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Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy

AIM: To report early imaging assessment of ablated area post electrochemotherapy (ECT) in patients with locally advanced pancreatic cancer (LAPC). METHODS: ECT was performed in 19 LAPC patients enrolled in an approved ongoing clinical phase I/II study. Before and after ECT, 18 patients underwent com...

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Autores principales: Granata, Vincenza, Fusco, Roberta, Setola, Sergio Venanzio, Piccirillo, Mauro, Leongito, Maddalena, Palaia, Raffaele, Granata, Francesco, Lastoria, Secondo, Izzo, Francesco, Petrillo, Antonella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514642/
https://www.ncbi.nlm.nih.gov/pubmed/28765698
http://dx.doi.org/10.3748/wjg.v23.i26.4767
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author Granata, Vincenza
Fusco, Roberta
Setola, Sergio Venanzio
Piccirillo, Mauro
Leongito, Maddalena
Palaia, Raffaele
Granata, Francesco
Lastoria, Secondo
Izzo, Francesco
Petrillo, Antonella
author_facet Granata, Vincenza
Fusco, Roberta
Setola, Sergio Venanzio
Piccirillo, Mauro
Leongito, Maddalena
Palaia, Raffaele
Granata, Francesco
Lastoria, Secondo
Izzo, Francesco
Petrillo, Antonella
author_sort Granata, Vincenza
collection PubMed
description AIM: To report early imaging assessment of ablated area post electrochemotherapy (ECT) in patients with locally advanced pancreatic cancer (LAPC). METHODS: ECT 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. RESULTS: For 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 χ(2) test was observed. A good correlation was reported between ΔHounsfield unit and Δmaximum standardized uptake value and between Δfp and ΔWOS, with a significant statistically difference (P < 0.05) using Spearman correlation coefficient. CONCLUSION: Perfusion and diffusion MR derived parameters, Choi, PERCIST criteria are more performant than morphological MR and CT criteria to assess ECT treatment response.
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spelling pubmed-55146422017-08-01 Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy Granata, Vincenza Fusco, Roberta Setola, Sergio Venanzio Piccirillo, Mauro Leongito, Maddalena Palaia, Raffaele Granata, Francesco Lastoria, Secondo Izzo, Francesco Petrillo, Antonella World J Gastroenterol Retrospective Study AIM: To report early imaging assessment of ablated area post electrochemotherapy (ECT) in patients with locally advanced pancreatic cancer (LAPC). METHODS: ECT 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. RESULTS: For 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 χ(2) test was observed. A good correlation was reported between ΔHounsfield unit and Δmaximum standardized uptake value and between Δfp and ΔWOS, with a significant statistically difference (P < 0.05) using Spearman correlation coefficient. CONCLUSION: Perfusion and diffusion MR derived parameters, Choi, PERCIST criteria are more performant than morphological MR and CT criteria to assess ECT treatment response. Baishideng Publishing Group Inc 2017-07-14 2017-07-14 /pmc/articles/PMC5514642/ /pubmed/28765698 http://dx.doi.org/10.3748/wjg.v23.i26.4767 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Granata, Vincenza
Fusco, Roberta
Setola, Sergio Venanzio
Piccirillo, Mauro
Leongito, Maddalena
Palaia, Raffaele
Granata, Francesco
Lastoria, Secondo
Izzo, Francesco
Petrillo, Antonella
Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title_full Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title_fullStr Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title_full_unstemmed Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title_short Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
title_sort early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514642/
https://www.ncbi.nlm.nih.gov/pubmed/28765698
http://dx.doi.org/10.3748/wjg.v23.i26.4767
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