Jung Won Moon, Presenter: Nothing to Disclose

Chin A Yi MD, PhD, Abstract Co-Author: Nothing to Disclose

Kyung Soo Lee MD, Abstract Co-Author: Nothing to Disclose

O Jung Kwon, Abstract Co-Author: Nothing to Disclose

Keunchil Park, Abstract Co-Author: Nothing to Disclose

Joungho Han, Abstract Co-Author: Nothing to Disclose

Myung Jin Chung MD, Abstract Co-Author: Nothing to Disclose

Tae Sung Kim MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Microvessel density (tumor angiogenesis) is significant prognostic indicator and the extent of enhancement of non-small cell lung cancer (NSCLC) is positively correlated with the extent of microvessel density. We retrospectively analyzed the relationship of the extent of enhancement of NSCLC with overall and relapse-free survival following curative surgery for T1 lung cancer.

131 patients (76 men, 57 women; mean age, 58 years) with T1 NSCLC underwent dynamic CT (unenhanced images and series of dynamic enhanced images covering primary lung cancer at 30, 60, 90 and 120 seconds and 5 and 15 minutes) after intravenous contrast medium injection (120mL) and followed by curative surgery. The size, peak attenuation, net enhancement, and washout were measured on dynamic CT. Pathologic subtype was divided into adenocarcinoma and others. These features were correlated with overall and relapse-free survival by univariate and multivariate analyses (median follow-up, 42 months). Kaplan-Meier survival curves were compared between the high risk group and the low risk group at different levels of cut-off values of peak attenuation and net enhancement using log-rank test for the determination of cut-off value indicating significant drop of survival.

Forty-six (35%, 46/133) patients were relapsed on follow up. None of the size (hazard ratio (HR) = 0.991 and 1.031), pathologic type (HR = 1.517 and 1.411 for adenocarcinoma), peak attenuation (HR = 1.006 and 1.003), net enhancement (HR = 0.990 and 1.004) and washout (HR = 1.003 and 1.006) were significant risk factors for overall and relapse-free survival in univariate analyses (P >.05). Multivariate analyses also did not show significant risk factor (P >.05). Log rank test determined minimum p-values at 100 HU for peak and 60 HU for net enhancement as possible cut-off values for deepening survival curves and 100 HU for peak and 70 HU for net enhancement for relapse-free survival. But, no significant difference was observed for the survival curves at these cut-off values (P >.05).

Contrary to our expectation, peak and net enhancement at dynamic CT can not be a significant prognostic indicator in patients with T1 NSCLC following curative surgery.

The relation of the peak and net enhancement on dynamic CT with underlying tumor angiogenesis may not be large enough to reflect the increased risk of tumor angiogenesis in early-stage NSCLC.

Moon, J, Yi, C, Lee, K, Kwon, O, Park, K, Han, J, Chung, M, Kim, T, et al, 0, Preoperative Dynamic Enhanced Multidetector Row CT: Can It Be a Prognostic Indicator in Early Stage Non-small Cell Lung Cancer?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8014187.html