Clinical application of dynamic contrast enhanced ultrasound in monitoring the treatment response of chemoradiotherapy of pancreatic ductal adenocarcinoma
Affiliations: [a] Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| [b] Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China
| [c]
Shanghai Institute of Medical Imaging, Shanghai, China
Correspondence:
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Corresponding authors: Prof. Dr. Yi Dong, MD, PhD and Prof. Dr. Wen-Ping Wang, MD, PhD, Department of Ultrasound, Zhongshan Hospital, Fudan University, 180th Fenglin Road, Shanghai 200032, China. Tel.: +86 021 64041990; Fax: +86 021 64220319; E-mail: [email protected]. (Yi Dong) and Tel.: +86 021 64041990; Fax: +86 21 64220319; E-mail: [email protected]. (Wen-Ping Wang)
Note: [1] Qi Zhang and Lili Wu contributed equally as co-first authors to this paper.
Note: [2] Yi Dong and Wen-Ping Wang contributed equally as co-corresponding authors to this paper.
Abstract: OBJECTIVES:To investigate the value of dynamic contrast enhanced ultrasound (D-CEUS) in monitoring the chemoradiotherapy (CRT) therapeutic response of local advanced pancreatic ductal adenocarcinoma (LAPC). PATIENTS AND METHODS:From October 2017 to December 2018, 11 patients diagnosed as LAPC were included (7 men, 4 women; mean age: 61.1±8.6 years). The algorithm of CRT was as following: the radiotherapy dose was 50.4 Gy/28Fx with S-1 40 mg bid orally taken in radiotherapy day. Conventional ultrasound scan and CEUS were performed before and 4 weeks after CRT. All ultrasound examinations were performed by an ACUSON Oxana 2 ultrasound equipment (Siemens Medical Solutions, Germany) with a C 6-1 convex array transducer (1–6 MHz). Time intensity curves (TICs) were generated in the region of interests (ROIs) both in LAPC lesions and in its surrounding pancreas parenchyma by SonoLiver software (TOMTEC Imaging Systems). Quantitative perfusion parameters including maximum intensity (MI), rise time (RT), mean transit time (mTT) and time to peak (TTP) were analyzed and compared before and after CRT. RESULTS:No significant difference could be found by conventional B mode ultrasound scan after CRT. TICs of CEUS showed lower ascending and descending slopes rate after CRT. Among all perfusion quantitative parameters, MI decreased significantly after CRT (42.1±18.8% vs 27.8±17.2%, P < 0.05). CONCLUSIONS:Depending on its unique advantages as non-radiation, effective and convenient, D-CEUS analysis and quantitative parameters, particularly MI, has potential application value in following up of the CRT treatment response in LAPC patients.
