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Erschienen in:
12.11.2015 | Oncology
Dual-Phase Dual-Energy CT in Patients Treated with Erlotinib for Advanced Non-Small Cell Lung Cancer: Possible Benefits of Iodine Quantification in Response Assessment
Erschienen in: European Radiology | Ausgabe 8/2016
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Objectives
To investigate the relationship of dual-phase dual-energy CT (DE-CT) and tumour size in the evaluation of the response to anti-EGFR therapy in patients with advanced non-small cell lung cancer (NSCLC).
Methods
Dual-phase DE-CT was performed in 31 patients with NSCLC before the onset of anti-EGFR (erlotinib) therapy and as follow-up (mean 8 weeks). Iodine uptake (IU; mg/mL) was quantified using prototype software in arterial and venous phases; arterial enhancement fraction (AEF) was calculated. The change of IU before and after therapy onset was compared with anatomical evaluation in maximal transverse diameter and volume (responders vs. non-responders).
Results
A significant decrease of IU in venous phase was proved in responders according to all anatomical parameters (p=0.002–0.016). In groups of non-responders, a significant change of IU was not proved with variable trends of development. The most significant change was observed using the anatomical parameter of volume (cut-off 73 %). A significant difference of percentage change in AEF was proved between responding and non-responders (p=0.019–0.043).
Conclusion
Dual-phase DE-CT with iodine uptake quantification is a feasible method with potential benefit in advanced assessment of anti-EGFR therapy response. We demonstrated a decrease in vascularization in the responding primary tumours and non-significant variable development of vascularization in non-responding tumours.
Key Points
• Dual-phase DE-CT is feasible for vascularization assessment of NSCLC with anti-EGFR therapy.
• There was a significant decrease of iodine uptake in responding tumours.
• There was a non-significant and variable development in non-responding tumours.
• There was significant difference of AEF percentage change between responders and non-responders.