Dynamic Contrast-enhanced Area-detector CT vs Dynamic Contrast-enhanced Perfusion MRI vs FDG-PET/CT: Comparison of Utility for Quantitative Therapeutic Outcome Prediction for NSCLC Patients Undergoing Chemoradiotherapy

Abstract

Purpose: To directly compare the utility for therapeutic outcome prediction of dynamic first-pass contrast-enhanced (CE)-perfusion area-detector computed tomography (ADCT), MR imaging assessed with the same mathematical method and 2-[fluorine-18]-fluoro-2-deoxy-d-glucose-positron emission tomography combined with CT (PET/CT) for non-small cell lung cancer (NSCLC) patients treated with chemoradiotherapy. Materials and Methods:Forty-three consecutive stage IIIB NSCLC patients, consisting of 25 males (mean age ± standard deviation: 66.6 ± 8.7 years) and 18 females (66.4 ± 8.2 years) underwent PET/CT, dynamic CE-perfusion ADCT and MR imaging, chemoradiotherapy, and follow-up examination. In each patient, total, pulmonary arterial, and systemic arterial perfusions were calculated from both perfusion data and SUV max on PET/CT, assessed for each targeted lesion, and averaged to determine final values. Receiver operating characteristics analyses were performed to compare the utility for distinguishing responders from non-responders using Response Evaluation Criteria in Solid Tumor (RECIST) 1.1 criteria. Overall survival (OS) assessed with each index were compared between two groups by means of the Kaplan-Meier method followed by the log-rank test.Results: Area under the curve (Az) for total perfusion on ADCT was significantly larger than that of pulmonary arterial perfusion (P < 0.05). Az of total perfusion on MR imaging was significantly larger than that of pulmonary arterial perfusion (P < 0.05). Mean OS of responder and non-responder groups were significantly different for total and systemic arterial (P < 0.05) perfusion. Conclusion:Dynamic first-pass CE-perfusion ADCT and MR imaging as well as PET/CT are useful for early prediction of treatment response by NSCLC patients treated with chemoradiotherapy.

Chemical Exchange Saturation Transfer MRI: Capability for Predicting Therapeutic Effect of Chemoradiotherapy on Non‐Small Cell Lung Cancer Patients

“…Intra‐ and inter‐observer agreements for MTR asym at 3.5 ppm, ADC, and SUV max measurements were less than 10% and close to those previously reported 9,12,20 …”

“…Different imaging techniques have been used for the evaluation or prediction of the therapeutic effect of CRT for NSCLC patients, such as chest radiography, computed tomography (CT), positron emission tomography (PET) or PET fused with CT (PET/CT) by means of 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose (FDG), and magnetic resonance imaging (MRI). In particular, contrast‐enhanced (CE) MRI, dynamic CE‐MRI, and diffusion‐weighted imaging (DWI) sequences have been commonly used according to clinical or academic practices 2–12 …”

“…In particular, contrast-enhanced (CE) MRI, dynamic CE-MRI, and diffusion-weighted imaging (DWI) sequences have been commonly used according to clinical or academic practices. [2][3][4][5][6][7][8][9][10][11][12] In addition to the above-mentioned methods, chemical exchange saturation transfer (CEST) has been introduced as a new technique for providing more detailed physiological and functional information than conventional MR imaging and has become prominent in the field of molecular imaging. [13][14][15][16][17][18][19][20][21][22] CEST imaging is attained by applying multiple magnetization transfer pulses to the resonance frequency of slowintermediate protons of endogenous or exogenous agents.…”

Predictive Radiomic Models for the Chemotherapy Response in Non-Small-Cell Lung Cancer based on Computerized-Tomography Images

“…The model used features extracted from lesions, margins, and blood vessels and reached an area under the curve (AUC) of 0.73 in a test cohort with 176 patients. Seki et al had demonstrated the usefulness of CT and Positron Emission Tomography (PET)/CT in the early prediction of chemoradiotherapy in NSCLC (24). In the present study, we constructed a radiomic model that used pre-chemotherapy CT images to predict the NSCLC chemotherapy response.…”

“…Seki et al. had demonstrated the usefulness of CT and Positron Emission Tomography (PET)/CT in the early prediction of chemoradiotherapy in NSCLC ( 24 ). In the present study, we constructed a radiomic model that used pre-chemotherapy CT images to predict the NSCLC chemotherapy response.…”