Perfusion CT Changes in Liver Metastases from Pancreatic Neuroendocrine Tumors During Everolimus Treatment

Anticancer Res. 2017 Mar;37(3):1305-1311. doi: 10.21873/anticanres.11448.

Abstract

Aim: To evaluate modifications of perfusional parameters assessed by perfusion computed tomography (P-CT) of liver metastases (LM) from pancreatic neuroendocrine tumors (PanNETs) during everolimus treatment.

Patients and methods: All patients with LMs from G1-2 PanNETs undergoing everolimus treatment between January 2013 and January 2015 were prospectively evaluated with P-CT at baseline, and after 2 and 4 months of therapy. Size, perfusion, blood volume (BV), peak enhancement intensity (PEI) and time to peak for each lesion were calculated.

Results: A total of 33 LMs in nine patients with G1-2 PanNETs were prospectively evaluated: 23/33 (69.7%) were responders, 10/33 (30.3%) were non-responders. Among perfusional parameters, only numerical peak enhancement intensity values significantly differed between the two groups at baseline (p=0.043). BV increase was the most significant perfusional modification identifying responding lesions, even at an early stage of treatment, with a high positive predictive value (89.47%).

Conclusion: P-CT seems to be useful for prediction of response to everolimus of LMs from PanNETs.

Keywords: Perfusion CT; everolimus; pancreatic neuroendocrine tumor; perfusion; predictive biomarkers.

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Biomarkers, Tumor
  • Contrast Media
  • Everolimus / administration & dosage*
  • Female
  • Humans
  • Liver / pathology
  • Liver Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neuroendocrine Tumors / diagnostic imaging*
  • Pancreatic Neoplasms / diagnostic imaging*
  • Perfusion
  • Prospective Studies
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Contrast Media
  • Everolimus