Predicting therapeutic efficacy and liver failure of molecular targeted therapy for hepatocellular carcinoma using CT with blood flow and tissue analysis.

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K08199
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Kobe University
• Principal Investigator: Murakami Takamichi 神戸大学, 医学研究科, 教授 (20252653)
• Co-Investigator(Kenkyū-buntansha): 鶴崎 正勝 近畿大学, 大学病院, 准教授 (00379356) ; 祖父江 慶太郎 神戸大学, 医学部附属病院, 准教授 (90622027)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 肝細胞癌 / 分子標的療法 / ヨードマップ / バイオマーカー / Dual-Energy CT

Outline of Final Research Achievements

The purpose of this study was to simultaneously evaluate the therapeutic efficacy of molecular targeted drugs for hepatocellular carcinoma and their effect on the background liver parenchyma using tissue material decomposition imaging obtained from Dual-Energy CT.
Dynamic contrast-enhanced CT imaging could be obtained from 39 patients according to the protocol, and the patients were enrolled for this study. Response rate and progression free survival (PFS) after lenvatinib treatment were compared for each treatment response criteria (1) mRECIST, 2) Choi criteria, and 3) blood flow evaluation using iodine quantitative imaging in Dual-Energy CT. Iodine quantitative iodine imaging was the most useful for predicting of PFS after lenvatinib treatment.

Free Research Field

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Academic Significance and Societal Importance of the Research Achievements

Dual-Energy CTで撮像を行ったヨード造影剤を用いたダイナミック造影CTの各時相データから得られる血流・組織解析法を用いることで、肝細胞癌に対する分子標的薬治療前後の3次元的な腫瘍内血流ならびに背景肝実質の性状を正確に評価でき、従来のSingle-Energy CTで行われるCT値で造影効果や背景肝実質を評価する方法と比較して抗腫瘍効果の正確な判定ならびに肝予備能悪化の予測が非侵襲的かつ同時に可能となり、患者の身体的・経済的負担が軽減できるとともに不要な治療の継続や肝不全の回避につながり生命予後の改善に寄与できると考えた。