Abhishek Mahajan MD, Presenter: Nothing to Disclose

Sripathi Smiti MBBS, DNB, Abstract Co-Author: Nothing to Disclose

V R K RAO MD, Abstract Co-Author: Nothing to Disclose

To prospectively investigate the feasibility and value of 64-detector row CT first-pass perfusion imaging in the evaluation of tumor perfusion in patients with lung carcinoma. To analyse the variation of CT perfusion (CTP) parameters in different histological types, sizes and presence of tumor necrosis in patients with lung carcinoma.

52 histopathologically proven lung malignancies were examined with 64-detector row CT. First-pass CTP study comprised of 20 repeated spiral acquisitions over 60 s following 80-ml intravenous bolus of contrast medium at 5 ml/sec. 32 benign lesions served as controls. In all the 84 lesions, CTP parameters were compared with normal lung parenchyma. Perfusion (BF), Peak Enhancement Intensity (PEI), Time To Peak (TTP), Blood Volume (BV) and Mean Transit Time (MTT) were calculated and statistically compared among different histological types, size and necrosis. Ratios of the CTP values between the tumor and the healthy parenchyma and between the benign lesion and the healthy parenchyma were also calculated.

Mean values for BF, PEI, TTP, BV and MTT of the 52 malignant lesions were 49.6 +/- 17.8 ml/min, 58.1 +/- 26.4 HU, 31 +/- 12 s, 28.2 +/- 16.4 ml/100 g and 18.3 +/- 4.2s respectively. Except for MTT, which was statistically (p 0.05). MTT and TTP values in benign lesions were comparable to that of normal parenchyma. The ratios of BF, BV, MTT and TTP parameters between malignant and benign lesions were statistically significant (p 0.05). BF, PEI, MTT and BV of stage T2 tumors were significantly lower than those of stage T1 tumors (all p 0.05). Considerable differences with higher BF, PEI and BV were noted in tumor ≤3.0 cm than in tumor > 3.0 cm (p < 0.05). The necrotic tumors showed significantly lower BF, PEI, MTT and BV compared with non-necrotic tumors (p < 0.05), but TTP longer than those of non-necrotic part of the necrotic tumors (p < 0.05).

First-pass perfusion imaging using 64-detector row CT is feasible noninvasive method for assessment of tumour perfusion and can be indicators for evaluating tumor necrosis and angiogenesis. Hence Lung Perfusion CT confers a worthwhile enhancement to the conventional CT for evaluating of lung cancer.

An increasing number of vascular-modulating drugs are used in the treatment of cancers, which in turn increase demand for noninvasive methods of assessing tumor vascularity in vivo.

Mahajan, A, Smiti, S, RAO, V, Qualitative and Quantitative Assessment of First-Pass Perfusion Parameters of Lung Cancer Perfusion Using 64-Detector Row CT.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010930.html