Objective: This study is to evaluate the changes in tumor perfusion CT before and after chemotherapy/radiotherapy, and its feasibility in assessing early treatment response and predicting the prognosis in lung cancer patients.
Methods: Perfusion CT scan was performed on a multidetector CT scanner with power injection of contrast medium (50 ml, 300 mg I/ml, 4 ml/s) in the patients before and after chemotherapy/radiotherapy. The treatment response after chemotherapy/radiotherapy was assessed by RECIST. The correlation of pre- and post-treatment tumor perfusion changes with progression-free survival (PFS) and overall survival (OS) was analyzed.
Results: The patients were divided into two groups according to PS changs. In the increased PS group (n = 13), the PS after treatment was significantly higher than that before treatment (20.1 +/- 7.5 ml x min(-1) x 100 g(-1) vs. 13.7 +/- 6.2 ml/min/100 g, P = 0.013), while in the decreased PS group (n = 11), the PS after treatment was significantly lower than that before treatment (8.2 +/- 5.5 ml x min (-1) x 100 g(-1) vs. 15.3 +/- 5.1 ml x min(-1) x 100 g(-1), P = 0.000). No significant differences were observed in BF, BV, and MTT in both groups. The median PFS of PS increased group and decreased groups was 4.2 months and 19.0 months, respectively, (P = 0.000), and the median OS was 7.9 months and 19.3 months, respectively (P = 0.002).
Conclusion: Perfusion CT may have a potential application in predicting the prognosis of lung cancer after chemotherapy/radiotherapy, and PS increase after treatment may indicate a poor survival.