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 OBJECTIVESTo prospectively investigate the feasibility and value of 64-slice MDCT in first-pass perfusion imaging of lung tumor perfusion.Differentiate CT perfusion (CTP) parameters in malignant tumors...
Methods and Materials
207 patients with lung lesions prospectively studied from January to September 2008.148 patients had histopathologically confirmed lung malignancies. (92 men, 56 women; mean age, 60 years; age range, 29–83 years).59 benign lesion served as controls.24 post chemotherapy cases excluded from the study.CTP parameters of the 207 lesions was compared with the normal lung parenchyma.For validation of : Correlation between Tumor Volume and Tumor Perfusion Changes Following Neo-adjuvant Chemotherapy in Patients with Lung CancerOf the 148 patient a total of 96 patients having lung cancer were...
Results
Good agreements were obtained between the replicated measurements (interclass correlation coefficient > 0.99)Except for MTT & TTP, which was statistically (p <0.05) lower in malignant lesions, all CTP parameter values were significantly (P <0 .05) higher in malignant lesions when compared with the benign lesions and the background lung parenchyma.When compared to normal parenchyma, benign lesions showed higher BF and BV but were not statistically significant(p >0.05). MTT and TTP values in benign lesions were comparable to that of normal parenchyma.Considerable differences with higher perfusion,...
Conclusion
DISSCUSION:Higher median perfusion index in malignant lesions than for those with benign lesions and the normal parenchyma can be explained on the basis of intrinsic high neoangiogenic activity of tumor or a secondary response to tissue hypoxiaThe arteriovenous shunts have very low resistance to flow, which results in markedly increased blood flow and shorter MTT.Benign lesions constitutes dense normal parenchyma and does not show much distortion in the vascular architecture and thus shows similar perfusion indices as that of the normal parenchymaAs shown in the...
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
Dr. Abhishek Mahajan, MDFellow In Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]