{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:53:13Z","timestamp":1781859193258,"version":"3.54.5"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"John S. Dunn, Sr. Distinguished Chair in Diagnostic Imaging"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is currently no biomarker for progression-free survival (PFS) for patients undergoing treatment for metastatic renal cell carcinoma (RCC). The aim of our study was to evaluate computed tomography perfusion (CTp) blood flow as an early marker of PFS in patients with mRCC treated with targeted agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Associations between CTp blood flow and PFS were evaluated from prospective randomized evidence using univariable and multivariable Cox proportional hazards regression models with Harrell\u2019s concordance index (c-index) in patients with mRCC randomized to receive one of three targeted agents (everolimus, bevacizumab, or pazopanib). Analyses included baseline tumor CTp blood flow (BF\n                      <jats:sub>0<\/jats:sub>\n                      ) and changes in blood flow after 8 weeks of therapy (\u0394BF). Demographic and clinical prognostic factors (International mRCC Database Consortium [IMDC] risk score and ECOG performance) were included in the models as covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median PFS of the 55-patient cohort was 0.80 years (95% CI: 0.76-1.38 years), with no significant difference among the targeted agents. \u0394BF and BF\n                      <jats:sub>0<\/jats:sub>\n                      were significantly associated with PFS on univariable analysis (p=0.002 and p=0.013, respectively). Multivariable analyses incorporating all the above factors indicated that higher baseline BF\n                      <jats:sub>0<\/jats:sub>\n                      (&gt;166 mL\/min\/100g) and reduced \u0394BF (&lt;2.8%) were significantly associated with longer PFS (p&lt;0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      CTp blood flow may have utility as independent prognostic and early surrogate markers of PFS in mRCC patients treated with targeted agents, surpassing clinical markers like IMDC risk classification. Higher baseline perfusion (BF\n                      <jats:sub>0<\/jats:sub>\n                      ) delineates tumors responsive to targeted therapy, while reductions in perfusion (\u0394BF) just 8 weeks after starting treatment are associated with longer PFS. These findings arise from randomized evidence, warranting further evaluations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338261462414","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:12:34Z","timestamp":1781716354000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["CT Perfusion Blood Flow Provides an Early Response Marker for Progression-free Survival in a Prospective Randomized Clinical Trial of Metastatic Renal Cell Carcinoma"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9261-7021","authenticated-orcid":false,"given":"Chaan S.","family":"Ng","sequence":"first","affiliation":[{"name":"University of Texas M.D. Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wei","sequence":"additional","affiliation":[{"name":"Lerner Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam G.","family":"Chandler","sequence":"additional","affiliation":[{"name":"Global Scientific Collaborations, United Imaging"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Telperian, Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizar M.","family":"Tannir","sequence":"additional","affiliation":[{"name":"University of Texas M.D. Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Progression-Free Survival: What Does It Mean for Psychological Well-Being or Quality of Life?","author":"Gutman Si PM","year":"2013","unstructured":"Gutman Si PM, Grant MD, et al. 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