Yukiko Kunou, Presenter: Nothing to Disclose

Masafumi Uchida MD, PhD, Abstract Co-Author: Nothing to Disclose

Hayato Kaida, Abstract Co-Author: Nothing to Disclose

Yasumitsu Hirose, Abstract Co-Author: Nothing to Disclose

Hidehiro Etou, Abstract Co-Author: Nothing to Disclose

Yoshinobu Okabe, Abstract Co-Author: Nothing to Disclose

Toshi Abe MD, Abstract Co-Author: Nothing to Disclose

to evaluate the utility of pancreatic perfusion CT for predicting the response of pancreatic carcinoma to combined chemotherapy and radiotherapy or chemotherapy.

From July 2009 to November 2012, we enrolled 43 patients (26 men, 17 women: mean age 67 years, range 37-81 years) with unresectable pancreatic carcinoma who underwent PPCT before receiving CCRT or chemotherapy. Four perfusion parameters (perfusion, peak enhancement intensity, time to peak, and blood volume) of pancreatic tumor were calculated and we divided each perfusion parameter into two groups: high value group and low value group. The CCRT response was evaluated morphologically on 3-month follow-up CT based on the Response Evaluation Criteria in Solid Tumors. Pretreatment CT perfusion parameters were compared between responders and nonresonders by the Fisher exact test. Overall survival of the two groups was estimated by using the Kaplan-Meier method and compared by using the log-rank test.

Based on RECIST criteria, 13 of the total 43 patients had partial response (PR) at 3 months post-initiation of therapy, 24 had stable disease (SD) and six had progressive disease (PD). There was a statistically significant difference in all perfusion parameters when patients with PR at three months were compared with patients with SD or PD: perfusion: P< .01, peak enhancement intensity: P< .05, time to peak: P < .01, and blood volume: P< .01. Of the 43 patients, four were lost to follow-up and were excluded from survival analysis. Of the remaining 39 patients, 13 were alive at a mean of 19 (range, 8 to 44) months after beginning therapy and 26 had died. Six of the 43 patients underwent surgical resection after neoadjuvant therapy, five of whom received CCRT and one received only chemotherapy. Of the four perfusion parameters measured, only the high value group of the peak enhancement intensity was significantly correlated with a higher likelihood of survival at 15 months post-initiation of therapy (p=0.01).

Prediction of therapeutic effects is useful in management of patients with pancreatic carcinoma. Although conventional CT relies on many morphological findings, evaluation of pancreatic tumor perfusion with CT can provide radiologists and clinicians with very useful information that can be applied directly to patient care.

Pancreatic perfusion CT

Kunou, Y, Uchida, M, Kaida, H, Hirose, Y, Etou, H, Okabe, Y, Abe, T, CT Perfusion Based Visualization and Quantification of Pancreatic Carcinoma Using 256 Slice CT -Feasibility on Predicting the Response in Combined Chemoradiotherapy or Chemotherapy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017501.html