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Early Changes in CT Perfusion Parameters: Primary Renal Carcinoma Versus Metastases After Treatment with Targeted Therapy

1
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
2
Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
3
Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA
4
Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA
5
Siemens Medical Solutions USA, Inc., Malvern, PA 19355, USA
6
Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
Cancers 2019, 11(5), 608; https://doi.org/10.3390/cancers11050608
Received: 25 February 2019 / Revised: 25 April 2019 / Accepted: 26 April 2019 / Published: 30 April 2019
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Abstract

Computed tomography (CT) perfusion is a novel imaging method to determine tumor perfusion using a low-dose CT technique to measure iodine concentration at multiple time points. We determined if early changes in perfusion differ between primary renal tumors and metastatic tumor sites in patients with renal cell carcinoma (RCC) receiving targeted anti-angiogenic therapy. A total of 10 patients with advanced RCC underwent a CT perfusion scan at treatment baseline and at one week after initiating treatment. Perfusion measurements included blood volume (BV), blood flow (BF), and flow extraction product (FEP) in a total of 13 lesions (six primary RCC tumors, seven RCC metastases). Changes between baseline and week 1 were compared between tumor locations: primary kidney tumors vs metastases. Metastatic lesions had a greater decrease in BF (average BF difference ± standard deviation (SD): −75.0 mL/100 mL/min ± 81) compared to primary kidney masses (−25.5 mL/100 mL/min ± 35). Metastatic tumors had a wider variation of change in BF, BV and FEP measures compared to primary renal tumors. Tumor diameters showed little change after one week, but early perfusion changes are evident, especially in metastatic lesions compared to primary lesions. Future studies are needed to determine if these changes can predict which patients are benefiting from targeted therapy. View Full-Text
Keywords: CT perfusion; renal cell carcinoma; metastases; targeted therapy; biomarker; therapeutic response CT perfusion; renal cell carcinoma; metastases; targeted therapy; biomarker; therapeutic response
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Fan, A.C.; Sundaram, V.; Kino, A.; Schmiedeskamp, H.; Metzner, T.J.; Kamaya, A. Early Changes in CT Perfusion Parameters: Primary Renal Carcinoma Versus Metastases After Treatment with Targeted Therapy. Cancers 2019, 11, 608.

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