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Texture features of colorectal liver metastases on pretreatment contrast-enhanced CT may predict response and prognosis in patients treated with bevacizumab-containing chemotherapy: a pilot study including comparison with standard chemotherapy

  • ABDOMINAL RADIOLOGY
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Abstract

Purpose

Bevacizumab added to chemotherapy can improve survival in patients with metastatic colorectal cancer, but no predictive factors of efficacy are available in clinical practice. The aim of this study is to assess the predictive and prognostic value of texture analysis on pretreatment contrast-enhanced CT in patients affected by colorectal liver metastases.

Materials and methods

Forty-three patients with colorectal liver metastases were retrospectively included in the study: 23 treated with bevacizumab-containing chemotherapy (group A), and 20 with standard chemotherapy (group B). Target liver lesions were analyzed by texture analysis of pretreatment contrast-enhanced CT. Texture analysis produced the parameter uniformity, describing lesion heterogeneity. Radiological response was classified after 3 months according to RECIST-1.1. Overall survival (OS) and progression-free survival (PFS) were considered to be outcome indicators. Multivariable logistic regression and survival analysis were performed.

Results

Uniformity was lower in responders than in nonresponders (p < 0.001) in group A but not in group B. Lesion CT density was lower in nonresponders in both groups (p = 0.03 and 0.02, respectively). In group A, uniformity was independently correlated with radiological response (odds ratio = 20, p = 0.01), OS and PFS (relative risks 6.94 and 5.05, respectively; p = 0.005 and p = 0.004, respectively). In group B, no variables were correlated with radiological response, OS or PFS.

Conclusion

Texture analysis on contrast-enhanced CT stratified response probability and prognosis in patients with colorectal liver metastases treated with bevacizumab-containing therapy. This result was specific for the bevacizumab group.

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Abbreviations

CT:

Computed tomography

CECT:

Contrast-enhanced computed tomography

DCE-MRI:

Dynamic contrast-enhanced magnetic resonance imaging

OS:

Overall survival

PFS:

Progression-free survival

RECIST:

Response evaluation criteria in solid tumors

U :

Uniformity

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Authors and Affiliations

  1. Department of Radiology, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Marco Ravanelli, Giorgio Maria Agazzi, Elena Tononcelli, Roberto Maroldi & Davide Farina

  2. Department of Oncology, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Elisa Roca & Alfredo Berruti

  3. Department of Surgery, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Gianluca Baiocchi

  4. Department of Radiology, Mellino Mellini Hospital, Viale Mazzini 4, 25032, Chiari, Italy

    Paolo Cabassa

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Ravanelli, M., Agazzi, G.M., Tononcelli, E. et al. Texture features of colorectal liver metastases on pretreatment contrast-enhanced CT may predict response and prognosis in patients treated with bevacizumab-containing chemotherapy: a pilot study including comparison with standard chemotherapy. Radiol med 124, 877–886 (2019). https://doi.org/10.1007/s11547-019-01046-4

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