The value of spectral CT in the pretreatment evaluation of stereotactic radiotherapy for non-small cell lung cancer

doi:10.3877/cma.j.issn.2095-655X.2019.01.002

Abstract

Abstract:

Objective

To explore the value of Gemstone spectral CT in the evaluation of stereotactic radiotherapy pretreatment in patients with non-small cell lung cancer (NSCLC).

Methods

Fifty patients with NSCLC (34 cases of adenocarcinoma, 15 cases of squamous cell carcinoma, and 1case of large cell undifferentiated carcinoma) who underwent Gemstone spectral CT scan at the department of Medical Imaging of Shandong Provincial Qianfoshan Hospital from June 2015 to December 2017 were selected. The region-of-interest for a given spatial placement of the tumors was set. The iodine density in the arterial phase and the maximum diameter of the tumor were measured. T test for two independent samples was used to compare the differences of iodine density in tumors with different pathological types and different air contents (44 cases of solid tumors, 6 cases of ground-glass opacity). The cases were divided into 3 groups according to the tumor maximum diameter(d): d≤2 cm group (n=18), 2<d≤3 cm group (n=12) and d>3 cm group (n=20). The differences of iodine density between the three groups were compared and they were separately compared by one-way ANOVA. Spearman correlation was used to analyze the relationship between iodine density and tumor maximum diameter.

Results

There was no significant difference in the iodine density between adenocarcinoma and squamous cell carcinoma [(21.71±4.12)×100 mg/L, (21.29±3.93)×100 mg/L, t=0.24, P>0.05]. And there was no significant difference in the iodine density between solid tumors and ground-glass opacity[(19.81±6.89)×100 mg/L, (18.27±3.01)×100 mg/L, t=0.54, P>0.05]. The iodine density of d≤2 cm group, 2<d≤3 cm group and d>3 cm group were(23.12±5.35)×100 mg/L, (19.10±3.33)×100 mg/L, (13.90±5.99)×100 mg/L, respectively. The difference between three groups was statistically significant (F=14.62, P<0.01). With the size of tumor increased, the iodine density decreased significantly (r=-0.71, P<0.05).

Conclusions

With the tumor enlarges, the iodine density in the tumor decreases, which may be related to the relatively decreased blood volume of the tumor. The iodine density may be a non-invasive and quantitative assessment of the radio-resistance ascribable to the hypoxic cell population in a tumor, which may indicate the prognosis of radiotherapy to some extent.

Key words: Spectral CT, Carcinoma, non-small-cell lung, Lodine density, Blood volume

Chengxiu Yuan, Huaqiang Sheng, Guangli Wang, Tianyu Zhang. The value of spectral CT in the pretreatment evaluation of stereotactic radiotherapy for non-small cell lung cancer[J]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(01): 7-10.

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References 20

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