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- Title
Dual-phase dual-energy CT in patients with lung cancer: assessment of the additional value of iodine quantification in lymph node therapy response.
- Authors
Baxa, Jan; Vondráková, Alena; Matousková, Táa; Rzicková, Olga; Schmidt, Bernhard; Flohr, Thomas; Sedlmair, Martin; Ferda, Jií; Matoušková, Táňa; Růžičková, Olga; Ferda, Jiří
- Abstract
<bold>Objectives: </bold>To investigate the potential contribution of iodine uptake calculation from dual-phase dual-energy CT (DE-CT) for lymph node staging and therapy response monitoring in lung cancer patients.<bold>Methods: </bold>Retrospective analysis of 27 patients with non-small cell lung carcinoma (NSCLC), who underwent dual-phase DE-CT before and after chemotherapy, was performed. Iodine uptake (mg/mL) and total iodine uptake (mg) were calculated using prototype software in the early (arterial) and late (venous) post-contrast circulatory phase in 110 mediastinal lymph nodes. The arterial enhancement fraction (AEF) was calculated and compared with lymph node size and response to chemotherapy.<bold>Results: </bold>A significant difference of AEF was observed between enlarged (90.4%; 32.3-238.5%) and non-enlarged (72.7%; -37.5-237.5%) lymph nodes (p = 0.044) before treatment onset. A significantly different change of AEF in responding (decrease of 26.3%; p = 0.022) and non-responding (increase of 43.0%; p = 0.031) lymph nodes was demonstrated. A higher value of AEF before treatment was observed in lymph nodes with subsequent favourable response (88.6% vs. 77.7%; p = 0.122), but this difference did not reach statistical significance.<bold>Conclusions: </bold>The dual-phase DE-CT examination with quantification of ratio of early and late post-contrast iodine uptake is a feasible and promising method for the functional evaluation of mediastinal lymph nodes including therapy response assessment.<bold>Key Points: </bold>• Dual-phase DE-CT is beneficial for mediastinal lymph node assessment in NSCLC. • Arterial to venous iodine uptake ratio was higher in enlarged lymph nodes. • Change of arterial enhancement fraction correlated to therapy response.
- Publication
European Radiology, 2014, Vol 24, Issue 8, p1981
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-014-3223-9