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European Radiology

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01-06-2013 | Chest

Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy

Authors: Sung Ho Hwang, Mi Ri Yoo, Chul Hwan Park, Tae Joo Jeon, Sang Jin Kim, Tae Hoon Kim

Published in: European Radiology | Issue 6/2013

Abstract

Objectives

To compare tumour enhancement patterns measured using dynamic contrast-enhanced (DCE)-CT with tumour metabolism measured using positron emission tomography (PET)-CT in patients with non-small cell lung cancer (NSCLC) and stable disease after chemotherapy or chemoradiotherapy.

Methods

After treatment, 75 NSCLC tumours in 65 patients who had stable disease on DCE-CT according to Response Evaluation Criteria in Solid Tumour (RECIST) were evaluated using PET-CT. On DCE-CT, relative enhancement ratios (RER) of tumour at 30, 60, 90, 120 s and 5 min after injection of contrast material were measured. Metabolic responses of tumours were classified into two groups according to the maximum standardized uptake value (SUVmax) by PET-CT: complete metabolic response (CR) with an SUVmax of less than 2.5, and noncomplete metabolic response (NR) with an SUVmax of at least 2.5.

Results

Using the optimal RER₆₀ cutoff value of 43.7 % to predict NR of tumour gave 95.7 % sensitivity, 64.2 % specificity, and 82.1 % positive and 95.0 % negative predictive values. After adjusting for tumour size, the odds ratio for NR in tumour with an RER₆₀ of at least 43.7 % was 70.85 (95 % CI = 7.95–630.91; P < 0.05).

Conclusions

Even when disease was stable according to RECIST, DCE-CT predicted hypermetabolic status of residual tumour in patients with NSCLC after treatment.

Key Points

• Dynamic contrast-enhanced CT (DCE-CT) can provide useful metabolic information about non-small cell lung cancer.

• NSCLC lesions, even grossly stable after treatment, show various metabolic states.

• DCE-CT enhancement patterns correlate with tumour metabolic status as shown by PET.

• DCE-CT helps to assess hypermetabolic NSCLC as stable disease after treatment.

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Title: Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy
Authors: Sung Ho Hwang
Mi Ri Yoo
Chul Hwan Park
Tae Joo Jeon
Sang Jin Kim
Tae Hoon Kim
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2755-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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