Document Detail

Advanced solid tumors treated with cediranib: comparison of dynamic contrast-enhanced MR imaging and CT as markers of vascular activity.
MedLine Citation:
PMID:  22891356     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess baseline reproducibility and compare performance of dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging versus DCE computed tomographic (CT) measures of early vascular response in the same patients treated with cediranib (30 or 45 mg daily).
MATERIALS AND METHODS: After institutional review board approval, written informed consent was obtained from 29 patients with advanced solid tumors who had lesions 3 cm or larger and in whom simultaneous imaging of an adjacent artery was possible. Two baseline DCE MR acquisitions and two baseline DCE CT acquisitions 7 days or fewer apart (within 14 days of starting treatment) and two posttreatment acquisitions with each modality at day 7 and 28 (±3 days) were obtained. Nonmodeled and modeled parameters were derived (measured arterial input function [AIF] for CT, population-based AIF for MR imaging; temporal sampling rate of 0.5 second for CT, 3-6 seconds for MR imaging). Baseline variability was assessed by using intra- and intersubject analysis of variance and Bland-Altman analysis; a paired t test assessed change from baseline to after treatment.
RESULTS: The most reproducible parameters were DCE MR imaging enhancement fraction (baseline intrapatient coefficient of variation [CV]=8.6%), volume transfer constant (CV=13.9%), and integrated area under the contrast agent uptake curve at 60 seconds (CV=15.5%) and DCE CT positive enhancement integral (CV=16.0%). Blood plasma volume was highly variable and the only parameter with CV greater than 30%. Average reductions (percentage change) from baseline were consistently observed for all DCE MR imaging and DCE CT parameters at day 7 and 28 for both starting-dose groups (45 and 30 mg), except for DCE CT mean transit time. Percentage change from baseline for parameters reflecting blood flow and permeability were comparable, and reductions from baseline at day 7 were maintained at day 28.
CONCLUSION: DCE MR imaging and DCE CT can depict vascular response to antiangiogenic agents with response evident at day 7. Improved reproducibility with MR imaging favors its use in trials with small patient numbers.
Christina Messiou; Matthew Orton; Joo Ern Ang; David J Collins; Veronica A Morgan; Dorothy Mears; Isabel Castellano; Dionysis Papadatos-Pastos; Andre Brunetto; Nina Tunariu; Helen Mann; Jean Tessier; Helen Young; Dana Ghiorghiu; Sarah Marley; Stan B Kaye; Johann S deBono; Martin O Leach; Nandita M deSouza
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-13
Journal Detail:
Title:  Radiology     Volume:  265     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-24     Completed Date:  2013-01-03     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  426-36     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2012
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MeSH Terms
Angiogenesis Inhibitors / administration & dosage
Antineoplastic Agents / administration & dosage
Contrast Media
Dose-Response Relationship, Drug
Gadolinium DTPA / diagnostic use
Iohexol / diagnostic use
Magnetic Resonance Imaging / methods*
Middle Aged
Neoplasms / complications,  diagnosis*,  drug therapy*
Neovascularization, Pathologic / diagnosis*,  drug therapy*,  etiology
Quinazolines / administration & dosage*
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Treatment Outcome
Grant Support
C1060/A10334//Department of Health; G0701533//Medical Research Council; //Cancer Research UK; //Medical Research Council
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antineoplastic Agents; 0/Contrast Media; 0/Quinazolines; 4419T9MX03/Iohexol; K2I13DR72L/Gadolinium DTPA; NQU9IPY4K9/cediranib

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