Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Abstract

To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 − 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726–0.9255, ICCInter = 0.8179–0.8842; ICCInter = 0.8881–0.9177, ICCInter = 0.9820–0.9970, ICCInter = 0.9780–0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P < .01) and 0.383 (P < .05). Correlation coefficient between λHU and AF, and PF were as follows: 0.564 (P < .01) and 0.388 (P < .05).Both the single-source DE-CT and dual-input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion parameters derived from DI-PCT.

Comparative study of dual energy CT iodine imaging and standardized concentrations before and after chemoradiotherapy for esophageal cancer

“…Our results showed that the NIC-A, NIC-V, NCT-A and NCT-V after treatment in the effective group were significantly lower than before treatment, and the NIC-V and NCT-V in the ineffective group were lower than those before treatment. After treatment, NIC-A, NIC-V, NCT-A, and NCT-A in esophageal cancer were all lower than those before treatment, indicating that CRT treatment led to reduced blood supply of EC, inhibited tumor cell proliferation, decreased tumor cells number, and thus reflected by the reduced tumor cells iodine intake, which is consistent with the previous study [ 18 ]. In addition, CMT drugs can exert toxic effects on cells and destroy vascular endothelial activity, induce necrosis of tumor lesions, mucosal congestion and edema, and inflammatory reactions, etc.…”

Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors

“…Dual-energy CT (DECT) perfusion imaging can not only obtain the features found on conventional CT but also several quantitative and semiquantitative spectral parameters (water concentration, WC; iodine concentration, IC; the slope of spectral Hounsfield unit curve, λ HU ) and perfusion parameters (blood flow, BF; blood volume, BV; mean transit time, MTT; permeability surface, PS) of tumours through a one-stop DECT perfusion scan. This CT scan method has been widely used in the evaluation of extramediastinal tumours, such as neck lymphoma and lung cancer [13][14][15] . Although only a few studies have used IC or perfusion parameters alone to evaluate TETs [16][17][18][19] , no studies have used the two different kinds of parameters to identify the different pathological subtypes of TETs simultaneously.…”

A prospective study of dual-energy CT in determining the metastatic and non-metastatic lymph nodes of colorectal cancer

“…In the present study, the nIWR, n△HU and λHU values of metastatic lymph nodes were signi cantly greater than those of non-metastatic lymph nodes. Iodine concentration re ects the degree of contrast enhancement [23]. An increase of iodine content in metastatic lymph nodes could be due to the increased tumor-related angiogenesis, blood volume or vascular permeability within the metastatic lymph nodes [24].…”