Masahiro Okada MD, Presenter: Nothing to Disclose

Norihisa Yada, Abstract Co-Author: Nothing to Disclose

Kazuomi Ueshima, Abstract Co-Author: Nothing to Disclose

Masayuki Kudo PhD,RT, Abstract Co-Author: Employee, General Electric Company

Masatoshi Kudo, Abstract Co-Author: Nothing to Disclose

Takamichi Murakami MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate changes of angiogenesis of advanced hepatocellular carcinoma (HCC) with treatment of antiangiogenic therapy (Sorafenib) by perfusion parameters measured with CT perfusion (CTp).

Fifteen patients, who had Sorafenib therapy for advanced HCC, underwent CTp. CTp was performed at baseline and 1 month after Sorafenib therapy by a 64-row MDCT. After iodinated contrast medium [0.5 mL x body weight (kg)] injection at a rate of 4 ml/sec, CTp scan with 40 sec breath hold on oxygen was performed, and data were processed based on deconvolution method (CT Perfusion 4, GE Healthcare). CTp revealed the quantitative parameters, such as blood flow (BF; mL/min/100g), blood volume (BV; mL/100g), mean transit time (MTT; sec), hepatic arterial fraction (HAF; %) and capillary permeability surface area (PS) in both HCC and surrounding liver parenchyma, with estimated effective radiation dose (CTDIvol: 54mGy, DLP: 675mGy.cm) on our protocol. Each CTp parameter in HCC and liver parenchyma were compared between pre-treatment and post-treatment.

Compared with baseline, the decrease in the tumor perfusion parameters, such as BF in 12 patients (301.1±102.0 at baseline, 207.2±81.9 after therapy) and BV in 13 patients (31.7±13.4 at baseline, 21.7±7.6 after therapy) on 1 month following Sorafenib administration. The changes in HCC before and after treatment were statistically significant for BV and BF (both, p<0.05). Whereas, no significant difference was seen for MTT, HAF and PS in the change of HCC before and after treatment. The changes in liver parenchyma before and after treatment were statistically significant for BV and MTT (both, p<0.05), but were not significant for BF, HAF and PS.

Based on the analysis by CTp parameters, the decrease of BF and BV values may reflect the efficacy of sorafenib.

CTp is a promising method in the evaluation of antiangiogenic response, and provides detailed capillary-level hemodynamics data of HCC.

Okada, M, Yada, N, Ueshima, K, Kudo, M, Kudo, M, Murakami, T, Evaluation of Angiogenesis after Antiangiogenic Therapy Using Liver CT Perfusion: Additional Detailed Capillary-level Hemodynamics in Patients with Advanced Hepatocellular Carcinoma.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002923.html