The Comparative Study Of CT Perfusion Parameters With Different Pathological Types Lung Cancer After Radiatiotherapy And Chemotherapy

Objective:To observe the featuresof parameters in CT perfusion of different pathological types of lung cancer. To analyzed the changes of parameters in CT perfusion before and after therapy for patients with different pathological types of lung cancer. To discuss the feasibility of CT perfusion in assessing early efficacy of radio-chemotherapy.Methods:Retrospective analyzed 78 patients (49 male and 29 female, the mean age was 56.5±7.2 years) of lung cancer with new diagnosis (confirmed with pathology), who had never received anti-tumor therapy. The patients included 34 with squamous cell carcinomas (SCC),29 with adenocarcinomas (AC) and 15 with small cell lung cancers (SCLC). All patients received CT perfusion before radio-chemotherapy and after two cycle of radio-chemotherapy, then contrast-enhanced CT were performed after four cycle of radio-chemotherapy. CT scan was performed using a Toshiba Aquilion ONETM 320 slice CT following bolus injection of contrast agent. All data collected form CT perfusion was transmitted to workstations, and applying perfusion software of body tumor in the package of CT perfusion to processing the data. CT perfusion parameters and tumor sizes were calculated for each CT scan. And according to RECIST criteria, grouped cases into remission group and non-remission group. Analyze the difference of perfusion parameters among different pathological types of lung cancer using analysis of variance. To analyze the changes of parameters in CT perfusion before and after therapy for patients with lung cancer to assess early efficacy of radio-chemotherapy.Results:(1)Among the perfusion parameters of patients with lung cancer before radio-chemotherapy, the capillary permeability surface area product (PS) value of AC (18.99±5.36) was higher than that of SCC (15.83±4.70) and SCLC (7.40±4.57); The PS value of SCC was higher than that of SCLC; The PS of CT perfusion parameter was statistically different among different pathological types of lung cancer (F=8.339,P=0.017); The difference of PS value in perfusion CT was statistically different among AC VS SCC and AC VS SCLC, no significant difference was revealed between AC and SCC, respectively by SNK q-test. (2) There is no significant difference between changes of tumor size before radio-chemotherapy and after two cycle of radio-chemotherapy. The BF, BV, PS value of patients before radio- chemotherapy was significantly higher than that of patients after two cycle of radio-chemotherapy in remission group, but the time to peak (TTP) value was with no statistical significance. In non-remission group of lung cancers, no significant differences were observed in all perfusion parameters. (3) BF, BV, and PS were significantly higher in non-remission group of SCC than in remission group after two cycle of radio-chemotherapy. BF and PS were significantly higher in non-remission group of AC than in remission group after two cycle of radio-chemotherapy. No correlation in BF, BV, TTP and PS between non-remission and remission group of SCLC.Conclusions:The PS of CT perfusion parameter was statistically different among different pathological types of lung cancer, which may contribute to diagnose patients with SCLC; The size of tumor had no significant change in the early stage of radio-chemotherapy, but the change of CT perfusion parameters which was more relevant to early efficacy happened prior to that of tumor size.Changes of parameters (BV, BF, PS) in perfusion CT before and after therapy for patients with lung cancer have a certain value of assessment the early efficacy of radio-chemotherapy in NSCLC. The perfusion parameter may be potentially useful in forecasting the early efficacy of radio-chemotherapyfor patients with lung cancer and providing a new technology for treatment planning.