COMPUTED TOMOGRAPHY FOR EVALUATION OF TUMOUR ANGIOGENESIS: THE CONTRIBUTION OF ADVANCED QUANTITATIVES PARAMETERS.

Abstract: Objective. The aim of this study was to know if quantitative parameters of perfusion CT could predict the response of bevacizumab therapy on patients with brain cancer based on the RECIST.1.1 guidelines Material and methods. This study included 18 patients (11 men and 7 women; mean age, 47,11 years) with brain neoplasm who were undergoing bevacizumab treatment. by comparing baseline studies with the best response achieved after completion of bevacizumab treatment and chemotherapy, patients were divided into two groups according to RECIST (version 1.1) guidelines as follows; responders (CR or PR) and non-responders (SD or PD). CT perfusion parameters (blood flow, blood volume, mean transit time, and permeability) were performed on baseline and were correlated with tumor size at first, then a logistic regression model was used to evaluate predictive factors for a response to bevacizumab treatment. Results. There were early changes shown after only few week of bevacizumab therapy between the 9 responders group of patients and the remaining 9 no responders patients. Then clinical responders showed significantly higher blood flow (P=0.01) than non-responders.Blood flow, accuracy was 80.2% for detection of clinical responders when the cut-off point was set at 50 ml/100 g/min. Patients with high blood flow tumors (≥50 ml/100 g/min) survived significantly longer than those with low blood flow tumors (<50 ml/100 g/min) (p=0.007). Multivariate analysis identified blood flow as a significant independent prognostic factor (p = 0.006; risk ratio, 5.18; 95% IC, 0.48-22.68). Conclusion. This study has shown the possibility that Perfusion CT could predict the response to Bevacizumab treatment in brain tumor