Dynamic contrast-enhanced CT for the assessment of tumour response in malignant pleural mesothelioma: a pilot study
The aim of this pilot study was to investigate the utility of haemodynamic parameters derived from dynamic contrast-enhanced computed tomography (DCE-CT) scans in the assessment of tumour response to treatment in malignant pleural mesothelioma (MPM) patients.
The patient cohort included nine patients undergoing chemotherapy and five patients on observation. Each patient underwent two DCE-CT scans separated by approximately 2 months. The DCE-CT parameters of tissue blood flow (BF) and tissue blood volume (BV) were obtained within the dynamically imaged tumour. Mean relative changes in tumour DCE-CT parameters between scans were compared between the on-treatment and on-observation cohorts. DCE-CT parameter changes were correlated with relative change in tumour bulk evaluated according to the modified RECIST protocol.
Differing trends in relative change in BF and BV between scans were found between the two patient groups (p = 0.19 and p = 0.06 for BF and BV, respectively). No significant rank correlations were found when comparing relative changes in DCE-CT parameters with relative change in tumour bulk.
Differing trends in the relative change of BF and BV between patients on treatment and on observation indicate the potential of DCE-CT for the assessment of pharmacodynamic endpoints with respect to treatment in MPM. A future study with a larger patient cohort and unified treatment regimens should be undertaken to confirm the results of this pilot study.
• CT-derived haemodynamic parameters show differing trends between malignant pleural mesothelioma patients on treatment and patients off treatment
• Changes in haemodynamic parameters do not correlate with changes in tumour bulk as measured according to the modified RECIST protocol
• Differing trends across the two patient groups indicate the potential sensitivity of DCE-CT to assess pharmacodynamic endpoints in the treatment of MPM
KeywordsMesothelioma Multidetector computed tomography Response Evaluation Criteria in Solid Tumours Haemodynamics Perfusion imaging
Tissue blood flow
Tissue blood volume
Dynamic contrast-enhanced computed tomography
Malignant pleural mesothelioma
Response Evaluation Criteria in Solid Tumours
The authors would like to thank The University of Chicago’s Human Imaging Research Office (HIRO) for their assistance in coordinating the imaging aspects of this study and providing anonymised, compliant images for evaluation. The HIRO is supported in part by pilot research funding provided by the Virginia and D. K. Ludwig Fund for Cancer Research via the Imaging Research Institute in the Biological Sciences Division of the University of Chicago and through Cancer Center Support Grant number P30 CA014599 from the University of Chicago Comprehensive Cancer Center.
This study has received funding by the Hodges Society of the Department of Radiology at The University of Chicago and the Plooy Family and the Kazan McClain Partners’ Foundation, Inc.
Compliance with ethical standards
The scientific guarantor of this publication is Samuel G. Armato III, Ph.D., at the University of Chicago.
Conflict of interest
The authors of this manuscript declare relationships with the following companies: SGA receives royalties and licensing fees for computer-aided diagnostic technology through the University of Chicago. SGA is a consultant for Aduro Biotech, Inc.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional review board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
- 21.Christner JA, Kofler JM, McCollough CH (2010) Estimating effective dose for CT using dose–length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection Publication 103 or dual-energy scanning. Am J Roentgenol 194:881–889CrossRefGoogle Scholar
- 26.Hodges JL Jr, Lehmann EL (1963) Estimates of location based on rank tests. Ann Math Stat 598–611Google Scholar
- 28.Abdi H (2007) The Bonferonni and Šidák corrections for multiple comparisons. Enc Meas Stat 3:103–107Google Scholar