Table_2_Can angiogenesis inhibitor therapy cause changes in imaging features of hepatic hemangioma- Initial study.docx

BackgroundTo observe whether anti-angiogenesis therapy can induce changes in size and enhancement characteristics of hepatic hemangioma.
Method133 patients with hepatic hemangioma lesions were analyzed and classified into a Bevacizumab group (n=65) and the control group (n=68). The parameters (Volume, CT enhancement ratio, enhancement patterns) of pre-and post-treatment in the bevacizumab and control groups independently calculated and compared by two radiologists. Correlation among the systolic blood pressure, diastolic blood pressure, heart rate with the hemangioma volume was evaluated using Pearson’s correlation analysis.
ResultsThe hepatic hemangioma volume was significantly decreased after treatment in the Bevacizumab group (8.6 ± 18.7mL vs.7.3 ± 16.3mL, P<0.05), and there was no significant change in the control group (15.1 ± 19.8mL vs.15.4 ± 20.7mL, P = 0.504). A significant difference in enhancement patterns of hepatic hemangiomas was observed after treatment with Bevacizumab (P<0.01). There was no significant difference in arterial phase (AP)enhancement rate and arterial phase-portal venous phase (AP-PVP) enhancement ratios after treatment in the Bevacizumab and control groups (Ps>0.05).The Pearson correlation results showed that blood pressure, heart rate, and hemangioma volume were unrelated or weakly related before and after bevacizumab treatment under the control of factors including weight, contrast injection scheme and CT scanning scheme.
ConclusionsAnti-angiogenesis therapy can cause changes in enhancement pattern and volume of hepatic hemangioma. Radiologists should pay more attention to the reexamination of tumor patients treated with anti-angiogenesis therapy.

**背景** 本研究旨在观察抗血管生成治疗是否可诱导肝血管瘤的体积及强化特征发生改变。
**方法** 共纳入133例肝血管瘤患者，将其分为贝伐珠单抗（Bevacizumab）组（n=65）与对照组（n=68）。由两名放射科医师独立计算并比较贝伐珠单抗组与对照组治疗前后的相关参数[包括体积（Volume）、CT强化比值（CT enhancement ratio）及强化模式（enhancement patterns）]。采用Pearson相关分析评估收缩压、舒张压、心率与血管瘤体积之间的相关性。
**结果** 贝伐珠单抗组患者治疗后肝血管瘤体积较治疗前显著降低（8.6±18.7mL vs.7.3±16.3mL，P<0.05）；对照组患者治疗前后肝血管瘤体积无显著变化（15.1±19.8mL vs.15.4±20.7mL，P=0.504）。贝伐珠单抗治疗后，肝血管瘤的强化模式出现显著差异（P<0.01）。贝伐珠单抗组与对照组治疗后的动脉期（arterial phase, AP）强化率及动脉-门静脉期（arterial phase-portal venous phase, AP-PVP）强化比值均无显著差异（均P>0.05）。Pearson相关分析结果显示，在控制体重、对比剂注射方案及CT扫描方案等混杂因素后，贝伐珠单抗治疗前后的血压、心率与血管瘤体积均无相关性或仅存在弱相关性。
**结论** 抗血管生成治疗可引起肝血管瘤的强化模式及体积发生改变，放射科医师应加强对接受抗血管生成治疗患者的肿瘤复查工作。