Dual-phase dual-energy CT in patients with lung cancer: assessment of the additional value of iodine quantification in lymph node therapy response
Language English Country Germany Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Adult MeSH
- Iodine pharmacokinetics MeSH
- Contrast Media pharmacokinetics MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymph Node Excision MeSH
- Lymph Nodes diagnostic imaging pathology surgery MeSH
- Mediastinum MeSH
- Multidetector Computed Tomography methods MeSH
- Lung Neoplasms diagnostic imaging metabolism pathology MeSH
- Carcinoma, Non-Small-Cell Lung diagnostic imaging secondary MeSH
- Radionuclide Imaging MeSH
- Reproducibility of Results MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Neoplasm Staging methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Iodine MeSH
- Contrast Media MeSH
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. KEY POINTS: • 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.
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