Rintaro Ito1, Shingo Iwano2, Hironori Shimamoto1, Hiroyasu Umakoshi1, Koji Kawaguchi3, Shinji Ito1, Katsuhiko Kato4, Shinji Naganawa1. 1. Nagoya University Graduate School of Medicine, Department of Radiology, 65 Tsurumai-cho, Showa-ku, Nagoya 4668550, Japan. 2. Nagoya University Graduate School of Medicine, Department of Radiology, 65 Tsurumai-cho, Showa-ku, Nagoya 4668550, Japan. Electronic address: iwano45@med.nagoya-u.ac.jp. 3. Nagoya University Graduate School of Medicine, Department of Thoracic Surgery, Japan. 4. Nagoya University Graduate School of Medicine, Department of Radiological and Medical Laboratory Sciences, Japan.
Abstract
PURPOSE: To compare dual-phase dual-energy CT (DE-CT) with FDG-PET/CT for predicting histopathological locoregional invasiveness of non-small cell lung cancers (NSCLCs). MATERIALS AND METHODS: We selected 63 consecutive patients with NSCLC lesions (37 males, 26 females; age range, 44-85 years; mean age, 69 years) who were evaluated preoperatively by both DE-CT and PET/CT at our institution. Postoperative microscopic invasiveness (lymphatic permeation, vascular invasion, and/or pleural involvement) was reviewed, and we defined locoregionally invasive tumors as those that had at least one positive finding of microscopic invasiveness. DE-CT scanning in the arterial and delayed phases was performed after injection of iodinated contrast media using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation of primary tumors in the arterial and delayed phases was quantified automatically using "syngo Dual Energy Lung Nodules" application software, and the ratio of arterial phase to delayed phase enhancement (A/D ratio) was calculated. The A/D ratio and SUVmax on PET/CT were evaluated with respect to postoperative invasiveness by univariate logistic regression analysis. RESULTS: The A/D ratio was significantly correlated with lymphatic permeation, vascular invasion, and pleural involvement (p=0.011, p=0.021, and p=0.010, respectively). In contrast, the SUVmax was significantly correlated with pleural involvement (p=0.020) but not with lymphatic permeation or vascular invasion (p=0.088 and p=0.100, respectively). In the subgroup of patients with lesion diameters ≤2cm, the A/D ratio was significantly correlated with locoregional invasiveness (p=0.040), while the SUVmax was not (p=0.121). CONCLUSION: For the prediction of microscopic invasiveness of NSCLCs, the diagnostic performance of dual-phase DE-CT may be comparable to that of FDG-PET/CT.
PURPOSE: To compare dual-phase dual-energy CT (DE-CT) with FDG-PET/CT for predicting histopathological locoregional invasiveness of non-small cell lung cancers (NSCLCs). MATERIALS AND METHODS: We selected 63 consecutive patients with NSCLC lesions (37 males, 26 females; age range, 44-85 years; mean age, 69 years) who were evaluated preoperatively by both DE-CT and PET/CT at our institution. Postoperative microscopic invasiveness (lymphatic permeation, vascular invasion, and/or pleural involvement) was reviewed, and we defined locoregionally invasive tumors as those that had at least one positive finding of microscopic invasiveness. DE-CT scanning in the arterial and delayed phases was performed after injection of iodinated contrast media using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation of primary tumors in the arterial and delayed phases was quantified automatically using "syngo Dual Energy Lung Nodules" application software, and the ratio of arterial phase to delayed phase enhancement (A/D ratio) was calculated. The A/D ratio and SUVmax on PET/CT were evaluated with respect to postoperative invasiveness by univariate logistic regression analysis. RESULTS: The A/D ratio was significantly correlated with lymphatic permeation, vascular invasion, and pleural involvement (p=0.011, p=0.021, and p=0.010, respectively). In contrast, the SUVmax was significantly correlated with pleural involvement (p=0.020) but not with lymphatic permeation or vascular invasion (p=0.088 and p=0.100, respectively). In the subgroup of patients with lesion diameters ≤2cm, the A/D ratio was significantly correlated with locoregional invasiveness (p=0.040), while the SUVmax was not (p=0.121). CONCLUSION: For the prediction of microscopic invasiveness of NSCLCs, the diagnostic performance of dual-phase DE-CT may be comparable to that of FDG-PET/CT.
Authors: Giuseppe Cicero; Giorgio Ascenti; Moritz H Albrecht; Alfredo Blandino; Marco Cavallaro; Tommaso D'Angelo; Maria Ludovica Carerj; Thomas J Vogl; Silvio Mazziotti Journal: Radiol Med Date: 2020-01-10 Impact factor: 3.469