Development of the prediction system of the early response of theSorafenib for advanced hepatocellular carcinoma using contrast enhanced ultrasonography

目前还没有确定的方法来预测索拉非尼对晚期肝细胞癌的早期反应。据报道，有效病例的肿瘤血流量在索拉非尼开始后不久就下降了。超声造影（CEUS）是预测的，因为它提供了高的空间和时间分辨率。在索拉非尼给药前和给药后2周，使用CEUS进行时间强度曲线（TIC）分析。计算基于TIC分析的五个参数（峰强度，PI;至峰强度的时间，TTP;曲线下面积，AUC;上升时间，RT;斜率洗脱，WIS）。RT定义为从PI的5%过渡到95%所需的时间。我们比较了这些参数的变化（变化率：2周后值/给药前值）与临床参数，并指出上升时间是最重要的因素。RT的变化率大于1.23时，可检出有效病例（SD有效性的敏感性为100%，特异性为83%），并与总生存期有良好的相关性（r = 0.882）。

There is no established way to predict the early response of the Sorafenib for advanced hepatocellular carcinoma. It is reported that tumor blood flow of effective cases decreased soon after the start of Sorafenib. Contrast enhanced ultrasonography （CEUS）is expected for the predictor, because it provides a high spatial and time resolution. Time intensity curve (TIC) analyses were performed using CEUS before and 2 weeks after administration of Sorafenib. Five parameters based on TIC analysis (peak intensity, PI; time to peak intensity, TTP; area under the curve, AUC; rise time, RT; wash in slope, WIS) were calculated. RT was defined as the time taken to transition from5 to 95% of PI. We compared the changes of these parameters (Change Rate: post 2 weeks value / pre administration value) with clinical parameters, and indicated the rise time was the most important factor. If the change rate of RT was more than 1.23, we could detect effective cases (100% sensitivity and 83% specificty of the effectiveness of the SD more),and also indicated the good correlation with overall survival time (r = 0.882).