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CT contrast predicts pancreatic cancer treatment response to verteporfin-based photodynamic therapy

Jermyn, M; Davis, SC; Dehghani, H; Huggett, MT; Hasan, T; Pereira, SP; Bown, SG; (2014) CT contrast predicts pancreatic cancer treatment response to verteporfin-based photodynamic therapy. Physics in Medicine and Biology , 59 (8) 1911 - 1921. 10.1088/0031-9155/59/8/1911. Green open access

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Abstract

The goal of this study was to determine dominant factors affecting treatment response in pancreatic cancer photodynamic therapy (PDT), based on clinically available information in the VERTPAC-01 trial. This trial investigated the safety and efficacy of verteporfin PDT in 15 patients with locally advanced pancreatic adenocarcinoma. CT scans before and after contrast enhancement from the 15 patients in the VERTPAC-01 trial were used to determine venous-phase blood contrast enhancement and this was correlated with necrotic volume determined from post-treatment CT scans, along with estimation of optical absorption in the pancreas for use in light modeling of the PDT treatment. Energy threshold contours yielded estimates for necrotic volume based on this light modeling. Both contrast-derived venous blood content and necrotic volume from light modeling yielded strong correlations with observed necrotic volume (R² = 0.85 and 0.91, respectively). These correlations were much stronger than those obtained by correlating energy delivered versus necrotic volume in the VERTPAC-01 study and in retrospective analysis from a prior clinical study. This demonstrates that contrast CT can provide key surrogate dosimetry information to assess treatment response. It also implies that light attenuation is likely the dominant factor in the VERTPAC treatment response, as opposed to other factors such as drug distribution. This study is the first to show that contrast CT provides needed surrogate dosimetry information to predict treatment response in a manner which uses standard-of-care clinical images, rather than invasive dosimetry methods.

Type: Article
Title: CT contrast predicts pancreatic cancer treatment response to verteporfin-based photodynamic therapy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1088/0031-9155/59/8/1911
Publisher version: http://dx.doi.org/10.1088/0031-9155/59/8/1911
Language: English
Additional information: Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence (http://creativecommons.org/licenses/by/3.0). Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Keywords: Adenocarcinoma, Humans, Organs at Risk, Pancreatic Neoplasms, Photochemotherapy, Porphyrins, Tomography, X-Ray Computed, Treatment Outcome
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/1424674
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