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• W2014706145 abstract "PurposeTreatment with selectively applied arterial or venous 177Lu/90Y-DOTATOC plays an important role in the treatment of patients with hepatic metastases of neuroendocrine cancers. As functional imaging approaches with contrast-enhanced ultrasound (CEUS) that can detect changes in perfusion earlier than structural imaging methods, CEUS was performed to compare the effects of i.a. versus i.v. therapy on metastatic perfusion. The purpose of this study was to compare the effects of i.a. versus i.v. therapy on metastatic perfusion by performing contrast-enhanced ultrasound (CEUS).Material & MethodsNeuroendocrine liver metastases of 11 patients were treated with 177Lutetium-/ 90Yttrium- labeled DOTA(0)-Phe(1)-Tyr(3)-octreotide (DOTATOC), in 6 patients applied intra-arterial (i.a.) via hepatic artery and in 5 patients intravenously. Prior to and 3 months after therapy low-MI CEUS (FR = 19fps, mechanical index MI = 0.15; SonoVue® (Bracco S.P.A., Italy)) with HI VISION Preirus (Hitachi, Switzerland) was performed. Image intensity was measured in 19 metastatic lesions (11 i.a., 8 i.v.) and normal liver parenchyma as a function of time to analyze peak intensities and time to peak.ResultsPrior to therapeutic intervention CEUS presented in both study groups a pronounced enhancement in the liver metastases compared with the adjacent liver parenchyma (median TTP metastasis = 26.6 sec; median TTP liver parenchyma = 53.6sec). 3 months after intervention the i.a.-DOTATOC-treatment group presented a decline of contrast enhancement (20-25%) characteristic compared with only minor perfusion changes in patients undergoing i.v-DOTATOC-treatment.ConclusionUsing CEUS NET-patients with limited liver disease presented a higher decline in lesions perfusion after i.a.-DOTATOC therapy compared with i.v.-DOTATOC therapy which implies an improved therapeutic outcome with this selective intra-arterial treatment approach. This study also shows CEUS to be an easily applicable and valuable method to monitor the DOTATOC treatment approach in daily clinical practice. PurposeTreatment with selectively applied arterial or venous 177Lu/90Y-DOTATOC plays an important role in the treatment of patients with hepatic metastases of neuroendocrine cancers. As functional imaging approaches with contrast-enhanced ultrasound (CEUS) that can detect changes in perfusion earlier than structural imaging methods, CEUS was performed to compare the effects of i.a. versus i.v. therapy on metastatic perfusion. The purpose of this study was to compare the effects of i.a. versus i.v. therapy on metastatic perfusion by performing contrast-enhanced ultrasound (CEUS). Treatment with selectively applied arterial or venous 177Lu/90Y-DOTATOC plays an important role in the treatment of patients with hepatic metastases of neuroendocrine cancers. As functional imaging approaches with contrast-enhanced ultrasound (CEUS) that can detect changes in perfusion earlier than structural imaging methods, CEUS was performed to compare the effects of i.a. versus i.v. therapy on metastatic perfusion. The purpose of this study was to compare the effects of i.a. versus i.v. therapy on metastatic perfusion by performing contrast-enhanced ultrasound (CEUS). Material & MethodsNeuroendocrine liver metastases of 11 patients were treated with 177Lutetium-/ 90Yttrium- labeled DOTA(0)-Phe(1)-Tyr(3)-octreotide (DOTATOC), in 6 patients applied intra-arterial (i.a.) via hepatic artery and in 5 patients intravenously. Prior to and 3 months after therapy low-MI CEUS (FR = 19fps, mechanical index MI = 0.15; SonoVue® (Bracco S.P.A., Italy)) with HI VISION Preirus (Hitachi, Switzerland) was performed. Image intensity was measured in 19 metastatic lesions (11 i.a., 8 i.v.) and normal liver parenchyma as a function of time to analyze peak intensities and time to peak. Neuroendocrine liver metastases of 11 patients were treated with 177Lutetium-/ 90Yttrium- labeled DOTA(0)-Phe(1)-Tyr(3)-octreotide (DOTATOC), in 6 patients applied intra-arterial (i.a.) via hepatic artery and in 5 patients intravenously. Prior to and 3 months after therapy low-MI CEUS (FR = 19fps, mechanical index MI = 0.15; SonoVue® (Bracco S.P.A., Italy)) with HI VISION Preirus (Hitachi, Switzerland) was performed. Image intensity was measured in 19 metastatic lesions (11 i.a., 8 i.v.) and normal liver parenchyma as a function of time to analyze peak intensities and time to peak. ResultsPrior to therapeutic intervention CEUS presented in both study groups a pronounced enhancement in the liver metastases compared with the adjacent liver parenchyma (median TTP metastasis = 26.6 sec; median TTP liver parenchyma = 53.6sec). 3 months after intervention the i.a.-DOTATOC-treatment group presented a decline of contrast enhancement (20-25%) characteristic compared with only minor perfusion changes in patients undergoing i.v-DOTATOC-treatment. Prior to therapeutic intervention CEUS presented in both study groups a pronounced enhancement in the liver metastases compared with the adjacent liver parenchyma (median TTP metastasis = 26.6 sec; median TTP liver parenchyma = 53.6sec). 3 months after intervention the i.a.-DOTATOC-treatment group presented a decline of contrast enhancement (20-25%) characteristic compared with only minor perfusion changes in patients undergoing i.v-DOTATOC-treatment. ConclusionUsing CEUS NET-patients with limited liver disease presented a higher decline in lesions perfusion after i.a.-DOTATOC therapy compared with i.v.-DOTATOC therapy which implies an improved therapeutic outcome with this selective intra-arterial treatment approach. This study also shows CEUS to be an easily applicable and valuable method to monitor the DOTATOC treatment approach in daily clinical practice. Using CEUS NET-patients with limited liver disease presented a higher decline in lesions perfusion after i.a.-DOTATOC therapy compared with i.v.-DOTATOC therapy which implies an improved therapeutic outcome with this selective intra-arterial treatment approach. This study also shows CEUS to be an easily applicable and valuable method to monitor the DOTATOC treatment approach in daily clinical practice." @default.
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• W2014706145 title "Therapy Monitoring of i.a. versus i.v. 177Lu/90Y-DOTATOC Approach Using Contrast-Enhanced Ultrasound in Patient with Neuroendocrine Hepatic Metastases" @default.
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