To directly compare the utility for therapeutic outcome prediction of dynamic first-pass contrast-enhanced (CE)-perfusion area-detector computed tomography (ADCT), MR imaging assessed with the same mathematical method and 2-[fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography combined with CT (PET/CT) for non-small cell lung cancer (NSCLC).
Thoracic radiation therapy
patients treated with chemoradiotherapy Based on the evidence of a meta-analysis showing the superiority of concurrent chemotherapy and thoracic radiation therapy (i.e. chemoradiotherapy) to sequential chemoradiotherapy for unresectable stage III non-small cell lung cancer (NSCLC); with a 2- and 5-year absolute survival benefits of 10% and 4.5%, respectively;1 radiation oncologists must evaluate whether the patients are suitable for chemoradiotherapy. Until now; the eligibility criteria for chemoradiotherapy are not precisely define.
In addition, early prediction of therapeutic effect may make it possible for physicians including radiation oncologists, oncologist; pulmonologist and patients to consider treatment options for personalized medicine; and thus has the potential to improve quality of life for NSCLC patients both during and after treatment.
For this clinical issue, two dynamic imaging techniques, dynamic contrast-enhanced (CE) perfusion CT and dynamic CE-MR imaging, diffusion-weighted MR imaging and positron emission tomography (PET) or PET combined with CT (PET/CT) using 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) has been suggested as useful for evaluating tumor perfusion parameters as well as glucose metabolism.
etc.2–15 Moreover; dynamic CE-perfusion CT using a 320-detector row CT scanner with an area detector CT (ADCT) has been recommend as a useful tool for quantitative perfusion evaluation for lung nodule; therapeutic effect prediction in NSCLC patients. 16–18 In addition; a mathematical model is find to be an important factor for quantitative perfusion parameter evaluation in this setting.
On the other hand, quantitatively assessed dynamic CE-perfusion MR imaging has been introduce as useful for evaluation of diagnosis of therapeutic effect as well as assessment of disease severity of pulmonary vascular diseases. 19–24 Under these circumstances; there seems to be an urgent need for reproducible assessment of quantitative pulmonary perfusion parameters on dynamic CE-perfusion CT and MR imaging using the same mathematical models at 3T MR system.
To the best of our knowledge; however, no studies have been report of a direct comparison of dynamic CE-perfusion ADCT and MR imaging; which are analyze using the same mathematical model; with PET/CT for therapeutic effect prediction for NSCLC patients treat with chemoradiotherapy Dynamic first-pass CE-perfusion ADCT and MR imaging are as useful as PET/CT for early prediction of treatment response of NSCLC patients treat with chemoradiotherapy.
In addition; when the same mathematical model is use for both dynamic first-pass CE-perfusion methods; tumor perfusion assessments for such patients can also be perform by dynamic first-pass CE-perfusion ADCT and MR imaging