Nunzia Tacelli MD, Presenter: Nothing to Disclose

Martine J. Remy-Jardin MD, PhD, Abstract Co-Author: Nothing to Disclose

Arnaud Scherpereel MD, Abstract Co-Author: Nothing to Disclose

Ernst Klotz PhD, Abstract Co-Author: Employee, Siemens Medical Solutions

Marie-Christine Copin MD, PhD, Abstract Co-Author: Nothing to Disclose

Jacques Remy MD, Abstract Co-Author: Nothing to Disclose

To evaluate tumoral perfusion with dual-source CT in patients with non-small cell lung carcinoma.

Nine consecutive patients with histologically proved nonsmall cell lung cancer (adenocarcinoma: n=7; squamous cell carcinoma: n=2) were prospectively enrolled in this study aimed at evaluating the technical conditions for CT analysis of tumoral perfusion. Dual-source 64-slice MDCT studies were obtained prior to antiangiogenic chemotherapy (Bevacizumab, Roche Laboratory; n=6) and lung surgery (n=3), the latter group enabling correlations between CT and histologic findings. Institutional review board approval and informed consent were obtained for this study.

Each perfusion study consisted of a noncontrast scan followed by 9 successive contrast-enhanced studies over the whole tumor, obtained every 6 seconds (80kV; 150 mAs), with administration of 108 mL of a 30% contrast agent at a decreasing rate over 90 seconds. Whole tumor coverage (mean height: 5.5 cm) was possible in all patients with generation of colored parametric maps of permeability and relative blood volume using Patlak analysis. Areas with high proportion of tumoral cells (tumor/stroma ratio: 90/10) showed the highest relative blood volume (mean value: 18.62 mL/100 mL) with a mean capillary permeability of 11.16 mL/100 mL/mn. The existence of intratumoral necrosis was depicted as areas of lower blood volume (mean value: 13.2 mL/100 mL) and lower permeability (mean value: 2.87 mL/100 mL/mn) compared to the cellular zones. The mean DLP value of perfusion studies was 628 mGy.cm (range: 591-787).

Whole tumor perfusion analysis is technically accessible to dual-source CT which could participate in monitoring of antiangiogenesis drugs.

Antiangiogenesis is an emerging strategy for lung cancer therapy, aimed at suppressing the tumour blood supply, an accessible in-vivo parameter with dynamic dual-source CT.

Tacelli, N, Remy-Jardin, M, Scherpereel, A, Klotz, E, Copin, M, Remy, J, Lung Tumoral Angiogenesis at Dual-Source CT: Technical Approach with Pathologic-CT Correlations.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011050.html