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

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

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1573-1581
Number of pages9
JournalEuropean Radiology
Volume23
Issue number6
DOIs
Publication statusPublished - 2013 Jun 1
Externally publishedYes

Fingerprint

Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Drug Therapy
Positron-Emission Tomography
Neoplasms
Residual Neoplasm
Therapeutics
Contrast Media
Odds Ratio
Sensitivity and Specificity
Injections

Keywords

  • F-fluoro- deoxyglucose positron emission tomography
  • Computed tomography
  • Enhancement pattern
  • Non-small cell lung cancer
  • Standardized uptake value

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy. / Hwang, Sung Ho; Yoo, Mi Ri; Park, Chul Hwan; Jeon, Tae Joo; Kim, Sang Jin; Kim, Tae Hoon.

In: European Radiology, Vol. 23, No. 6, 01.06.2013, p. 1573-1581.

Research output: Contribution to journalArticle

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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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T1 - Dynamic contrast-enhanced CT to assess metabolic response in patients with advanced non-small cell lung cancer and stable disease after chemotherapy or chemoradiotherapy

AU - Hwang, Sung Ho

AU - Yoo, Mi Ri

AU - Park, Chul Hwan

AU - Jeon, Tae Joo

AU - Kim, Sang Jin

AU - Kim, Tae Hoon

PY - 2013/6/1

Y1 - 2013/6/1

N2 - 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.

AB - 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.

KW - F-fluoro- deoxyglucose positron emission tomography

KW - Computed tomography

KW - Enhancement pattern

KW - Non-small cell lung cancer

KW - Standardized uptake value

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