The Study Of CT Perfusion Image In Assessing Response To Chemotherapy Of Lung Cancer

ⅠThe value of CT perfusion imaging on classification of lung cancerObjective:The objective of this study was to investigate the hemodynamic features of different dimension,histological types and different differentiated of lung cancers on multislice spiral CT perfusion imaging;and to assess the utility of CT perfusion imaging in diagnosis of histological type of lung cancer.Materials and Methods:Sixty-five patients with histologically proven lung cancer were involved in this study from September 2006 to June 2008.There were 41 male and 24 female in this group.Their age ranged from 33 to 76 years,with a mean of 55 years.The masses were 2.0-8.6cm(mean,4.7cm) in greatest dimension.There were 31 cases of squamous cell carcinoma,26 cases of adenocarcinoma and 8 cases of small cell carcinoma.In 41 of 57 cases with non-small cell carcinoma,there were 23 tumors of well differentiated,12 tumors of moderately differentiated and 6 tumors of poorly differentiated.A conventional thoracic CT scan was obtained as a routine to locate the lung lesion.Fifty milliliters of nonionic contrast(300mgI/ml) were injected at 5 ml/s,and then followed by dynamic CT scans at the same location. Postprocessing was performed on GE Advantage Window 4.2 workstation using the Body Perfusion software in the package of Perfusion 3.0.The perfusion measurements were calculated for each dynamic scan.The perfusion values of different dimension,histological types and different differentiated of lung cancers were compared using analysis of variance.Result:Tumors of the different greatest dimension(≤50mm,>50mm) had no impact on perfusion parameters.No significant differences were noted on all perfusion values among different histological types(NSCLC and SCLC,squamous cell carcinoma and adenocarcinoma) of lung cancers.Among different differentiated of lung cancers,no significant differences were observed in all perfusion parameters.Conclusion:The CT perfusion imaging not only may be of litter help to differential diagnosis of different histological types of lung cancers,but also can not conduce towards classify the differentiate degree of NSCLC.The dimension of tumors had no influence upon the CT perfusion parameters. ⅡThe study of CT perfusion image in assessing response to chemotherapy of lung cancerPurpose:To investigate the changes in tumors perfusion measurement before and after chemotherapy,to assess the value of CT perfusion parameters in predicting early response to chemotherapy of lung cancers.Materials and Methods:Thirty-seven patients with NSCLC confirmed by histology were involved in this study from April 2008 to February 2009.Perfusion CT scan and enhancement CT scan were performed before and after chemotherapies. The greatest dimension measurements and perfusion parameter measurements were taken.RECIST is permitted to evaluate the morphological early response to chemotherapy.The correlation of perfusion parameters and their changes pre-and post-treament with early response to chemotherapies was analyzed.Result:Thirty-seven patients with lung cancer were divided into two groups according to response to chemotherapy based on RECIST,14 patients were in the response group,and 23 patients were in the nonresponse group.After treatment,BF in the response group was significantly higher than that in the nonresponse group (96.2±44.2 ml/min/100g vs.69.1±33.2 ml/min/100g,P=0.0409),while MTT in the response group were lower than that in the nonresponse group,and BV and PS were higher than that in the nonresponse group,but no significant differences were observed.In the response group,tumors after treatment showed significant reduction in BF(descended to 65.0±29.3ml/min/100g,P=0.0368),and increase in MTT (4.2±1.3s vs.5.7±2.2s,P=0.0372);There is no significant differences were noted in BV and PS.In the nonresponse group,There is no significant differences were observed in BF,BV,MTT and PS.Conclusion:Before treatment,tumors of NSCLC in high blood flow were relatively sensitive to chemotherapy,and the response rate was relatively higher. Reduction in BF and increase in MTT after treatment may indicate sensitive to chemotherapy.