Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 14, 2012; 18(6): 541-545
Published online Feb 14, 2012. doi: 10.3748/wjg.v18.i6.541
Response evaluation of chemotherapy in metastatic colorectal cancer by contrast enhanced ultrasound
Ramin Schirin-Sokhan, Ron Winograd, Christoph Roderburg, Jhenee Bubenzer, Nicole Cabral do Ó, Dorothee Guggenberger, Hartmut Hecker, Christian Trautwein, Jens J W Tischendorf
Ramin Schirin-Sokhan, Ron Winograd, Christoph Roderburg, Jhenee Bubenzer, Nicole Cabral do Ó, Christian Trautwein, Jens J W Tischendorf, Department of Medicine III, University Hospital Aachen (RWTH), Aachen 52074, Germany
Dorothee Guggenberger, Oncological Medical Practice, Aachen 52064, Germany
Hartmut Hecker, Institute of Biometry, Medical School of Hannover, Hannover 30625, Germany
Author contributions: Tischendorf JJW, Winograd R and Trautwein C designed the study; Tischendorf JJW and Winograd R performed the ultrasound examinations; Schirin-Sokhan R, Hecker H and Roderburg C analyzed the data; Roderburg C, do Ó NC and Guggenberger D were responsible for recruitment and management of patients; Schirin-Sokhan R, Tischendorf JJW, Trautwein C and Roderburg C wrote the manuscript; all authors have approved the final draft of the manuscript.
Correspondence to: Jens J W Tischendorf, MD, Department of Medicine III, University Hospital Aachen (RWTH), Pauwels str. 30, Aachen 52074, Germany. jenstischendorf@freenet.de
Telephone: +49-241-8080860 Fax: +49-241-8082455
Received: August 10, 2010
Revised: October 26, 2010
Accepted: November 9, 2011
Published online: February 14, 2012
Abstract

AIM: To evaluate whether contrast enhanced ultrasound (CEUS) might also be used for response prediction and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.

METHODS: Thirty consecutive patients with non primary resectable liver metastases from colorectal cancer underwent CEUS before treatment (CEUS date 1) and before the second (CEUS date 2) and fourth (CEUS date 3) cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak (TTP) and RISE RATE]were correlated with radiological response.

RESULTS: For neoadjuvant purpose a reduction of tumour mass was required to assume clinical response. Based on these response criteria there was a significant (P < 0.001) correlation in TTP between metastases of responders (9.08 s) and non-responders (14.76 s) archived on CEUS date 1. By calculating a standardized quotient (metastases divided by normal liver tissue) we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting TTP was also significantly (P < 0.01) different between responders and non-responders. In contrast, Peak and Rise rate did not show any significant difference between responder and non-responder.

CONCLUSION: CEUS might serve as a surrogate marker to predict treatment response in patients with metastasized colorectal cancer who receive antiangiogenic therapy.

Keywords: Colorectal cancer; Liver metastases; Response prediction to chemotherapy; Contrast-enhanced ultrasound; Bevacizumab