Journal
EUROPEAN RADIOLOGY
Volume 28, Issue 6, Pages 2281-2290Publisher
SPRINGER
DOI: 10.1007/s00330-017-5220-2
Keywords
Sunitinib; Carcinoma, Renal cell; Magnetic resonance imaging; Tomography, X-Ray computed; Prognosis
Funding
- Terry Fox Programme of the National Cancer Institute of Canada
- Canadian Institutes of Health Research
- Pfizer Canada
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To identify dynamic contrast-enhanced (DCE) imaging parameters from MRI, CT and US that are prognostic and predictive in patients with metastatic renal cell cancer (mRCC) receiving sunitinib. Thirty-four patients were monitored by DCE imaging on day 0 and 14 of the first course of sunitinib treatment. Additional scans were performed with DCE-US only (day 7 or 28 and 2 weeks after the treatment break). Perfusion parameters that demonstrated a significant correlation (Spearman p < 0.05) with progression-free survival (PFS) and overall survival (OS) were investigated using Cox proportional hazard models/ratios (HR) and Kaplan-Meier survival analysis. A higher baseline and day 14 value for Ktrans (DCE-MRI) and a lower pre-treatment vascular heterogeneity (DCE-US) were significantly associated with a longer PFS (HR, 0.62, 0.37 and 5.5, respectively). A larger per cent decrease in blood volume on day 14 (DCE-US) predicted a longer OS (HR, 1.45). We did not find significant correlations between any of the DCE-CT parameters and PFS/OS, unless a cut-off analysis was used. DCE-MRI, -CT and ultrasound produce complementary parameters that reflect the prognosis of patients receiving sunitinib for mRCC. Blood volume measured by DCE-US was the only parameter whose change during early anti-angiogenic therapy predicted for OS and PFS. aEuro cent DCE-CT, -MRI and ultrasound are complementary modalities for monitoring anti-angiogenic therapy. aEuro cent The change in blood volume measured by DCE-US was predictive of OS/PFS. aEuro cent Baseline vascular heterogeneity by DCE-US has the strongest prognostic value for PFS.
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