Objectives To investigate early changes in tumour perfusion parameters by dynamic contrast-enhanced ultrasonography (D- CEUS) and to identify any correlation with survival and tumour response in patients with metastatic colorectal cancer (CRC) treated with bevacizumab (B). Methods Thirty-seven patients randomized to either chemotherapy (C) plus B or C alone were considered for this study. D- CEUS was performed at baseline and after the first treatment cycle (day 15). Four D-CEUS perfusion parameters were consid- ered: derived peak intensity (DPI), area under the curve (AUC), slope of wash-in (A) and time to peak intensity (TPI). Results In patients treated with C plus B, a ≥22.5%reductioninDPI, ≥20 % increase in TPI and ≥10 % reduction in AUC were correlated with higher progression-free survival in the C+B arm (p = 0.048, 0.024 and 0.010, respectively) but not in the C arm. None of the evaluated parameter modifications had a correlation with tumour response or overall survival. Conclusions D-CEUS could be useful for detecting and quantifying dynamic changes in tumour vascularity as early as 15 days after the start of B-based therapy. Although these changes may be predictive of progression-free survival, no correlation with response or overall survival was found. Key Points �
European Radiology – Springer Journals
Published: Feb 7, 2018
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