Thomas Gauthier, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Harpreet Wasan MBBCHIR, MD, Abstract Co-Author: Nothing to Disclose

Mike Averkiou PhD, Abstract Co-Author: Consultant, Koninklijke Philips Electronics NV

David Owen, Abstract Co-Author: Nothing to Disclose

Konstantina Kyriakopoulou MD, Abstract Co-Author: Nothing to Disclose

Edward Leen MD, Presenter: Research grant, Bracco Group Research grant, AngioDynamics, Inc Equipment support, Koninklijke Philips Electronics NV Equipment support, General Electric Company Equipment support, SuperSonic Imagine

The purpose of this study was to introduce and evaluate a dynamic contrast-enhanced ultrasound (DCE-US) technique assessing early response to the treatment of liver malignancies.

The study protocol was approved by the local Research Ethics Committee. Informed consent was obtained from all subjects. Sixty-four subjects (20 healthy controls, 25 subjects with untreated liver malignancy, 14 post treatment for liver malignancy, and 5 subjects pre and post combined anti-angiogenic with cytotoxic therapy for colorectal liver metastases) were studied. DCE-US of each subject was performed to measure the dynamic contrast-enhanced hepatic perfusion index (DCE-HPI) defined as the ratio of hepatic arterial to portal venous blood flow. Response to treatment was also assessed using conventional RECIST criteria. Intra- and inter-observer variability of DCE-HPI was assessed using two independent readers blinded to clinical information.  

Compared with healthy controls, DCE-HPI was significantly elevated in the untreated liver malignancy group (mean+/-sd: 34.85+/-19.54 vs. 3.59+/-3.3; p<0.0001) with sensitivity and specificity of 100% for DCE-HPI cut-off of 13.12. DCE-HPI was significantly reduced in responders compared with the untreated liver malignancy group (6.34+/-3.82 vs. 34.85+/-19.54; p<0.0001) whereas DCE-HPI of non-responders was not (197.4+/-180.5 vs. 34.85+/-19.54; p=0.0549). The intra- and inter-observer coefficient of variability of DCE-HPI was 9% and 15% respectively.  

DCE-HPI is a non-invasive, reproducible sonographic biomarker, which has potential clinically in the early prediction of response to liver cancer therapies, including novel investigational biological agents. Further validation studies of DCE-HPI in larger cohorts of subjects undergoing specific therapies are warranted.

DCE-HPI is a rapid, non-invasive and reproducible imaging biomarker, which may be a useful surrogate to predict early response to therapy in liver cancer patients.

Gauthier, T, Wasan, H, Averkiou, M, Owen, D, Kyriakopoulou, K, Leen, E, A Novel Dynamic Contrast-enhanced Ultrasound Biomarker to Monitor Therapy Response in Liver Malignancies: The Dynamic Contrast-enhanced Hepatic Perfusion Index.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007017.html