Usefulness of dynamic contrast enhanced computed tomography in patients with non-small-cell lung cancer scheduled for radiation therapy

ObjectiveThe goal of this study was to investigate the local tumor blood supply parameters relative tumor blood volume (rTBV) and transfer coefficient (Ktrans) measurable with dynamic contrast enhanced computed tomography (DCE-CT) in patients with non-small-cell lung cancer (NSCLC) scheduled for radiation therapy (RT).Materials and methodsrTBV and Ktrans were measured before RT in 31 patients with clinically inoperable NSCLC (Stages I–III), which received (n = 19) or did not receive (n = 12) induction chemotherapy (IChT). Possible links between rTBV and Ktrans and time-to-progression (TTP), overall survival (OS) and maximum standardized uptake value (SUVmax) from fluorodeoxyglucose positron emission tomography as well as histology were analyzed.ResultsNSCLC showed a wide range of rTBV and Ktrans values as estimated by DCE-CT (6.4 ± 0.6 ml/100 ml and 18.2 ± 1.5 ml/100 ml/min correspondingly). A significant difference in rTBV values in patients with IChT (4.6 ± 0.6 ml/100 ml) and without IChT (7.5 ± 0.9 ml/100 ml; p = 0.023), depending on the number of cycles of the IChT and the clinical stage was found. A negative correlation between rTBV and TTP was revealed only in RT patients up-staged by FDG-PET/CT from stage III to stage IV (n = 7, r = −0.96, p = 0.0006). An inverse correlation between Ktrans and TTP (n = 24, r = −0.53, p = 0.008) was observed in all RT patients. No relevant correlation was detected between rTBV, Ktrans and SUVmax or histologic subtypes and grading.ConclusionsTumor blood supply parameters derived from DCE-CT are useful to characterize tumor vascularization before radiotherapy in patients with NSCLC and data on outcome prediction are supplemented.