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ORIGINAL ARTICLE
Year : 2018  |  Volume : 14  |  Issue : 7  |  Page : 1556-1562

Liver computed tomographic perfusion for monitoring the early therapeutic response to sorafenib in advanced hepatocellular carcinoma patients


1 Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai 200032, China
2 Department of Radiology, Zhongshan Hospital of Fudan University; Department of Medical Imaging, Shanghai Medical College, Fudan University; Shanghai Institute of Medical Imaging, Shanghai 200032, China
3 Department of Liver Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
4 Department of Pathology, Zhongshan Hospital of Fudan University, Shanghai 200032, China

Correspondence Address:
Dong Wu
Department of Radiology, Zhongshan Hospital of Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrt.JCRT_979_17

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Background: Sorafenib is the only approved treatment for advanced hepatocellular carcinoma (HCC). However, it is a diagnostic challenge to monitor its early treatment effects on HCC. Purpose: The purpose of this study is to investigate the effects of sorafenib on HCC with liver computed tomography perfusion (CTP) and investigate its efficacy in assessing the early therapeutic response of sorafenib for advanced HCC. Materials and Methods: A total of 23 HCC patients were included in this study. Sorafenib was continuously administered orally at a dose of 400 mg twice daily. CTP was performed before and after 2 weeks of sorafenib treatment, and the changes of perfusion parameters were obtained with a 320-detector row CT scanner including hepatic artery flow (HAF), portal vein flow (PVF), and perfusion index. The modified response evaluation criteria in solid tumor (mRECIST) assessment were performed after two and 4 months of treatment. Results: According to the result of mRECIST, three patients (13%) showed partial response, eight patients (34.7%) showed stable disease (SD) and 12 patients (52.2%) showed progressive disease (PD) after 2 months of treatment, whereas 10 patients (43.5%) showed SD and 13 (56.5%) showed PD after 4 months of treatment. The group that responded to sorafenib showed a significantly decreased HAF value after 2 months compared to that of baseline, whereas nonresponder group showed a significant increase in HAF. The patients with PD showed significantly higher HAF compared to that of SD patients. Conclusions: CTP might be applied to evaluate therapeutic effects of sorafenib in advanced HCC, where HAF could potentially serve as imaging biomarkers for monitoring early therapeutic effects after treatment.


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