Saba N. Elias MSc, Presenter: Nothing to Disclose

William TC Yuh MD, Abstract Co-Author: Nothing to Disclose

Nina A. Mayr MD, Abstract Co-Author: Nothing to Disclose

Michael Vinzenz Knopp MD, PhD, Abstract Co-Author: Nothing to Disclose

Guang Jia PhD, Abstract Co-Author: Nothing to Disclose

John Christopher Grecula MD, Abstract Co-Author: Research Grant, Teva Pharmaceutical Industries Ltd Research Grant, Soligenix, Inc Stockholder, Pfizer Inc Stockholder, F. Hoffman-La Roche Ltd Stockholder, WebMD Health Corp Stockholder, Merck & Co, Inc Stockholder, Amgen Inc Stockholder, AstraZeneca PLC Stockholder, Baxter International Inc Stockholder, Bristol-Myers Squibb Company Stockholder, EntreMed, Inc Stockholder, Express Scripts Holding Company Stockholder, General Electric Company Stockholder, Eli Lilly and Company Stockholder, Medtronics

The relative signal intensity (rSI) of the dynamic contrast enhancement in tumor region (the ratio of the signal intensity post-contrast to signal intensity pre-contrast) and the systemic oxygen carrier, hemoglobin parameters (Hgb) have the potential on predicting the resectability and survival for lung cancer patients treated with preoperative neoadjuvant chemoradiotherapy (PNT). 

8 stage IIIA non-small cell lung cancer patients, were treated with PNT, underwent 3 serial dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) at pre-, early-and post-therapy. 3D tumor region of interest (ROI) drawn on DCE-MRI using MIMs software, the rSI for individual patients and the Hgb levels including pre-RT, nadir and mean Hgb were correlated with the tumor resectability (eligibility for tumor resection) and time at risk (months of no local recurrence from the time of PNT). Based on the clinical and pathological response 2 patient groups were identified: resectable tumor group (n=6) and non-resectable tumor group (n=2). 

The high nadir Hgb and low rSI at early therapy are predominant with longer period of no tumor recurrence (r=-0.43, r=0.67) respectively, however the rSI showed no correlation with the resectability for the 8 patients. The resectable tumor group rSI and pre-RT Hgb positively correlated (r=0.51) and rSI pre and early therapy were negatively correlated with time at risk (r= -0.67, r=-0.74). Nadir Hgb is significantly higher in the resectable tumor group than the non-resectable tumor group (P=0.04). No event of death for the resectable tumor group. Our study is limited by the number of patients studied.

Tumor resectability and survival outcome appear to be related to the level of DCE-MRI-detectable tumor perfusion characteristic and Hgb level in patients with lung cancer receiving PNT. DCE-MRI should be included in the diagnostic imaging studies during PNT.

Assessing the local tumor vascularity by DCE-MRI and the systemic Hgb level should be used to improve the management of the PNT and appropriate patient selection to improve therapy outcomes.

Elias, S, Yuh, W, Mayr, N, Knopp, M, Jia, G, Grecula, J, Hemoglobin and Tumor Perfusion Effects on Outcome Using Magnetic Resonance Imaging for Patients with Non-Small Cell Lung Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016046.html