Quantitative assessment of therapy response of non-small cell lung cancer with dual-energy CT

doi:10.16150/j.1671-2870.2018.05.009

Abstract

Abstract: Objective: To investigate the level of iodine-uptake estimated by dual-energy CT (DECT) for assessing the therapy response of non-small cell lung cancer (NSCLC) treated with chemotherapy or target therapy and to determine whether DECT criteria can evaluate the response of NSCLC treated with chemotherapy or target therapy. Methods: Thirty NSCLC patients receiving chemotherapy or target therapy and contrast-enhanced DECT scan at baseline and follow-up (at least 8 weeks and one time point) were analyzed retrospectively. Iodine-uptake level of the target lesion was measured and compared with the longest diameter and CT value of the target lesion. The 30 target lesions were evaluated by RECIST criteria, Choi criteria and dual energy CT criteria, respectively. Paired t test was used to compare the longest diameter, CT value and iodine-uptake level of the lesion at baseline and follow-up examination. Kappa statistics were used to evaluate the agreement between the results of the three response evaluation items. McNemar test was used to compare the partial response rate of DECT criteria, RECIST criteria and Choi criteria. Results: The lowering of iodine-uptake level assessed by DECT between baseline and follow-up was distinct (-10.47±23.34)%, P<0.05), while the longest diameter and CT density did not show significant change[ (-3.45±15.76)%, P>0.05; （-4.80±25.00）%, P>0.05]. DECT had better consistency with Choi criteria(kappa=0.718, P<0.05) than with RECIST （kappa=0.302, P<0.05). The partial response rate of DECT criteria had significant difference with RECIST criteria (P<0.05) and no significant difference with Choi criteria (P>0.05). Conclusions: The iodine-uptake level measured by DECT is more sensitive to evaluate the early response of NSCLC when treated with chemotherapy and target therapy than both the longest diameter and CT value. DECT criteria based on iodine uptake level and longest diameter has the potential to be a feasible method to evaluate the response of NSCLC treated with chemotherapy and target therapy.

Key words: Non-small cell lung cancer, Response assessment, Dual-energy CT, Level of iodine-uptake

CLC Number:

R734.2

GU Shengjia, CAO Qiqi, YAN Fuhua, YANG Wenjie. Quantitative assessment of therapy response of non-small cell lung cancer with dual-energy CT[J]. Journal of Diagnostics Concepts & Practice, 2018, 17(05): 526-532.

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