Comparison of Computed Tomography and Pathologic Examination for Evaluation of Response of Primary Lung Cancer to Neoadjuvant Therapy

Seto, Mayumi; Kuriyama, Kinya; Kasugai, Tsutomu; Shoji, K.; Sawai, Yugo; Kuroda, C; Kodama, Ken; Doi, Osamu; Horai, Takeshi; Ando, Masashi

doi:10.1097/00005382-199901000-00007

Cited by 7 publications

(4 citation statements)

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“…It is possible that the observed shrinkage seen radiologically is related to retraction associated with fibrosis. This possibility has been raised previously by Seto et al (22). In their study, the shape of the residual tumor nodule was of im-port, and the development of a concave profile was included as a response criterion.…”

Section: Discussionmentioning

confidence: 96%

Histologic Assessment of Non–Small Cell Lung Carcinoma after Neoadjuvant Therapy

et al. 2003

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Chemotherapy or chemoradiation is often used in Stage IIIA non-small cell lung carcinoma before surgical resection (neoadjuvant therapy). In reviewing the histopathology of such tumors after resection, the recognition that the pathologic changes are related to prior therapy and the assessment of tumor regression are both of importance. To refine histologic parameters for tumor regression and describe patterns of tumor reaction to therapy, we identified 30 lobectomy or pneumonectomy specimens from 1996-2000 in which neoadjuvant therapy was received before surgical resection. Histologic patterns of treatment-induced tumor regression were analyzed semiquantitatively and included necrosis, fibrosis, mixed inflammatory infiltrate, foamy macrophages, and giant cells. To identify clinical and histologic parameters that correlate with treatment response, the 30 specimens were graded for tumor regression. No correlation was found between tumor regression and age, gender, or type of therapy (chemoradiation versus chemotherapy alone). Squamous cell carcinoma showed a significantly higher rate of response than adenocarcinoma (P =.04), with a significant number of adenocarcinomas in the nonresponder subgroup (P =.05). Tumor size reduction by radiologic assessment, when compared with histologic regression, did not reveal a statistically significant association. However, a positive correlation was found between extent of fibrosis and radiologic estimate of size reduction.

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Section: Discussionmentioning

confidence: 96%

Histologic Assessment of Non–Small Cell Lung Carcinoma after Neoadjuvant Therapy

et al. 2003

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“…Promising initial results concerning the use of contrast-enhanced CT for the characterization of small lesions have been reported [14]. Furthermore, the decrease in tumor contrast enhancement was shown to be an important criterion for therapy monitoring of bronchial carcinomas [15], complementing morphological criteria such as size and contours. A further development was the establishment of dynamic CT protocols, which enable the calculation of vascular parameters based on density-time curves [16,17].…”

Section: Introductionmentioning

confidence: 99%

Perfusion CT in patients with advanced bronchial carcinomas: a novel chance for characterization and treatment monitoring?

et al. 2004

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Advanced bronchial carcinomas by means of perfusion and peak enhancement using dynamic contrast-enhanced multislice CT are characterized. Twenty-four patients with advanced bronchial carcinoma were examined. During breathhold, after injection of a contrast-medium (CM), 25 scans were performed (1 scan/s) at a fixed table position. Density-time curves were evaluated from regions of interest of the whole tumor and high- and low-enhancing tumor areas. Perfusion and peak enhancement were calculated using the maximum-slope method of Miles and compared with size, localization (central or peripheral) and histology. Perfusion of large tumors (> 50 cm3) averaged over both the whole tumor (P = 0.001) and the highest enhancing area (P = 0.003) was significantly lower than that of smaller ones. Independent of size, central carcinomas had a significantly (P = 0.04) lower perfusion (mean 27.9 ml/min/100 g) than peripheral ones (mean 66.5 ml/min/100 g). In contrast, peak enhancement of central and peripheral carcinomas was not significantly different. Between non-small-cell lung cancers and small-cell lung cancers, no significant differences were observed in both parameters. In seven tumors, density increase after CM administration started earlier than in the aorta, indicating considerable blood supply from pulmonary vessels. Tumor perfusion was dependent on tumor size and localization, but not on histology. Furthermore, perfusion CT disclosed blood supply from both pulmonary and/or bronchial vessels in some tumors.

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“…CT criteria tend to underestimate the therapeutic effect demonstrated by pathological examination. A 50% size reduction, a change in tumour morphology (round versus irregular), and the disappearance of contrast enhancement after application of intravenous contrast were suggested as criteria for complete response [52]. Similar criteria can also be employed for MRI.…”

Section: Control After Treatment/tumour Recurrencementioning

confidence: 99%

“…Most important, however, is that all the additional information from the surrounding structures is available from the scans. Thus, there is information of the transmural extent of a tumour, the presence and location of lymph nodes and the location of suspicious areas within the lung parenchyma [52].…”

Section: Role Of Virtual Bronchoscopy and Computed Tomography Bronchomentioning

confidence: 99%

New imaging techniques in the treatment guidelines for lung cancer

Schaefer-Prokop¹,

Prokop²

2002

European Respiratory Journal

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New imaging techniques in the treatment guidelines for lung cancer. C. SchaeferProkop, M. Prokop. #ERS Journals Ltd 2002. ABSTRACT: Computed tomography (CT) remains the main imaging technique for the preoperative staging and post-therapeutic evaluation of bronchogenic carcinoma. Spiral CT has already overcome some of the problems encountered with central or more extensive tumours. Multislice CT offers further improvement and allows for scanning of the whole chest within a single breath-hold using a thin-section high-resolution technique. Problem-adapted sections in arbitrary directions become available and provide an excellent spatial resolution. One can expect improved accuracy for the evaluation of transfissural tumour growth, chest wall involvement, mediastinal infiltration and lymph node staging.Despite recent advances in magnetic resonance (MR) techniques for imaging the chest, the role of MR for staging of bronchogenic carcinoma remains limited. It offers advantages such as the assessment of chest-wall involvement or mediastinal involvement in patients in whom CT remains equivocal. Lymph-node-specific MR contrast agents offer new diagnostic potential for the assessment of metastatic disease.New techniques for the display of three-dimensional data sets include volume rendering and virtual bronchoscopy. These techniques represent new tools for the evaluation and demonstration of pathology within the central tracheobronchial tree. Their most important application is the guidance of bronchoscopic biopsies.The assessment of an indeterminate pulmonary nodule is frequently based on positron emission tomography imaging. As an alternative, nodule vascularization (contrast enhancement patterns on CT or magnetic resonance imaging (MRI)), calcifications (absorption characteristics at various X-ray energies on CT or dual energy radiography), and morphological features (high resolution imaging at CT) can be used as the basis for nodule differentiation. The dynamics of contrast enhancement in CT or MRI can also be used for the assessment of tumour viability after chemotherapy.Lung cancer screening programmes are still controversial. Low-dose computed tomography scanning and computed assisted detection algorithms based on chest radiographs or computed tomography scans form the technical basis for such projects.

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Comparison of Computed Tomography and Pathologic Examination for Evaluation of Response of Primary Lung Cancer to Neoadjuvant Therapy

Cited by 7 publications

References 0 publications

Histologic Assessment of Non–Small Cell Lung Carcinoma after Neoadjuvant Therapy

Histologic Assessment of Non–Small Cell Lung Carcinoma after Neoadjuvant Therapy

Perfusion CT in patients with advanced bronchial carcinomas: a novel chance for characterization and treatment monitoring?

New imaging techniques in the treatment guidelines for lung cancer

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