The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients

• Published in: European radiology Vol. 17; no. 7; pp. 1700 - 1713
• Main Authors: Meijerink, Martijn R, van Cruijsen, Hester, Hoekman, Klaas, Kater, Matthijs, van Schaik, Cors, van Waesberghe, Jan Hein T M, Giaccone, Giuseppe, Manoliu, Radu A
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.07.2007
• Subjects: Administration, Oral; Adult; Aged; Angiogenesis; Angiography; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Computed tomography; Contrast agents; Contrast media; Contrast Media - administration & dosage; Disease Progression; Dose-Response Relationship, Drug; Feasibility studies; Female; Follow-Up Studies; Gefitinib; Hemodynamic responses; Hepatic artery; Humans; Image acquisition; Image contrast; Image enhancement; Image Processing, Computer-Assisted; Injections, Intravenous; Lesions; Liver; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Male; Mediastinal Neoplasms - diagnostic imaging; Mediastinal Neoplasms - drug therapy; Middle Aged; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - drug therapy; Pelvic Neoplasms - diagnostic imaging; Pelvic Neoplasms - drug therapy; Perfusion; Pleural Neoplasms - diagnostic imaging; Pleural Neoplasms - drug therapy; Prognosis; Quinazolines - administration & dosage; Quinazolines - adverse effects; Therapy; Tomography, Spiral Computed; Tumors
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-006-0425-9

The purpose of this study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (CTP) in evaluating the hemodynamic response of tumors in the chest and abdomen treated with a combination of AZD2171 and gefitinib. Thirteen patients were examined just before and every 4-6 weeks after starting therapy. Following intravenous injection of a contrast agent, dynamic image acquisition was obtained at the level of a selected tumor location. To calculate perfusion, the maximum-slope method was used. Pre-treatment average perfusion for extra-hepatic masses was 84 ml/min/100 g, for liver masses arterial perfusion was 25 ml/min/100 g, and a portal perfusion of 30 ml/min/100 g was found. After the administration of AZD2171 and gefitinib, in extra-hepatic masses an initial decrease in perfusion of 18% was followed by a plateau and in liver masses an initial decrease of 39% within the lesions and of 36% within a rim region surrounding the lesions was followed by a tendency to recovery of hepatic artery flow. In conclusion, CTP is feasible in showing changes of perfusion induced by anti-angiogenic therapy.