Dual-energy computed tomography for the assessment of early treatment effects of regorafenib in a preclinical tumor model: comparison with dynamic contrast-enhanced CT and conventional contrast-enhanced single-energy CT
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The potential diagnostic value of dual-energy computed tomography (DE-CT) compared to dynamic contrast-enhanced CT (DCE-CT) and conventional contrast-enhanced CT (CE-CT) in the assessment of early regorafenib treatment effects was evaluated in a preclinical setting.
A rat GS9L glioma model was examined with contrast-enhanced dynamic DE-CT measurements (80 kV/140 kV) for 4 min before and on days 1 and 4 after the start of daily regorafenib or placebo treatment. Tumour time-density curves (0-240 s, 80 kV), DE-CT (60 s) derived iodine maps and the DCE-CT (0-30 s, 80 kV) based parameters blood flow (BF), blood volume (BV) and permeability (PMB) were calculated and compared to conventional CE-CT (60 s, 80 kV).
The regorafenib group showed a marked decrease in the tumour time-density curve, a significantly lower iodine concentration and a significantly lower PMB on day 1 and 4 compared to baseline, which was not observed for the placebo group. CE-CT showed a significant decrease in tumour density on day 4 but not on day 1. The DE-CT-derived iodine concentrations correlated with PMB and BV but not with BF.
DE-CT allows early treatment monitoring, which correlates with DCE-CT. Superior performance was observed compared to single-energy CE-CT.
• Regorafenib treatment response was evaluated by CT in a rat tumour model.
• Dual-energy contrast-enhanced CT allows early treatment monitoring of targeted anti-tumour therapies.
• Dual-energy CT showed higher diagnostic potential than conventional contrast enhanced single-energy CT.
• Dual-energy CT showed diagnostic potential comparable to dynamic contrast-enhanced CT.
• Dual-energy CT is a promising method for efficient clinical treatment response evaluation.
KeywordsDual-energy computed tomography Contrast media Drug monitoring Regorafenib Anti-angiogenesis effect
The scientific guarantors of this publication are Gesine Knobloch and Gregor Jost, and both contributed equally to this study. The authors of this manuscript declare relationships with the following companies: Jost and Pietsch (Employee Bayer AG) and Huppertz (Employee Siemens AG).
The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Approval from the institutional animal care committee was obtained. Methodology: prospective, randomised controlled trial, performed at one institution.
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