title: Dynamic contrast-enhanced perfusion area detector CT for non-small cell lung cancer patients: Influence of mathematical models on early prediction capabilities for treatment response and recurrence after chemoradiotherapy.
abstract: OBJECTIVE
  To determine the capability and influence of the mathematical method on dynamic contrast-enhanced (CE-) perfusion area detector CT (ADCT) for early prediction of treatment response as well as progression free and overall survival (PFS and OS) of non-small cell lung cancer (NSCLC) patients treated with chemoradiotherapy.
  
  
  METHODS
  Sixty-six consecutive stage III NSCLC patients underwent dynamic CE-perfusion ADCT examinations, chemoradiotherapy and follow-up examinations. Response Evaluation Criteria in Solid Tumors (RECIST) criteria were used to divide all patients into responders and non-responders. Differences in each of the indices for all targeted lesions between measurements obtained 2 weeks prior to the first and the third course of chemotherapy were determined for all patients. ROC analyses were employed to determine the capability of perfusion indices as markers for distinguishing RECIST responders from non-responders. To evaluate their capability for early prediction of therapeutic effect, OS of perfusion index-based responders and non-responders were compared by using the Kaplan-Meier method followed by log-rank test.
  
  
  RESULTS
  Area under the curve (Az) for total perfusion by means of the dual-input maximum slope method was significantly larger than that of pulmonary arterial perfusion using the same method (p=0.007) and of perfusion with the single-input maximum slope method (p=0.007). Mean OS demonstrated significantly difference between responder- and non-responder groups for total perfusion (p=0.02).
  
  
  CONCLUSIONS
  Mathematical models have significant influence on assessment for early prediction of treatment response, disease progression and overall survival using dynamic CE-perfusion ADCT for NSCLC patients treated with chemoradiotherapy.
authors.affiliation: Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yosirad@kobe-u.ac.jp.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Toshiba Medical Systems Corporation, Otawara, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fujisawa
authors.affiliation: Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Seki
authors.affiliation: Toshiba Medical Systems Corporation, Otawara, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sugihara
authors.affiliation: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000628:therapy*; D059248:Chemoradiotherapy; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008962:Models, Theoretical; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: CT; Chemoradiotherapy; Non-small cell lung cancer; Perfusion; Therapeutic effect