The Study Of Quantitative Therapy Response Assessment Of Non-Small Cell Lung Cancer With Dual-Energy Computed Tomography

Objective To investigate the iodine-uptake amount in assessing the response of non-small cell lung cancer(NSCLC) treated with chemotherapy or target therapy by dual-energy CT(DECT) and to determine whether DECT criteria can evaluate the response of NSCLC treated with chemotherapy or target therapy.Methods 25 patients(30 target lesions in total) with NSCLC received chemotherapy or target therapy, contrast-enhanced DECT scan at baseline and follow-up(at least 8 weeks and one time point) were retrospectively evaluated. The iodine-uptake amount of 30 target lesions in total were measured and compared with the longest diameter and CT value of target lesions. 30 target lesions were evaluated by RECIST criteria, Choi criteria and dual energy CT criteria, respectively. Paired t test was used to compare the longest diameter, CT value and the iodine-uptake amount of the lesions between baseline and follow-up examinations. Chi-square test was used to compare the disease control rate of DECT criteria with RECIST criteria and Choi criteria.Results The variation(-27.0±165.7%) in DECT between baseline and follow-up was distinct(t=2.053, P=0.049) while longest diameter and CT density did not show significant change(1.1±38.3%, t=1.199, P=0.240;-4.0±72.1%, t=1.182, P=0.247). The disease control rate of DECT criteria(83.33%) had no significant difference with RECIST criteria(80%, P=0.739) and Choi criteria(76.67%, P=0.718).Conclusion The iodine-uptake amount measured by DECT is more sensitive to evaluate the early response of NSCLC treated with chemotherapy and target therapy than both of longest diameter and CT value. DECT criteria based on both iodine uptake amount and longest diameter is potential to be a feasible method to evaluate the response of NSCLC treated with chemotherapy and target therapy.