Preoperative hepatic CT perfusion as an early predictor for the recurrence of esophageal squamous cell carcinoma: Initial clinical results

Fujishiro,Takeshi; Shuto,Kiyohiko; Hayano,Koichi; Satoh,Asami; Kono,Tsuguaki; Ohira,Gaku; Tohma,Takayuki; Gunji,Hisashi; Narushima,Kazuo; Tochigi,Toru; Hanaoka,Toshiharu; Ishii,Sayaka; Yanagawa,Noriyuki; Matsubara,Hisahiro

doi:10.3892/or.2014.2992

Preoperative hepatic CT perfusion as an early predictor for the recurrence of esophageal squamous cell carcinoma: Initial clinical results

Authors:
- Takeshi Fujishiro
- Kiyohiko Shuto
- Koichi Hayano
- Asami Satoh
- Tsuguaki Kono
- Gaku Ohira
- Takayuki Tohma
- Hisashi Gunji
- Kazuo Narushima
- Toru Tochigi
- Toshiharu Hanaoka
- Sayaka Ishii
- Noriyuki Yanagawa
- Hisahiro Matsubara
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Affiliations: Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chuo‑ku, Chiba, Chiba 260‑8677, Japan, Department of Surgery, Teikyo University Medical Center, Ichihara, Chiba 299-0111, Japan, Department of Radiological Technology, Chiba University Hospital, Chuo-ku, Chiba, Chiba 260-8677, Japan
Published online on: January 22, 2014 https://doi.org/10.3892/or.2014.2992
Pages: 1083-1088
Copyright: © Fujishiro et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

Reports suggest that hepatic blood flow may have an association with cancer progression. The aim of the present study was to evaluate whether the hepatic blood flow measured by CT perfusion (CTP) may identify patients at high‑risk for postoperative recurrence of esophageal squamous cell carcinoma (ESCC). Prior to surgery, hepatic CTP images were obtained using a 320-row area detector CT. The data were analyzed by a commercially available software based on the dual input maximum slope method, and arterial blood flow (AF, ml/min/100 ml tissue), portal blood flow (PF, ml/min/100 ml tissue) and perfusion index [PI (%) = AF/AF + PF x 100] were measured. These parameters were compared with the pathological stage and outcome of the ESCC patients. Forty-five patients with ESCC were eligible for this study. The median follow-up period was 17 months, and recurrences were observed in 9 patients (20%). The preoperative PI values of the 9 patients with recurrence were significantly higher than those of the 36 patients without recurrence (23.9 vs. 15.9, P=0.0022). Patients were categorized into the following two groups; high PI (>20) and low PI (<20). The recurrence-free survival of the low PI group was significantly better than that of the high PI group (P<0.0001). A multivariate analysis showed that a high PI was an independent risk factor for recurrence (odds ratio, 19.1; P=0.0369).Therefore, the preoperative PI of the liver may be a useful imaging biomarker for predicting the recurrence of patients with esophageal cancer.

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