Purpose
INTRODUCTION An increasing number of vascular-modulating drugs are used in the treatment of cancers, which in turn increase demand for noninvasive methods of assessing tumor vascularity in vivo. Perfusion CT is a new technology that allows measurement of tumor vascular physiology . Apart from being noninvasive and fast, it can be repeated at regular intervals to assess tumor response to antiangiogenic therapy.AIMS AND OBJECTIVES To evaluate lung perfusion studies in the differentiation of cavitary mass.To assess the predictive value of perfusion parameters within the cavity...
Methods and Materials
42patients (33 men, 9 women; mean age, 60 years; age range, 40–83 years) with cavitary lung masses who underwent dynamic chest CT scans with lung perfusion CT protocol between January 2008 and January 2009 were examined retrospectively.All patients’ diagnoses were histopathologically proved.4 post chemotherapy cases excluded from the study.CTP parameters of the 42 lesions was compared with the normal lung parenchyma.CT perfusion was performed with a 64 –slice MDCT. Tumor was localized and a 4-cm tumor region was selected independently for the dynamic study ....
Results
patients ranged in age from 28 to 84 years(mean age, 58.7 years); 33 were men and 9 were women.Of these patients 8 had pyogenic cavities, 6 had tuberculous cavities, and the remaining 28 had malignant cavities.Mean values for BF, PEI, TTP, BV and MTT of the 28 malignant cavities were 64.5 +/- 11.2 ml/min, 49.5 +/- 17.2 HU, 18.5 +/- 7 s, 28.6 +/- 9.4 ml/100 g and 5.0 +/- 2.5s respectively.Except for MTT and TTP, which were statistically lower in malignant cavities (p <0.05),...
Conclusion
In conclusion, lung perfusion CT is a promising and feasible method for distinguishing benign from malignant cavity.Thus, it could be very beneficial in allowing for noninvasive diagnoses of cavitary mass and in planning the proper therapeutic planning.One of the important applications of this technique is the indication of a highly perfused area, which could be used to guide biopsy to the site of the most active tumour, reducing the chance of sampling error.In future, pre and post treatment tumor response can be monitored by using...
References
Giatromanolaki A, Koukourakis M, O’Byrne K, et al. Prognostic value of angiogenesis in operable non–small cell lung cancer. J Pathol 1996; 179:80-88.Miles KA, Griffiths MR, Keith CJ. Blood flow-metabolic relationships are dependent on tumor size in non-small cell lung cancer: a study using quantitative contrast-enhanced computer tomography and positron emission tomography. Eur J Nucl Med Imag 2006;33:22—8.Miles KA, Griffiths MR. Perfusion CT: a worthwhile enhancement? Br J Radiol 2003;76:220—31.Quan-Sing et al Lung Cancer Perfusion at Multi–Detector Row CT Radiology May 2006;239:547-553.Tateishi U, Nishihara H, Watanabe...
Personal Information
Author details:Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]