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Quelle place pour l’imagerie fonctionnelle en 2012 dans le suivi des traitements antiantigiogéniques ?

Functional imaging assessment of anti-angiogenic therapies: what is its place in 2012?

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Oncologie

Abstract

Functional imaging, which allows the study of the Brownian motion of water molecules (DW-MRI) or the microcirculation (DCE-MRI, functional CT or contrast-enhanced ultrasound), is now available in clinical practice to assess treatment efficacy in oncologic patients. These techniques are mainly used in animal model studies and in phase I clinical trials. Indeed, they lead to a better understanding of the cascade of events that occur on the vascular bed and in the tissue structure during targeted or non-targeted therapies. DW-MRI provides indirect information about the structure and particularly the cellularity of the tissue. Perfusion imaging gives information about local blood volume, blood flow, and about the transfers between intra- and extravascular spaces. However, the spread of functional imaging in everyday oncology practice as support of a treatment decision still needs additional validation and standardization efforts.

Résumé

Les techniques d’imagerie fonctionnelle, qui étudient les mouvements de l’eau extracellulaire (IRM de diffusion) ou la microcirculation (imagerie fonctionnelle de la microcirculation en IRM, TDM ou échographie), sont actuellement disponibles pour le suivi sous traitement des patients en oncologie. Elles sont pour le moment plutôt employées en précliniques sur des modèles animaux et lors des études de phase I, car elles permettent de faire progresser notre compréhension des phénomènes microcirculatoires et structuraux qui se produisent au cours d’une thérapie ciblée ou non. L’IRM de diffusion permet d’obtenir des informations sur l’architecture et en particulier la cellularité tissulaire. L’imagerie de perfusion renseigne sur les volumes sanguins locaux, sur les vitesses circulatoires et sur l’importance des échanges entre les compartiments intra- et extravasculaires. Leur emploi à large échelle dans une optique d’aide à la décision d’arrêt ou de poursuite d’un traitement nécessite encore plusieurs étapes de validation et de standardisation.

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  1. Service de radiologie, groupe hospitalier Pitié-Salpêtrière, APHP, UPMC, F-75013, Paris, France

    O. Lucidarme

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Lucidarme, O. Quelle place pour l’imagerie fonctionnelle en 2012 dans le suivi des traitements antiantigiogéniques ?. Oncologie 14, 248–256 (2012). https://doi.org/10.1007/s10269-012-2146-9

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  • DOI: https://doi.org/10.1007/s10269-012-2146-9

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