CT perfusion in non-small cell lung cancers for assessing treatment response, monitoring treatment and predicting prognosis

Abstract Introduction To determine whether Computed Tomography Perfusion (CTP) can predict treatment response and prognosis in non-small cell lung cancers (NSCLC). To determine which one of the perfusion parameter correlated best with treatment outcome. Methods Sixteen patients with NSCLC underwent CTP before and after completion of chemo-radiotherapy. Patients with complete and partial response were grouped as responders and patients with stable and progressive disease were grouped as non-responders. Pre and post-treatment whole tumour perfusion parameters (blood flow - BF, blood volume - BV, mean transit time - MTT and permeability surface area product - PS) were compared between responders and non-responders. Results Responders had higher baseline BF and PS values than non-responders; P  = 0.047, 0.028 respectively. On 1 year follow up, patients with even 2.65% increase in PS value from baseline developed metastasis while patients with decrease in PS value by 24% did not develop metastasis ( P  = 0.05). Greater decrease in BF values (17%) were noted among responders than non-responders (2.4%) following chemoradiation, though the results were not statistically significant ( P  u003e 0.05). Conclusions Tumours with higher baseline BF and PS respond well to chemo-radiation. Changes in the PS values can predict the development of metastasis and hence, the long term outcome.