Abstract:

Aim: was to develop a score scale for the prediction of complete tumor necrosis to assess the potential effectiveness of radiofrequency ablation of colorectal cancer focals in liver, on the base of results of the use of radiological diagnostic methods.

Materials and methods: a comparative analysis of results of radiological diagnosis of solitary colorectal cancer metastases in liver was carried out in 51 patients, depending on their characteristics before and at different times after radiofrequency ablation (RFA).

The survey and interventions were carried out between 2014 and 2020 in accordance with standards of treatment approved in Belarus. Ultrasound and CT with bolus contrast enhancement were used as radiation diagnostic methods.

The initial morphological parameters of tumor focals were evaluated according to results of ultrasound examination. CT with bolus contrast was used to control the effectiveness of RFA (determining the frequency of complete tumor necrosis): on the day of discharge of patients from the hospital, after 1 month, and then - once every 3 months (quarterly) during the year.

Results: the dependence of the effectiveness of RFA (frequency of complete tumor necrosis) on initial characteristics of solitary focals of colorectal cancer in liver was revealed and confirmed by results of a comparative statistical analysis. On the basis of obtained data, a score scale for predicting the effectiveness of RFA was developed and validated. The sensitivity of the new technique was 80,0%; specificity - 82,9%.

Conclusion: for the first time, a scale for the prediction of complete tumor necrosis was developed to assess the potential effectiveness of radiofrequency ablation of solitary colorectal cancer focals in liver.

ROC-analysis of the scale validation results showed that the sensitivity and specificity of the model are sufficient for its application in practice: 80,0% and 82,93%, respectively.

References

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Abstract:

Purpose. Was to estimate the efficiency of MRI in specified diagnostics of colorectal cancer (CRC) local spread (distal parts of a rectum anc anal channel cancer). To develop diagnostic criteria of tumor local spread, lymph nodes' lesion and involvement of surrounding tissues and organs.

Materials and methods. Research included 25 patients with verified CRC. For specificied diagnostics of cancer local spread patients underwent MRI before and after paramagnetic contrast enhanced. All researches were spent on magnetic-resonance tomography platform GE Signa 1,5T.

Results. We have revealed and studied all the types of CRC local spread in connection with TNM classification due to MRI.

Conclusion. MRI gives the full information about tumor local spread. Application of paramagnetics gives additional information about expression degree of invasive process. MRI is effective technique as a diagnostic procedure during preoperative preparation.

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Abstract:

Background: this report describes our experience in CT-perfision (CTP) use for evaluation of rectal tumors neoadjuvant treatment effectiveness. Tumor response for combination of radiation and chemotherapy was related to CTP pattern.

Material and Methods: five patients aged 48 - 62 years with rectal adenocarcinomas histologically verified (4 patients of T3N0M0 stage and 1 patient T3N1 M0) were included. All of them had combined neoadjuvant radiotherapy and chemotherapy followed by surgery. Before and after neoadjuvant treatment virtual colonoscopy (VCS) with CTP was done in all the cases prior to surgical intervention.

Results and Conclusions: comparing perfusion pattern in rectal tumor and in normal tissue, we saw blood volume (BV) to be significantly increased, and mean transit time (MTT) moderately shortened in tumor tissues. Tumor tissue BV in neoadjuvant therapy responders was much higher than in those for whom the therapy appeared to be ineffective. On combination of radio- and chemotherapy, BVin tumor tissue significantly decreased, and MTT elongated.

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Abstract:

Introduction. The RECIST criteria, which are routinely used to assess results of treatment of colorectal liver metastases with the transarterial chemoembolization (TACE), are not based on the identification of the tumor necrosis, and therefore their objectivity is questionable.

Aim: was to develop method of assessment of tumor response, based on tumor necrosis after TACE.

Materials and Methods: own technique of assessment of the tumor responce, based on measurement of computed tomography density of metastatic lesions in native and post-contrast phases, before and after treatment («criteria of N») is offered. Data of 13 patients who have undergone treatment of metastases of a colorectal cancer in a liver by the TACE method with application of microspheres «DC Beads» and irinotekan are analysed. Comparison of results of treatment according to criteria of RECIST and «criteria of N» is carried out.

Results: аccording to RECIST criteria stable disease was achieved in 11(85%) patients, and 2(15%) patients had a partial response. Neither complete response, nor progressive disease was observed. Later, progressive disease occurred in 11 patients. The period from the start of treatment until progression fixation averaged 7-9 months. According to the «N criteria», 4 (31%) patients had a complete response, 6(46%) patients had a partial response: and in 3(23%) patients we detected stable disease. Then progressive disease was monitored in all 13 patients, the period from the start of treatment until the progression fixation averaged 3-6 months. In 4 cases the progression process according to «N criteria» was detected earlier than by RECIST criteria.

Conclusion: The usе of RECIST criteria may underestimate the objective response to treatment, and as a result - the progression of disease later on. The proposed method of tumor response assessment, based on the analysis of tumor necrosis («the N criteria»), proves to be more productive. 

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