TY - JOUR
T1 - Dynamic contrast-enhanced perfusion area-detector CT assessed with various mathematical models
T2 - Its capability for therapeutic outcome prediction for non-small cell lung cancer patients with chemoradiotherapy as compared with that of FDG-PET/CT
AU - Ohno, Yoshiharu
AU - Fujisawa, Yasuko
AU - Koyama, Hisanobu
AU - Kishida, Yuji
AU - Seki, Shinichiro
AU - Sugihara, Naoki
AU - Yoshikawa, Takeshi
N1 - Funding Information:
This prospective study was approved by the institutional review board of Kobe University Graduate School of Medicine (Kobe. Univ. 200009) and written informed consent was obtained from all patients. It was financially and technically supported by Toshiba Medical Systems Corporation, and financially by Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS·KAKEN; No. 24591762), the Adaptive and Seamless Technology Transfer Program through Target Driven R & D from the Japan Science and Technology (JST) Agency and Bayer Pharma. Two of the authors (Y.F. and N.S.), who are employees of Toshiba Medical Systems Corporation, developed the software, but had no control over any data or information submitted for publication or any control over any parts of data and information included in this study.
Funding Information:
This work was supported by Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 24591762), the Adaptive and Seamless Technology Transfer Program through Target Driven R & D from the Japan Science and Technology (JST) Agency (AS2511335P), Toshiba Medical Systems Corporation and Bayer Pharma.
Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Purpose To directly compare the capability of dynamic first-pass contrast-enhanced (CE-) perfusion area-detector CT (ADCT) and PET/CT for early prediction of treatment response, disease progression and overall survival of non-small cell carcinoma (NSCLC) patients treated with chemoradiotherapy. Materials and methods Fifty-three consecutive Stage IIIB NSCLC patients who had undergone PET/CT, dynamic first-pass CE-perfusion ADCT, chemoradiotherapy, and follow-up examination were enrolled in this study. They were divided into two groups: 1) complete or partial response (CR + PR) and 2) stable or progressive disease (SD + PD). Pulmonary arterial and systemic arterial perfusions and total perfusion were assessed at targeted lesions with the dual-input maximum slope method, permeability surface and distribution volume with the Patlak plot method, tumor perfusion with the single-input maximum slope method, and SUVmax, and results were averaged to determine final values for each patient. Next, step-wise regression analysis was used to determine which indices were the most useful for predicting therapeutic effect. Finally, overall survival of responders and non-responders assessed by using the indices that had a significant effect on prediction of therapeutic outcome was statistically compared. Results The step-wise regression test showed that therapeutic effect (r2 = 0.63, p = 0.01) was significantly affected by the following three factors in order of magnitude of impact: systemic arterial perfusion, total perfusion, and SUVmax. Mean overall survival showed a significant difference for total perfusion (p = 0.003) and systemic arterial perfusion (p = 0.04). Conclusion Dynamic first-pass CE-perfusion ADCT as well as PET/CT are useful for treatment response prediction in NSCLC patients treated with chemoradiotherapy.
AB - Purpose To directly compare the capability of dynamic first-pass contrast-enhanced (CE-) perfusion area-detector CT (ADCT) and PET/CT for early prediction of treatment response, disease progression and overall survival of non-small cell carcinoma (NSCLC) patients treated with chemoradiotherapy. Materials and methods Fifty-three consecutive Stage IIIB NSCLC patients who had undergone PET/CT, dynamic first-pass CE-perfusion ADCT, chemoradiotherapy, and follow-up examination were enrolled in this study. They were divided into two groups: 1) complete or partial response (CR + PR) and 2) stable or progressive disease (SD + PD). Pulmonary arterial and systemic arterial perfusions and total perfusion were assessed at targeted lesions with the dual-input maximum slope method, permeability surface and distribution volume with the Patlak plot method, tumor perfusion with the single-input maximum slope method, and SUVmax, and results were averaged to determine final values for each patient. Next, step-wise regression analysis was used to determine which indices were the most useful for predicting therapeutic effect. Finally, overall survival of responders and non-responders assessed by using the indices that had a significant effect on prediction of therapeutic outcome was statistically compared. Results The step-wise regression test showed that therapeutic effect (r2 = 0.63, p = 0.01) was significantly affected by the following three factors in order of magnitude of impact: systemic arterial perfusion, total perfusion, and SUVmax. Mean overall survival showed a significant difference for total perfusion (p = 0.003) and systemic arterial perfusion (p = 0.04). Conclusion Dynamic first-pass CE-perfusion ADCT as well as PET/CT are useful for treatment response prediction in NSCLC patients treated with chemoradiotherapy.
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U2 - 10.1016/j.ejrad.2016.11.008
DO - 10.1016/j.ejrad.2016.11.008
M3 - Article
C2 - 28027771
AN - SCOPUS:84994879766
VL - 86
SP - 83
EP - 91
JO - European Journal of Radiology
JF - European Journal of Radiology
SN - 0720-048X
ER -