Value of whole-tumor dual-input perfusion CT in predicting the effect of multiarterial infusion chemotherapy on advanced non-small cell lung cancer

• Published in: American journal of roentgenology (1976) Vol. 203; no. 5; pp. W497 - W505
• Main Authors: Li, Xiang Sheng, Fan, Hong Xia, Fang, Hong, Huang, He, Song, Yun Long, Zhou, Chun Wu
• Format: Journal Article
• Language: English
• Published: United States 01.11.2014
• Subjects: Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Carboplatin - administration & dosage; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - drug therapy; Epirubicin - administration & dosage; Female; Humans; Infusions, Intra-Arterial; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Male; Middle Aged; Neovascularization, Pathologic - diagnostic imaging; Neovascularization, Pathologic - drug therapy; Neovascularization, Pathologic - prevention & control; Perfusion Imaging - methods; Radiography, Thoracic - methods; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Treatment Outcome; lung cancer; perfusion CT; multiarterial infusion chemotherapy
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/AJR.13.11621

The purposes of this study were to prospectively evaluate tumor perfusion using whole-tumor dual-input perfusion CT in advanced non-small cell lung cancer treated with multiarterial infusion chemotherapy and to determine whether treatment effect can be predicted in light of perfusion parameters. Forty-two patients with advanced non-small cell lung cancer were enrolled in this study. Whole-tumor dual-input perfusion CT was performed for all these patients, who subsequently received multiarterial infusion chemotherapy. The patients were divided into responders and nonresponders according to response to treatment. The relation between baseline perfusion parameters and prognosis after therapy was analyzed. The responder group had higher bronchial flow than the nonresponder group (p = 0.02). The AUC for bronchial flow was 0.83; pulmonary flow, 0.71; and perfusion index, 0.66. The higher bronchial flow group (≥ 65.34 mL/min/100 mL) and lower pulmonary flow group (< 23.05 mL/min/100 mL) had longer median progression-free survival periods (p = 0.01, p = 0.03) and overall survival periods (p = 0.04, p = 0.04). Multivariate analysis showed that bronchial flow was a significant prognostic factor for progression-free survival and overall survival (p = 0.01, p = 0.02) and that pulmonary flow may be helpful for predicting progression-free survival (p = 0.04) and overall survival (p = 0.03). Whole-tumor dual-input perfusion CT can provide information on the dual blood supply of tumors, which is helpful for predicting the treatment effect of multiarterial infusion chemotherapy for advanced non-small cell lung cancer.