18 months: 24 were good responders and 18 bad responders. A total of 265 DCE-US were performed. Among 7 parameters: 3 at D3 and D 14 related (AUC, AUWI, AUWO) to the blood volume were significantly correlated to the response (p=0:03; 0.04; 0.02 and p=0.05; 0.04; 0.05 respectively)

Quantitative functional evaluation by DCE-US performed at D 3 and D 14 is able to predict the response at 2 months in patients with HCC treated by bevacizumab. Parameters correlated to the blood volume are more appropriate.

The improvement of the methodology of DCE-US using raw linear data allows to calculate parameters related to blood volume for the early evaluation of anti-angiogenic treatments in HCC.

Lassau, N, Chebil, M, Koscielny, S, Chami, L, Bendjilali, R, Roche, A, Dynamic Contrast-enhanced Ultrasonography (DCE-US) with Quantification for the Early Evaluation of HCC Treated by Bevacizumab:  Which Parameters?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011169.html