Current status and guidelines for the assessment of tumour vascular support with dynamic contrast-enhanced computed tomography.

Journal article

Dynamic contrast-enhanced computed tomography (DCE-CT) assesses the vascular support of tumours through analysis of temporal changes in attenuation in blood vessels and tissues during a rapid series of images acquired with intravenous administration of iodinated contrast material. Commercial software for DCE-CT analysis allows pixel-by-pixel calculation of a range of validated physiological parameters and depiction as parametric maps. Clinical studies support the use of DCE-CT parameters as surrogates for physiological and molecular processes underlying tumour angiogenesis. DCE-CT has been used to provide biomarkers of drug action in early phase trials for the treatment of a range of cancers. DCE-CT can be appended to current imaging assessments of tumour response with the benefits of wide availability and low cost. This paper sets out guidelines for the use of DCE-CT in assessing tumour vascular support that were developed using a Delphi process. Recommendations encompass CT system requirements and quality assurance, radiation dosimetry, patient preparation, administration of contrast material, CT acquisition parameters, terminology and units, data processing and reporting. DCE-CT has reached technical maturity for use in therapeutic trials in oncology. The development of these consensus guidelines may promote broader application of DCE-CT for the evaluation of tumour vascularity. Key Points • DCE-CT can robustly assess tumour vascular support • DCE-CT has reached technical maturity for use in therapeutic trials in oncology • This paper presents consensus guidelines for using DCE-CT in assessing tumour vascularity.

Authors: Miles, K; Lee, T; Goh, V; Klotz, E; Cuenod, C

• Publication status: Published
• Journal: European radiology
• Volume: 22
• Issue: 7
• Pages: 1430-1441
• Publication date: 2012-07-01
• DOI: 10.1007/s00330-012-2379-4
• EISSN: 1432-1084
• ISSN: 0938-7994
• Language: English
• Keywords: Neoplasms; Tomography, X-Ray Computed; Contrast Media; Experimental Cancer Medicine Centre Imaging Network Group; Humans; Forecasting; Practice Guidelines as Topic; Neovascularization, Pathologic; Reference Standards