Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy

作     者：Vincenza Granata Roberta Fusco Sergio Venanzio Setola Mauro Piccirillo Maddalena Leongito Raffaele Palaia Francesco Granata Secondo Lastoria Francesco Izzo Antonella Petrillo 

作者机构：Department of Diagnostic ImagingRadiant and Metabolic Therapy'Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli' Department of Surgical OncologyHepatobiliary Unit'Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli' Departement of Civil and Mechanical Engineering'University of Cassino and Southern Lazio'Viale dell’Università 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第26期

页      面：4767-4778页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Reversible electroporation Response assessment Positron emission tomography/computed tomography Pancreatic cancer Magnetic resonance imaging 

摘      要：To report early imaging assessment of ablated area post electrochemotherapy (ECT) in patients with locally advanced pancreatic cancer (LAPC). METHODSECT was performed in 19 LAPC patients enrolled in an approved ongoing clinical phase I/II study. Before and after ECT, 18 patients underwent computed tomography (CT) scan, 11 patients underwent morphological and functional magnetic resonance (MR) scan (dynamic contrast enhanced-MRI) calculating wash-in slope (WIS) and wash-out slope (WOS); diffusion weighted imaging calculating pseudo-diffusivity (Dp), perfusion fraction (fp) and tissue diffusivity (Dt); 10 patients underwent positron emission tomography (PET). Response evaluation criteria in solid tumour (RECIST) on MR and CT were used to assess tumour therapy response. Choi on CT, PET response criteria in solid tumors (PERCIST) on PET and functional parameters on MR were used to evaluate treatment response. RESULTSFor each patient no significant reduction was measurable by CT and MR using RECIST. According Choi criteria a partial response was obtained in 18/18 (100.0%) patients. According PERCIST criteria 6/10 (60.0%) patients showed a partial response, 3/10 (30.0%) stable disease and 1/10 (10.0%) progression disease. Moreover, using functional MR parameters, a significant reduction of viable tumour after ECT can be observed. According ΔWIS and ΔWOS 9/11 (81.8%) patients exhibited a partial response and 2/11 (18.2%) stable disease; 8/11 (72.7%) patients were considered in partial response by ΔDp evaluation and 3/11 (27.3%) in stable disease; according ΔDt 7/11 (63.6%) patients showed a partial response, 1/11 (9.1%) showed progression of disease and 3/11 (27.3%) were stable. Perfusion fraction fp showed a significant reduction after ECT only in four patients. No significant difference was observed after ECT in signal intensity of T1-weighted images and T2-weighted images, and in equilibrium-phase of contrast study, according to χ2 test was observed. A good c