Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy

Tacelli, Nunzia; Santangelo, Teresa; Scherpereel, Arnaud; Duhamel, Alain; Deken, Valérie; Klotz, Ernst; Cortot, A.; Lafitte, Jean-Jacques; Wallyn, F.; Rémy, Jacques; Rémy‐Jardin, Martine

doi:10.1007/s00330-013-2821-2

Cited by 67 publications

(50 citation statements)

References 25 publications

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“…Previous studies have also documented that higher MVD is associated with higher blood flow and blood volume values [23]. Regarding the assessment of therapy response, Tacelli et al determined whether CT perfusion can depict early perfusion changes in lung cancer treated with anti-angiogenic drugs [24]. The authors could disclose that patients treated with conventional chemotherapy with bevacizumab had a significant perfusion reduction, as compared to patients without anti-angiogenic treatment [24].…”

Section: Imaging Techniquesmentioning

confidence: 95%

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Thaiss

Sauter

Bongers

et al. 2015

European Journal of Radiology

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Section: Imaging Techniquesmentioning

confidence: 95%

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Thaiss

Sauter

Bongers

et al. 2015

European Journal of Radiology

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“…17,18 Functional parameters, derived from the assessment of peak tumor enhancement over time in the tissue during the CTP scan, give information about blood volume (BV), blood flow (BF), and mean transit time (MTT) within the network of tumoral neovascularity, as well as the rate of abnormal leakage into the extracellular space, due to the vascular hyperpermeability in the abnormal neovessel wall. 5,19 One of the first applications for the assessment of lung lesions with CTP was pulmonary nodules, particularly in comparison with 18 F-fluoro-2-deoxy-D-glucose positron emission tomography/ CT (PET/CT). 20 Cutoff values have been defined for several CTP parameters to differentiate benign from malignant pulmonary nodules, with lower perfusion index (PI) and higher BF and BV obtained in malignancy.…”

Section: Results: According To Biopsy 37 Patients Had Nsclc (22 Adenmentioning

confidence: 99%

“…Fraioli et al 19,36 demonstrated a significant difference in BF and BV in LCC patients for partial response and progressive disease. Although we did not address therapeutic effects, the results of our study indicate that both histological subtype and tumor volume likely should be taken into account when assessing tumoral treatment response using CTP.…”

Section: Nguyen-kim Et Almentioning

confidence: 99%

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Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Nguyen-Kim¹,

Frauenfelder²,

Strobel³

et al. 2015

Investigative Radiology

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OBJECTIVES: The aim of this study was to investigate the dual blood supply of non-small cell lung cancer (NSCLC) and its association with tumor subtype, size, and stage, using computed tomography perfusion (CTP). MATERIALS AND METHODS: A total of 54 patients (median age, 65 years; range, 42-79 years; 15 women, 39 men) with suspected lung cancer underwent a CTP scan of the lung tumor. Pulmonary and bronchial vasculature regions of interest were used to calculate independently CTP parameters (blood flow [BF], blood volume [BV], and mean transit time [MTT]) of the tumor tissue. The mean and maximum pulmonary and bronchial perfusion indexes (PImean and PImax) were calculated. The tumoral volume and the largest tumoral diameter were assessed. Differences in CTP parameters and indexes among NSCLC subtypes, tumor stages and tumor dimensions were analyzed using non-parametric tests. RESULTS: According to biopsy, 37 patients had NSCLC (22 adenocarcinomas [ACs], 8 squamous cell carcinomas [SCCs], 7 large-cell carcinomas [LCC]). The mean bronchial BF/pulmonary BF, bronchial BV/pulmonary BV, and bronchial MTT/pulmonary MTT was 41.2 ± 30.0/36.9 ± 24.2 mL/100 mL/min, 11.4 ± 9.7/10.4 ± 9.4 mL/100 mL, and 11.4 ± 4.3/14.9 ± 4.4 seconds, respectively. In general, higher bronchial BF than pulmonary BF was observed in NSCLC (P = 0.014). Using a tumoral volume cutoff of 3.5 cm, a significant difference in pulmonary PImax was found (P = 0.028). There was a significantly higher mean pulmonary BF in LCCs and SCCs compared with ACs (P = 0.018 and P = 0.044, respectively), whereas the mean bronchial BF was only significantly higher in LCCs compared with ACs (P = 0.024). Correspondingly, the PImax was significantly higher in LCCs and SCCs than in ACs (P = 0.001 for both). Differences between bronchial and pulmonary PImean and PImax among T stages and Union Internationale Contre le Cancer stages were not statistically significant (P values ranging from 0.691 to 0.753). CONCLUSIONS: The known dual blood supply of NSCLC, which depends on tumor size and histological subtype, is reflected in CTP parameters, with parameters depending both on tumor size and histological subtype. This has to be accounted for when analyzing NSCLC with CTP.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

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“…CTp was shown to be effective for response assessment of antiangiogenic chemotherapy of NSCLC. 104 Moreover, Wang et al 105 showed that CTp can predict early tumour response and overall survival, mentioning, however, that image quality was good or moderate in only 68.2% of the cases.…”

Section: Mr Spectroscopy Mr Spectroscopy (Mrs) That Ismentioning

confidence: 99%

Validation of functional imaging as a biomarker for radiation treatment response

Jentsch¹,

Beuthien‐Baumann²,

Troost³

et al. 2015

BJR

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Major advances in radiotherapy techniques, increasing knowledge of tumour biology and the ability to translate these advances into new therapeutic approaches are important goals towards more individualized cancer treatment. With the development of non-invasive functional and molecular imaging techniques such as positron emission tomography (PET)-CT scanning and MRI, there is now a need to evaluate potential new biomarkers for tumour response prediction, for treatment individualization is not only based on morphological criteria but also on biological tumour characteristics. The goal of individualization of radiotherapy is to improve treatment outcome and potentially reduce chronic treatment toxicity. This review gives an overview of the molecular and functional imaging modalities of tumour hypoxia and tumour cell metabolism, proliferation and perfusion as predictive biomarkers for radiation treatment response in head and neck tumours and in lung tumours. The current status of knowledge on integration of PET/CT/MRI into treatment management and bioimage-guided adaptive radiotherapy are discussed.

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Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy

Cited by 67 publications

References 25 publications

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Validation of functional imaging as a biomarker for radiation treatment response

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