Prediction of Therapeutic Effect of Chemotherapy for NSCLC Using                    Dual-Input Perfusion CT Analysis: Comparison among Bevacizumab Treatment,                    Two-Agent Platinum-based Therapy without Bevacizumab, and Other Non-Bevacizumab                    Treatment Groups

Yabuuchi, Hidetake; Kawanami, Satoshi; Iwama, Eiji; Okamoto, Isamu; Kamitani, Takeshi; Sagiyama, Koji; Yamasaki, Yoshio; Honda, Hiroshi

doi:10.1148/radiol.2017162204

Cited by 14 publications

(11 citation statements)

References 26 publications

(27 reference statements)

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“…Spectral CT imaging provides various quantitative parameters and tools for lesion analysis, which may support qualitative analysis and treatment assessment of lesions (21,22). CT perfusion imaging can reflect the structural and functional differences between normal vessels and neovascularization in different tissues (23)(24)(25). However, CT perfusion imaging is associated with some limitations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Spectral and Perfusion Computed Tomography Imaging in the Differential Diagnosis of Peripheral Lung Cancer and Focal Organizing Pneumonia

et al. 2021

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ObjectiveTo investigate the spectral and perfusion computed tomography (CT) findings of peripheral lung cancer (PLC) and focal organizing pneumonia (FOP) and to compare the accuracy of spectral and perfusion CT imaging in distinguishing PLC from FOP.Materials and MethodsPatients who were suspected of having lung tumor and underwent “one-stop” chest spectral and perfusion CT, with their diagnosis confirmed pathologically, were prospectively enrolled from September 2020 to March 2021. Patients who were suspected of having lung tumor and underwent “one-stop” chest spectral and perfusion CT, with their diagnosis confirmed pathologically, were prospectively enrolled from September 2020 to March 2021. A total of 57 and 35 patients with PLC and FOP were included, respectively. Spectral parameters (CT40keV, CT70keV, CT100keV, iodine concentration [IC], water concentration [WC], and effective atomic number [Zeff]) of the lesions in the arterial and venous phases were measured in both groups. The slope of the spectral curve (K70keV) was calculated. The perfusion parameters, including blood volume (BV), blood flow (BF), mean transit time (MTT), and permeability surface (PS), were measured simultaneously in both groups. The differences in the spectral and perfusion parameters between the groups were examined. Receiver operating characteristic (ROC) curves were generated to calculate and compare the area under the curve (AUC), sensitivity, specificity, and accuracy of both sets of parameters in both groups.ResultsThe patients’ demographic and clinical characteristics were similar in both groups (P > 0.05). In the arterial and venous phases, the values of spectral parameters (CT40keV, CT70keV, spectral curve K70keV, IC, and Zeff) were greater in the FOP group than in the PLC group (P < 0.05). In contrast, the values of the perfusion parameters (BV, BF, MTT, and PS) were smaller in the FOP group than in the PLC group (P < 0.05). The AUC of the combination of the spectral parameters was larger than that of the perfusion parameters. For the former imaging method, the AUC, sensitivity, and specificity were 0.89 (95% confidence interval [CI]: 0.82–0.96), 0.86, and 0.83, respectively. For the latter imaging method, the AUC, sensitivity, and specificity were 0.80 (95% CI: 0.70–0.90), 0.71, and 0.83, respectively. There was no significant difference in AUC between the two imaging methods (P > 0.05).ConclusionSpectral and perfusion CT both has the capability to differentiate PLC and FOP. However, compared to perfusion CT imaging, spectral CT imaging has higher diagnostic efficiency in distinguishing them.

