title: Dynamic contrast-enhanced perfusion area-detector CT assessed with various mathematical models: Its capability for therapeutic outcome prediction for non-small cell lung cancer patients with chemoradiotherapy as compared with that of FDG-PET/CT.
abstract: OBJECTIVE
  To directly compare the capability of dynamic first-pass contrast-enhanced (CE-) perfusion area-detector CT (ADCT) and PET/CT for early prediction of treatment response, disease progression and overall survival of non-small cell carcinoma (NSCLC) patients treated with chemoradiotherapy.
  
  
  METHODS
  Fifty-three consecutive Stage IIIB NSCLC patients who had undergone PET/CT, dynamic first-pass CE-perfusion ADCT, chemoradiotherapy, and follow-up examination were enrolled in this study. They were divided into two groups: 1) complete or partial response (CR+PR) and 2) stable or progressive disease (SD+PD). Pulmonary arterial and systemic arterial perfusions and total perfusion were assessed at targeted lesions with the dual-input maximum slope method, permeability surface and distribution volume with the Patlak plot method, tumor perfusion with the single-input maximum slope method, and SUVmax, and results were averaged to determine final values for each patient. Next, step-wise regression analysis was used to determine which indices were the most useful for predicting therapeutic effect. Finally, overall survival of responders and non-responders assessed by using the indices that had a significant effect on prediction of therapeutic outcome was statistically compared.
  
  
  RESULTS
  The step-wise regression test showed that therapeutic effect (r2=0.63, p=0.01) was significantly affected by the following three factors in order of magnitude of impact: systemic arterial perfusion, total perfusion, and SUVmax. Mean overall survival showed a significant difference for total perfusion (p=0.003) and systemic arterial perfusion (p=0.04).
  
  
  CONCLUSIONS
  Dynamic first-pass CE-perfusion ADCT as well as PET/CT are useful for treatment response prediction in NSCLC patients treated with chemoradiotherapy.
authors.affiliation: Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan; Advanced Biomedical Imaging Research Center, 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: Toshiba Medical Systems Corporation, Otawara, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fujisawa
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: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kishida
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 Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan; Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D064847:Multimodal Imaging / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: CT; Non-small cell lung cancer; PET/CT; Perfusion; Therapeutic effect