CT perfusion in non-small cell lung cancers for assessing treatment response, monitoring treatment and predicting prognosis

Abstract

Introduction: To determine whether Computed Tomography Perfusion (CTP) can predict treatment response and prognosis in non-small cell lung cancers (NSCLC). To determine which one of the perfusion parameter correlated best with treatment outcome. Methods: Sixteen patients with NSCLC underwent CTP before and after completion of chemo-radiotherapy. Patients with complete and partial response were grouped as responders and patients with stable and progressive disease were grouped as non-responders. Pre and post-treatment whole tumour perfusion parameters (blood flow - BF, blood volume - BV, mean transit time - MTT and permeability surface area product - PS) were compared between responders and non-responders. Results: Responders had higher baseline BF and PS values than non-responders; P = 0.047, 0.028 respectively. On 1 year follow up, patients with even 2.65% increase in PS value from baseline developed metastasis while patients with decrease in PS value by 24% did not develop metastasis (P = 0.05). Greater decrease in BF values (17%) were noted among responders than non-responders (2.4%) following chemoradiation, though the results were not statistically significant (P > 0.05). Conclusions: Tumours with higher baseline BF and PS respond well to chemo-radiation. Changes in the PS values can predict the development of metastasis and hence, the long term outcome.

Keywords

• Oncologic imaging
• Chest imaging
• CT perfusion
• Response assessment
• Functional imaging