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Erschienen in:
01.08.2014 | Oncology
Dual-phase dual-energy CT in patients with lung cancer: assessment of the additional value of iodine quantification in lymph node therapy response
Erschienen in: European Radiology | Ausgabe 8/2014
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Objectives
To investigate the potential contribution of iodine uptake calculation from dual-phase dual-energy CT (DE-CT) for lymph node staging and therapy response monitoring in lung cancer patients.
Methods
Retrospective analysis of 27 patients with non-small cell lung carcinoma (NSCLC), who underwent dual-phase DE-CT before and after chemotherapy, was performed. Iodine uptake (mg/mL) and total iodine uptake (mg) were calculated using prototype software in the early (arterial) and late (venous) post-contrast circulatory phase in 110 mediastinal lymph nodes. The arterial enhancement fraction (AEF) was calculated and compared with lymph node size and response to chemotherapy.
Results
A significant difference of AEF was observed between enlarged (90.4 %; 32.3–238.5 %) and non-enlarged (72.7 %; −37.5-237.5 %) lymph nodes (p = 0.044) before treatment onset. A significantly different change of AEF in responding (decrease of 26.3 %; p = 0.022) and non-responding (increase of 43.0 %; p = 0.031) lymph nodes was demonstrated. A higher value of AEF before treatment was observed in lymph nodes with subsequent favourable response (88.6 % vs. 77.7 %; p = 0.122), but this difference did not reach statistical significance.
Conclusions
The dual-phase DE-CT examination with quantification of ratio of early and late post-contrast iodine uptake is a feasible and promising method for the functional evaluation of mediastinal lymph nodes including therapy response assessment.
Key Points
• Dual-phase DE-CT is beneficial for mediastinal lymph node assessment in NSCLC.
• Arterial to venous iodine uptake ratio was higher in enlarged lymph nodes.
• Change of arterial enhancement fraction correlated to therapy response.