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Erschienen in: European Radiology 6/2013

01.06.2013 | Chest

Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy

verfasst von: Sung Ho Hwang, Mi Ri Yoo, Chul Hwan Park, Tae Joo Jeon, Sang Jin Kim, Tae Hoon Kim

Erschienen in: European Radiology | Ausgabe 6/2013

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Abstract

Objectives

To compare tumour enhancement patterns measured using dynamic contrast-enhanced (DCE)-CT with tumour metabolism measured using positron emission tomography (PET)-CT in patients with non-small cell lung cancer (NSCLC) and stable disease after chemotherapy or chemoradiotherapy.

Methods

After treatment, 75 NSCLC tumours in 65 patients who had stable disease on DCE-CT according to Response Evaluation Criteria in Solid Tumour (RECIST) were evaluated using PET-CT. On DCE-CT, relative enhancement ratios (RER) of tumour at 30, 60, 90, 120 s and 5 min after injection of contrast material were measured. Metabolic responses of tumours were classified into two groups according to the maximum standardized uptake value (SUVmax) by PET-CT: complete metabolic response (CR) with an SUVmax of less than 2.5, and noncomplete metabolic response (NR) with an SUVmax of at least 2.5.

Results

Using the optimal RER60 cutoff value of 43.7 % to predict NR of tumour gave 95.7 % sensitivity, 64.2 % specificity, and 82.1 % positive and 95.0 % negative predictive values. After adjusting for tumour size, the odds ratio for NR in tumour with an RER60 of at least 43.7 % was 70.85 (95 % CI = 7.95–630.91; P < 0.05).

Conclusions

Even when disease was stable according to RECIST, DCE-CT predicted hypermetabolic status of residual tumour in patients with NSCLC after treatment.

Key Points

Dynamic contrast-enhanced CT (DCE-CT) can provide useful metabolic information about non-small cell lung cancer.
NSCLC lesions, even grossly stable after treatment, show various metabolic states.
DCE-CT enhancement patterns correlate with tumour metabolic status as shown by PET.
DCE-CT helps to assess hypermetabolic NSCLC as stable disease after treatment.
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Metadaten
Titel
Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy
verfasst von
Sung Ho Hwang
Mi Ri Yoo
Chul Hwan Park
Tae Joo Jeon
Sang Jin Kim
Tae Hoon Kim
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 6/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2755-0

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