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Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy

Authors
 Sung Ho Hwang  ;  Mi Ri Yoo  ;  Chul Hwan Park  ;  Tae Joo Jeon  ;  Sang Jin Kim  ;  Tae Hoon Kim 
Citation
 European Radiology, Vol.23(6) : 1573-1581, 2013 
Journal Title
 European Radiology 
ISSN
 0938-7994 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging* ; Carcinoma, Non-Small-Cell Lung/therapy ; Chemoradiotherapy/methods ; Contrast Media/pharmacology* ; Drug Therapy/methods ; Female ; Fluorodeoxyglucose F18/pharmacology ; Humans ; Image Processing, Computer-Assisted ; Lung Neoplasms/diagnosis* ; Lung Neoplasms/diagnostic imaging* ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Odds Ratio ; Positron-Emission Tomography/methods ; Prospective Studies ; Sensitivity and Specificity ; Time Factors ; Tomography, X-Ray Computed/methods* ; Treatment Outcome
Keywords
Non-small cell lung cancer ; Computed tomography ; 18F-fluoro-deoxyglucose positron emission tomography ; Enhancement pattern ; Standardized uptake value
Abstract
OBJECTIVES: To compare tumour enhancement patterns measured using dynamic contrast-enhanced (DCE)-CT with tumour metabolism measured using positron emission tomography (PET)-CT in patients with non-small cell lung cancer (NSCLC) and stable disease after chemotherapy or chemoradiotherapy. METHODS: After treatment, 75 NSCLC tumours in 65 patients who had stable disease on DCE-CT according to Response Evaluation Criteria in Solid Tumour (RECIST) were evaluated using PET-CT. On DCE-CT, relative enhancement ratios (RER) of tumour at 30, 60, 90, 120 s and 5 min after injection of contrast material were measured. Metabolic responses of tumours were classified into two groups according to the maximum standardized uptake value (SUVmax) by PET-CT: complete metabolic response (CR) with an SUVmax of less than 2.5, and noncomplete metabolic response (NR) with an SUVmax of at least 2.5. RESULTS: Using the optimal RER₆₀ cutoff value of 43.7 % to predict NR of tumour gave 95.7 % sensitivity, 64.2 % specificity, and 82.1 % positive and 95.0 % negative predictive values. After adjusting for tumour size, the odds ratio for NR in tumour with an RER60 of at least 43.7 % was 70.85 (95 % CI = 7.95-630.91; P < 0.05). CONCLUSIONS: Even when disease was stable according to RECIST, DCE-CT predicted hypermetabolic status of residual tumour in patients with NSCLC after treatment. KEY POINTS : • Dynamic contrast-enhanced CT (DCE-CT) can provide useful metabolic information about non-small cell lung cancer. • NSCLC lesions, even grossly stable after treatment, show various metabolic states. • DCE-CT enhancement patterns correlate with tumour metabolic status as shown by PET. • DCE-CT helps to assess hypermetabolic NSCLC as stable disease after treatment.
Full Text
http://link.springer.com/article/10.1007/s00330-012-2755-0
DOI
10.1007/s00330-012-2755-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Jin(김상진)
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Jeon, Tae Joo(전태주) ORCID logo https://orcid.org/0000-0002-7574-6734
Hwang, Sung Ho(황성호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87280
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