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 Cancer
Of the 148 patient a total of 96 patients having lung cancer were further evaluated prospectively.
Of which 9 patients underwent neo-adjuvant chemotherapy (bevacizumab and ipilimumab) +/- radiotherapy .
Follow up scans were performed at 10-14 days post treatment and at 3 months.
Global values of the entire lesion were calculated by taking the mean values of all individual sections.
Followed by routine contrast-enhanced thoracic scan CT perfusion was performed with a 64 –slice MDCT. The routine scan was used for routine cancer diagnosis.
Interobserver agreement was tested by another radiologist who was blinded to the histopathology and the previous perfusion results.
After interclass correlation agreement between the 2 observers, average values of the two sets were chosen .
CTP parameters were compared in necrotic and non-necrotic part of the tumor.
In all the malignant lesions CTP values were statistically compared among different histological types , tumor stages and size.
We used maximum slope analytical model method, yielding five major kinetic parameters:
(1) Perfusion (measured in ml/min/ml);
(2) Peak enhancement intensity (PEI, measured in HU);
(3) Time to peak (TTP, measured in s);
(4) Blood volume (BV, measured in ml/100 g);
(5)Mean transit time (MTT) (sec).
Along with colour maps of the five kinetic parameters, time attenuation curves (TACs) for the input artery and tumour were generated.
The response to treatment was assessed according to the RECIST criteria.
We investigated correlations between perfusion parameters and the response to CRT.
Statistical analysis was performed with the ANOVA test for comparison of two data sets, and the Spearman-rank correlations were used to assess the relationship between perfusion parameters and the tumor contraction rate. P < 0.05 was considered to indicate a statistically significant difference.