Jian-Wei Wang MD, Presenter: Nothing to Disclose

Ning Wu MD, Abstract Co-Author: Nothing to Disclose

Ying Song, Abstract Co-Author: Nothing to Disclose

To compare the parameters of advanced lung cancer (ALC) on perfusion CT (pCT) before and after chemotherapy and/or radiotherapy and to investigate whether pCT can monitor the therapeutic effect and predict the prognosis.

Thirty patients with ALC underwent pCT examinations using a GE LightSpeed Pro or GE LightSpeed Ultra multislice CT scanner before and after chemotherapy (2 cycles) and/or radiotherapy (DT50~60Gy). Contrast medium was injected at a rate of 4 ml/sec with a power injector. The scanning delay was 10 seconds and the scanning time was 50 seconds. Eight patients with apparent respiratory movement artifacts were excluded. In 22 patients, there were 11 squamous cell carcinomas, 8 adenocarcinomas and 3 small cell lung cancers. With the software “CT Perfusion 3”, the parameters of pCT including blood flow (BF), blood volume (BV), mean transit time (MTT) and capillary permeability surface area product (PS) were calculated and compared. All patients were followed up with routine enhanced CT during and after succeeding chemotherapy.

After treatment the largest dimension of the tumor significantly was decreased (62.4mm VS 49.7mm, t=4.997, P＜0.001). All the patients were divided two groups according to PS. In increased PS group (n=11), PS was significantly higher after than before treatment (18.14ml/min/100g VS 14.1ml/min/100g, t=4.281, p=0.002), without significant differences observed in BF, BV, and MTT. In decreased PS group (n=11), BV (4.2ml/100g VS 6.4ml/100g, t=2.796, p=0.019) and PS (10.3ml/min/100g VS 17.2ml/min/100g, t=4.896, p=0.001) was significantly lower after than before treatment, without significant differences observed in BF and MTT. In increased PS group, tumor recurrence and/or metastasis were found in 1-4 months, while in decreased PS group, the progress free survival period exceeded 3-10 months.

Among the pCT parameters, PS can be the most helpful for predicting the prognosis of ALC.

Perfusion CT can monitor the therapeutic effect and predict the prognosis of advanced lung cancer.

Wang, J, Wu, N, Song, Y, Perfusion CT of Advanced Lung Cancer: A Novel Chance for Evaluation of Therapeutic Response and Prognosis?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4431650.html