Value of DCE-MRI and FDG-PET/CT in the prediction of response to preoperative chemotherapy with bevacizumab for colorectal liver metastases

摘要: Colorectal cancer (CRC) is the second most common cause of in women and third men, representing fourth death after lung, stomach liver cancer. It more developed than developing countries. The initial distant metastatic site about 30% patients (Leporrier et al, 2006). Complete surgical resection offers best chance for cure with metastases, 5-year survival rates ranging from 21 to 33% (Scheele Altendorf-Hofmann, 1999; Choti 2002; Nordlinger 2008). Over last decades, combined chemotherapy regimens including irinotecan oxaliplatin have markedly improved response rate survival. addition biological agents (anti-EGFR antibodies anti-VEGF example bevacizumab) conventional increases overall colorectal (mCRC). Biological also improve subsequently enlarge proportion referred surgery by rendering unresectable metastases resectable (Cunningham 2004; Hurwitz Gruenberger 2008; Saltz Chaudhury 2010). With use perioperative strategies such as two-stage hepatectomy, may increase 31 50% (Togo 2005; Chun 2007; Pamecha Wicherts 2008). Response bevacizumab, which exerts an anti-angiogenic action, be inadequately assessed traditional size-based radiologic criteria, Response Evaluation Criteria In Solid Tumours (RECIST) (Therasse 2000; Eisenhauer 2009). They were designed assessing tumour volume reduction following cytotoxic only provide information on anatomy. Therefore, introduction targeted therapies requires new tools monitoring therapeutic effects focusing physiology (Rehman Jayson, Shih Lindley, 2006; de Langen 2011; Mulder 2011). Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) attractive modality evaluating rapid acquisition images before intravenous contrast media administration can used assess changes vasculature. thus provides a dimension assessment physiology. utility DCE-MRI has already been explored animal experiments (Ceelen Bauerle 2010; Ellingsen Casneuf 2011) well several clinical trials (Vriens 2009; Hirashima O'Connor 2011), it was suggested that useful pharmacodynamic biomarker (Morgan 2003; Liu Wedam Jarnagin 2009). Molecular fluorodeoxyglucose positron emission tomography computed (FDG-PET/CT) management CRC. Fluorodeoxyglucose role staging locally recurrent residual masses treatment. Nowadays, there growing interest FDG-PET/CT prediction treatment, metabolic alterations cells occur size. Several studies indicated possible evaluation treatment (Langenhoff Donckier Dimitrakopoulou-Strauss Guillem Cascini Geus-Oei 2008). Both these specifically adequate anti-angiogenetic bevacizumab. are expensive early response, allowing us stop therapy nonresponders, needed. Moreover, exists need predict will benefit chemotherapy. The goal this study prospectively evaluate long-term outcome potentially treated bevacizumab surgery. addition, histological parameters analysed specimens their value prognosis evaluated.