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19.06.2018 | Hepatobiliary-Pancreas

Extracellular volume fraction determined by equilibrium contrast-enhanced multidetector computed tomography as a prognostic factor in unresectable pancreatic adenocarcinoma treated with chemotherapy

verfasst von: Yoshihiko Fukukura, Yuichi Kumagae, Ryutaro Higashi, Hiroto Hakamada, Koji Takumi, Kosei Maemura, Michiyo Higashi, Kiyohisa Kamimura, Masanori Nakajo, Takashi Yoshiura

Erschienen in: European Radiology | Ausgabe 1/2019

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Abstract

Objectives

To assess whether extracellular volume (ECV) fraction with equilibrium contrast-enhanced multidetector computed tomography (MDCT) predicts outcomes for unresectable pancreatic adenocarcinoma patients treated with chemotherapy

Methods

Sixty-seven patients (42 men, 25 women; mean age, 67.5 years; range, 45–83 years) with histologically confirmed surgically unresectable pancreatic adenocarcinoma underwent contrast-enhanced MDCT before systemic chemotherapy. Tumour contrast enhancement (CE) and ECV fraction were calculated using region-of-interest measurement within the pancreatic adenocarcinoma and aorta on unenhanced and equilibrium phase-enhanced CT. The effect on survival variables including age, sex, tumour location, tumour size, TNM stage, carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA), tumour CE and tumour ECV fraction was determined on univariate and multivariate analyses using Cox proportional hazards regression model.

Results

Median overall survival was 10.5 months. On univariate analysis, elevated serum CA19-9 (hazard ratio (HR), 1.00; p = 0.006) and CEA (HR, 1.02; p = 0.011) levels were found to be associated with a negative effect on overall survival. Increasing tumour CE (HR, 0.98; p < 0.001) and ECV fraction (HR, 0.97; p = 0.001) were associated with a positive effect. Multivariate analysis revealed that only tumour ECV fraction was an independent predictor of overall survival (HR, 0.97; p = 0.012).

Conclusions

ECV fraction with equilibrium contrast-enhanced MDCT could be a useful imaging biomarker for predicting patient survival after chemotherapy for unresectable pancreatic adenocarcinoma.

Key Points

• Tumour aggressiveness and response to therapy are influenced by the extravascular extracellular space.

• Extracellular volume (ECV) fraction can be quantified with equilibrium contrast-enhanced CT.

• Patients with higher tumour ECV fraction had better prognosis after chemotherapy.

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Titel: Extracellular volume fraction determined by equilibrium contrast-enhanced multidetector computed tomography as a prognostic factor in unresectable pancreatic adenocarcinoma treated with chemotherapy
verfasst von: Yoshihiko Fukukura
Yuichi Kumagae
Ryutaro Higashi
Hiroto Hakamada
Koji Takumi
Kosei Maemura
Michiyo Higashi
Kiyohisa Kamimura
Masanori Nakajo
Takashi Yoshiura
Publikationsdatum: 19.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5570-4

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Extracellular volume fraction determined by equilibrium contrast-enhanced multidetector computed tomography as a prognostic factor in unresectable pancreatic adenocarcinoma treated with chemotherapy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Objectives

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