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 characterize lung nodules based on its arterial supply using hepatic perfusion software.•To differentiate malignant lesions from benign lesions based on the arterial supply.
Methods and Materials
•62histopathologically proven lung nodules whichwere examined with 64-slice MDCT were included. (47 men, 16 women; mean age, 51 years; age range, 32–83 years)•December 2007 and May 2009.•All patients’ diagnoses were histopathologically proved.•CTP parameters of the 62 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 .•Contrast bolus infusion at a rate of 50 mL at 5 mL/sec for 10 seconds, followed by a saline...
Results
•Using the heptatic perfusion software•we deduced that the malignant lesions were predominantly supplied by the bronchial artery and had minimalpulmonary arteryperfusion.•The ratio of BAP to PAP was 9.1:1 +/- 2.4 which was statistically different from the benign lesions(p <0.0001).•Lesions showedlow BAP and high PAP and the ratio of BAP toPAP was1:8.3 +/-1.7.the malignant lesions showed higher perfusion index which was statistically different from the benign lesions (p<0.001).•Routine general perfusion software calculation showed :Except for MTT and TTP, which was statistically (p <0.0001) lower in malignant...
Conclusion
•In conclusion, The preliminary results show that using hepatic perfusion software lesion Vascularity (bronchial Vs pulmonary artery)can be shown and lesion characterization can be done which will significantly add relevant information to results based on the general perfusion software and conventional contrast CT.•In future, pre and post treatment tumor response can be monitored by using perfusion imaging
References
1.Quan-Sing et al Lung Cancer Perfusion at Multi–Detector Row CT Radiology May 2006;239:547-5532.Tateishi U, Nishihara H, Watanabe S, Morikawa T, Abe K, Miyasaka K. Tumor angiogenesis and dynamic CT in lung adenocarcinoma: radiologic-pathologic correlation. J Comput Assist Tomogr 2001; 25:23-27.3.Miles KA. Tumor angiogenesis and its relation to contrast enhancement on computed tomography: a review. Eur J Radiol 1999; 30:198-205.4.K A MilesPerfusion CT for the assessment of tumour vascularity: which protocol? Br. J. Radiol., December 1, 2003; 76(suppl_1): S36 - S42.5.K A Miles and M R...
Personal Information
Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]