CONTRAST-ENHANCED ULTRASOUND MONITORING OF PERFUSION CHANGES IN HEPATIC NEUROENDOCRINE METASTASES AFTER SYSTEMIC VERSUS SELECTIVE ARTERIAL 177LU/90Y-DOTATOC AND 213BI-DOTATOC RADIOPEPTIDE THERAPY

Radiopeptide therapy with beta emitter labeled 177Lu/90Y- DOTA(0)-Phe(1)-Tyr(3)-octreotide (DOTATOC) and more recently also alpha emitting 213Bi-DOTATOC are promising new treatments for neuroendocrine tumors. No early predictors for treatment response have been recognized and tumor-shrinkage after radiation therapy appears slowly. In some solid tumors a decline in tumor perfusion was found predictive of final treatment response but the gold standard multiphase computed tomography (CT) has a high radiation burden. Therefore we evaluated the ability of contrast-enhanced ultrasound (CEUS) to evaluate tumor perfusion as a response criteria. Materials and Methods: 14 patients with hepatic neuroendocrine tumor (NET) metastases were enrolled in the retrospective study. Eleven patients were treated with beta-emitting 177Lu/90Y-DOTATOC, either intravenous (i.v.) (n = 5) or intra-arterial (i.a.) (n = 6) and three patients received alpha-emitting 213Bi-DOTATOC (i.a.). CEUS and contrast-enhanced CT (CE-CT) were performed before and 3 months after treatment. Results: CE-CT and CEUS presented comparable results in the baseline study and in the assessment of perfusion changes due to the different treatment regimes. A therapy related decrease in tumor perfusion is an early predictor of longterm morphologic response. Conclusion: CEUS is a cheap, ubiquitary available and radiation free technique which showed comparable results for perfusion and diameter of liver metastases compared to CE-CT. Intensity reduction in an arterial phase CEUS can be seen as a positive sign indicating long term tumor response to treatment. Therefore CEUS may be considered as an imaging modality for monitoring early treatment after focal alpha and beta targeted therapy.

GIESEL Frederik;  FLECHSIG Paul;  KUDER T;  SCHWARTZ L;  WULFERT Sarah;  ZECHMANN Christian;  BRUCHERTSEIFER Frank;  HABERKORN Uwe;  KRATOCHWIL Clemens; 

2013-07-12

MORION LLC, 10A Bazhana ave., 02140, Kyiv-140, Ukraine

JRC82713

1812-9269,