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Graf M, Ziegelmayer S, Reischl S, Teumer Y, Gassert FT, Marka AW, Raffler P, Bachmann J, Makowski M, Reim D, Lohöfer F, Burian E, Braren R. CT-Derived Quantitative Image Features Predict Neoadjuvant Treatment Response in Adenocarcinoma of the Gastroesophageal Junction with High Accuracy. Cancers (Basel) 2025; 17:216. [PMID: 39857998 PMCID: PMC11763438 DOI: 10.3390/cancers17020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 01/08/2025] [Accepted: 01/09/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND The purpose of this retrospective study was to evaluate the value of contrast-enhanced computed tomography (CE-CT) image features at baseline and after neoadjuvant chemotherapy in predicting histopathological response in patients with adenocarcinoma of the gastroesophageal junction (GEJ). METHODS A total of 105 patients with a diagnosis of adenocarcinoma of the GEJ were examined by CE-CT at baseline and preoperatively after neoadjuvant chemotherapy. All patients underwent surgical resection. Histopathological parameters and tumor regression grading according to Becker et al. were collected in 93 patients. Line profiles of the primary tumor area in baseline and preoperative CE-CT were generated using ImageJ. Maximum tumor density and tumor-to-wall density delta were calculated and correlated with the histopathological tumor response. In addition, tumor response was assessed according to standard RECIST measurements in all patients and by endoscopy in 72 patients. RESULTS Baseline and change in baseline to preoperative CE-CT parameters showed no significant differences between responders (Becker grade 1a, 1b) and non-responders (Becker grade 2, 3). After neoadjuvant therapy, responders and non-responders showed significant differences in maximum density and tumor-to-wall density delta values. Line profile measurements showed excellent inter-rater agreement. In comparison, neither RECIST nor endoscopy showed significant differences between these groups. CONCLUSIONS Posttreatment CE-CT can predict histopathological therapy response to neoadjuvant treatment in adenocarcinoma of GEJ patients with high accuracy and thus may improve patient management.
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Affiliation(s)
- Markus Graf
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Sebastian Ziegelmayer
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Stefan Reischl
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Yannick Teumer
- Department of Medicine II, Ulm University Medical Center, 89081 Ulm, Germany;
| | - Florian T. Gassert
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Alexander W. Marka
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Philipp Raffler
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Jeannine Bachmann
- Department of Surgery, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (J.B.); (D.R.)
| | - Marcus Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Daniel Reim
- Department of Surgery, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (J.B.); (D.R.)
| | - Fabian Lohöfer
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
| | - Egon Burian
- Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, 8006 Zurich, Switzerland;
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
| | - Rickmer Braren
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (S.Z.); (S.R.); (F.T.G.); (A.W.M.); (P.R.); (M.M.); (F.L.); (R.B.)
- German Cancer Consortium (DKTK, Partner Site Munich), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Gray S, Santamaria N, Olsson-Brown A. Immune checkpoint inhibitor-induced cholangitis-a three-case series. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2024; 5:818-825. [PMID: 39280251 PMCID: PMC11390286 DOI: 10.37349/etat.2024.00250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 06/06/2024] [Indexed: 09/18/2024] Open
Abstract
Over the last decade, immune checkpoint inhibitors (ICIs) have dramatically improved the systemic treatment of multiple solid tumour types. However, they can also induce inflammation in an extensive range of normal tissues types. The entity of ICI-induced cholangitis is rare and has not been widely described. We present three cases of ICI-induced cholangitis which illustrate the difficulties associated with its diagnosis and management. We also present associated radiological findings that include intrahepatic duct abnormalities consistent with sclerosing cholangitis-progressive worsening of intrahepatic duct dilatation and pericholecystic haziness suggesting inflammation characteristic of this rare, but severe, toxicity.
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Affiliation(s)
- Simon Gray
- Department of Medical Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
- Department of Molecular and Clinical Cancer Medicine, Faculty of Health and Life Sciences, University of Liverpool, L69 7BE Liverpool, UK
| | - Nuria Santamaria
- Department of Radiology, Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
| | - Anna Olsson-Brown
- Department of Medical Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
- Department of Molecular and Clinical Cancer Medicine, Faculty of Health and Life Sciences, University of Liverpool, L69 7BE Liverpool, UK
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Special Issue on Clinical Applications of Magnetic Resonance Imaging in Genitourinary Cancers. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the field of oncologic imaging, MRI represents one of the most powerful diagnostic tools at physicians’ disposal, with its superb contrast resolution and its capability to assess both the morphological and functional features of neoplasms [...]
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Wei HP, Mao J, Hu ZL. Successful apatinib treatment for advanced clear cell renal carcinoma as a first-line palliative treatment: A case report. World J Clin Cases 2022; 10:3593-3600. [PMID: 35582051 PMCID: PMC9048545 DOI: 10.12998/wjcc.v10.i11.3593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/26/2022] [Accepted: 02/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Apatinib is an orally bioavailable small-molecule receptor tyrosine kinase inhibitor. In December 2014, the China Food and Drug Administration made it the first anti-angiogenic therapy to be approved for treating metastatic gastric cancer. It was specifically designated as a third-line or later treatment for metastatic gastric cancer.
CASE SUMMARY Here, we present a case of advanced renal cell carcinoma (RCC) with multiple metastases (Stage IV) in a 48-year-old male with an extremely poor general status (Karnofsky 30%). He was initially given pazopanib as a targeted therapeutic. However, he experienced severe adverse reactions within two weeks, including grade IV oral mucositis. We, thus, tried switching his targeted treatment to an apatinib dose of 250 mg once daily since April 2018. The patient demonstrated striking benefits from this switch to the apatinib palliative treatment. Nearly one month later, his pain and other associated symptoms were alleviated. The patient was able to move freely and had an excellent general status (Karnofsky 90%). His progress has been followed up with regularly, allowing for a documented progression-free survival interval of approximately 32 mo.
CONCLUSION This case suggests that, like other multi-target drugs, apatinib may be a useful first-line therapeutic drug for advanced RCC. It may be a particularly helpful curative option when patients are found to be intolerant of other targeted drugs.
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Affiliation(s)
- Hang-Ping Wei
- Department of Medical Oncology, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang 322100, Zhejiang Province, China
| | - Jie Mao
- Department of Radiology, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang 322100, Zhejiang Province, China
| | - Zu-Liang Hu
- Department of Medical Oncology, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang 322100, Zhejiang Province, China
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