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Section: Discussionmentioning

confidence: 99%

Comparison of Spectral and Perfusion Computed Tomography Imaging in the Differential Diagnosis of Peripheral Lung Cancer and Focal Organizing Pneumonia

et al. 2021

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“…However, the results in the literature are rather conflicting. This is most likely due to the notable variability in treatments (different chemotherapy combinations, targeted therapies, and/or radiotherapy), in the time points used for imaging acquisition, and in the criteria used for response evaluation, which is mostly limited to the same single lesion from which the perfusion parameters were measured [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ] ( Table S2 ).…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study to Evaluate Early Predictive Value of Thorax Perfusion-CT in Advanced NSCLC

Aya

Benegas

Viñolas

et al. 2021

Cancers

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Background: The role of perfusion computed tomography (pCT) in detecting changes in tumor vascularization as part of a response to antiangiogenic therapy in non-small cell lung cancer (NSCLC) remains unclear. Methods: In this prospective pilot study (IMPACT trial, NCT02316327), we aimed to determine the ability of pCT to detect early changes in blood flow (BF), blood volume (BV), and permeability (PMB), and to explore whether these changes could predict the response at day +42 in patients with advanced, treatment-naive, non-squamous NSCLC treated with cisplatin and gemcitabine plus bevacizumab. Results: All of the perfusion parameters showed a consistent decrease during the course of treatment. The BV difference between baseline and early assessment was significant (p = 0.013), whereas all perfusion parameters showed significant differences between baseline and day +42 (p = 0.003, p = 0.049, and p = 0.002, respectively). Among the 16 patients evaluable for efficacy, a significant decline in BV at day +7 from baseline was observed in tumors with no response (p = 0.0418). Conclusions: Our results confirm that pCT can capture early changes in tumor vasculature. A substantial early decline of BV from baseline might identify tumors less likely responsive to antiangiogenic-drugs.

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“…It is conceivable that lung cancer, which relies on dual bronchial and pulmonary arterial blood supply [56,57], may be similarly affected by such changes, particularly in an SBRT population typified by chronic illness and comorbidity [58]. Retrospective evidence in the setting of advanced nonsmall cell lung cancer suggests that increased tumor perfusion on CT is associated with improved response to chemotherapy and chemoradiotherapy [59,60]. Thus, decreased serum bicarbonate may be the product of ventilatory, perfusional, or other systemic changes that are associated with decreased radiotherapeutic response of NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Pre-treatment serum bicarbonate predicts for primary tumor control after stereotactic body radiation therapy in patients with localized non-small cell lung cancer

Sebastian

Driscoll

et al. 2019

Radiotherapy and Oncology

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Background: Tumor aggressiveness and hypoxia are linked to acidosis in the tumor microenvironment (TME). We hypothesized that low pre-treatment serum bicarbonate, potentially correlating with an acidic and hypoxic TME, predicts for poor outcomes after stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC). Methods:We included patients with localized NSCLC treated to a biologically effective dose (BED) ≥ 100 Gy, with available pre-treatment bicarbonate values within 3 months of treatment. We used receiver operating characteristic analysis to determine the bicarbonate concentration optimally predicting for primary tumor recurrence, and evaluated its association with recurrence and survival. We validated our findings in an independent cohort of patients from three collaborating institutions.Results: A total of 110 patients and 114 tumors were included in the training cohort, with median follow-up of 15.0 months. Bicarbonate < 26 mEq/L was associated with primary tumor recurrence on univariate (HR = 5.92; 95% CI 1.69-24.88; p = 0.005) and multivariate analysis (HR = 5.48; 95% CI 1.37-25.19; p = 0.020). The validation cohort consisted of 195 patients and

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Prediction of Therapeutic Effect of Chemotherapy for NSCLC Using Dual-Input Perfusion CT Analysis: Comparison among Bevacizumab Treatment, Two-Agent Platinum-based Therapy without Bevacizumab, and Other Non-Bevacizumab Treatment Groups

Abstract: To determine whether dual-input perfusion computed tomography (CT) can predict therapeutic response and prognosis in patients who underwent chemotherapy for non-small cell lung cancer (NSCLC).

Cited by 14 publications

References 26 publications

Comparison of Spectral and Perfusion Computed Tomography Imaging in the Differential Diagnosis of Peripheral Lung Cancer and Focal Organizing Pneumonia

Comparison of Spectral and Perfusion Computed Tomography Imaging in the Differential Diagnosis of Peripheral Lung Cancer and Focal Organizing Pneumonia

A Pilot Study to Evaluate Early Predictive Value of Thorax Perfusion-CT in Advanced NSCLC

Pre-treatment serum bicarbonate predicts for primary tumor control after stereotactic body radiation therapy in patients with localized non-small cell lung cancer

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