Preliminary assessing no-surgical treatment response in bronchogenic carcinoma with double-phase contrast material-enhanced computed tomography

Objective： To evaluate the efficacy of double-phase contrast material-enhanced computed tomography （CT） in assessing no-surgical treatment response in bronchogenic carcinoma preliminarily. Methods： 52 patients with bronchogenic carcinoma after no-surgical treatment underwent double-phase contrast material-enhanced computed tomography. Two spiral CT scans were obtained at 25 and 90 seconds respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 4 mUs by using an autoinjector. Precontrast and postcontrast attenuation on every scan was recorded and peak height was calculated. Enhancement pattern was evaluated on the images obtained at 25 and 90 seconds after injection of contrast medium. Results： Precontrast attenuation, postcontrast attenuation at 25 and 90 seconds were 42.20 ± 7.43 Hu, 57.35 ± 10.09 Hu and 71.85 ±12.45 Hu, respectively. No statistically significant difference in precontrast attenuation was found between our results in the study and the results in our old study （mean precontrast attenuation 40.70 Hu） which was obtained in cases before therapy （t = 1.455, P = 0.152 〉 0.05）. Peak height of bronchogenic carcinoma after no-surgical treatment （29.46 ±10.85 Hu） were significantly lower than that of bronchogenic carcinoma before therapy obtained in our old study （mean peak height 35.79 Hu; t = 4.206, P = 0.001 〈 0.05）. 32 of 52 cases showed homogeneous enhancement at 90 seconds. Of the 32 cases, there were 21 with inhomogeneous enhancement, 7 with inhomogeneous enhancement, 2 with central enhancement and 2 with peripheral enhancement at 25 seconds. Conclusion： Bronchogenic carcinoma after no-surgical treatment shows a gradual increase to the peak height after administration of contrast material. Peak heights can reflect the blood supply of bronchogenic carcinoma and might be index for evaluation of no-surgical treatment response in bronchogenic carcinoma.

Preliminary assessing no-surgical treatment response in bronchogenic carcinoma with changes in enhancement pattern

Objective： The aim of this study was to evaluate the efficacy of changes in enhancement pattern in assessing no-surgical treatment response in bronchogenic carcinoma preliminarily. Methods Thirty-three patients with bronchogenic carcinoma underwent two-phase contrast material-enhanced computed tomography prior to and after stopping no-surgical treatment more than one-month respectively. Two spiral CT scans were obtained at 25 and 90 s respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 3 mL/s by using an autoinjector. The sum of the tumor longest diameters （LD） prior to treatment, after treatment and the sum of the post-treatment tumor enhancement area LD on the images obtained at 90 s after injection of contrast medium were recorded, Precontrast and postcontrast attenuation on every scan was recorded and peak height was calculated. The significance of the difference among groups was analyzed by means of ANOVA, student t test and chi-square test. Results： The sum of the tumor LD prior to treatment, that of after treatment and the sum of the post-treatment tumor enhancement area LD on the images obtained at 90 s after injection of contrast medium were （4.49 ± 1.32）, （4.05 ± 1.63）, （3.36 ± 1.22） cm respectively and there were statistically significant dif- ferences among them （f= 5.467, P = 0.006）. The sum of the tumor LD prior to treatment was significantly higher than that of the post-treatment tumor enhancement area （P = 0.001）. No statistically significant difference in the sum of the tumor LD was found between the pre- treatment and the post-treatment （P = 0.207）. There was no statistically significant difference between the sum of the tumors LD and that of tumor enhancement area after treatment （P = 0.086）. The response rate （RR） （21.21%） according to changes in sum of the tumor LD was significantly lower than that （30.30%） according to changes in the sum of the post-treatment tumor enhancement area LD （x2 = 15.12, P 〈 0.05）, and the progressive diseases （PD） rate （21.21%） was significantly higher than that （12.12%; X2 = 14.12, P 〈 0.05）. No statistically significant difference was found between precontrast attenuation prior to treatment [（41.77±7.03） HU] and that after treatment [（41.89 ± 7.63） HU; t = 0.335, P = 0.740 〉 0.05]. Peak height of bronchogenic carcinoma prior to treatment [（36.50 ± 11.21） HU] were significantly higher than that after treatment [（29.91 ± 10.35） HU; t = 10.081, P = 0.001]. Conclusion： Therapeutic effect may be underestimated with use of changes in sum of the tumor LD. The changes in sum of tumor enhancement area LD in addition to peak height is suggested to be used in assessing no-surgical.treatment response in bronchogenic carcinoma.

Preliminary assessing no-surgical treatment response in bronchogenic carcinoma with changes in enhancement area size

Objective:The aim of this study was to evaluate the efficacy of changes in the sum of the enhancement area longest diameters(LD) in assessing no-surgical treatment response in bronchogenic carcinoma preliminarily.Methods:Twentytwo patients with bronchogenic carcinoma underwent two-phase contrast material-enhanced computed tomography prior to and after stopping no-surgical treatment more than one-month respectively.Two spiral CT scans were obtained at 25 and 90 sec respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 3 mL/sec by using an autoinjector.The sum of the tumor LD prior to treatment,after treatment and the sum of the post-treatment tumor enhancement area LD on the images obtained at 90 sec after injection of contrast medium were recorded.Enhancement pattern was evaluated on the images obtained at 25 and 90 sec after injection of contrast medium.Response Evaluation Criteria In Solid Tumors(RECIST) guidelines were adopted to evaluate treatment response.The significance of the difference among groups was analyzed by means of ANOVA.Results:The sum of the tumor LD prior to treatment,that of after treatment and the sum of the post-treatment tumor enhancement area LD on the images obtained at 90 sec after injection of contrast medium were(4.48 ± 1.19),(3.98 ± 1.50),(3.35 ± 1.11) cm respectively and there were statistically significant differences among them(F = 4.273,P = 0.018).The sum of the tumor LD prior to treatment was significantly higher than that of the post-treatment tumor enhancement area(P = 0.005).No statistically significant difference in the sum of the tumor LD was found between the pre-treatment and the post-treatment(P = 0.203).There was not statistically significant difference between the sum of the tumors LD prior to treatment and that of after treatment.According to changes in sum of the tumor LD,there were 4 of 22(18.18%) partial responses(PRs),14 of 22(63.64%) stable diseases(SDs),4 of 22(18.18%) progressive diseases(PD) and response rate was 18.18%.According to changes in the sum of the post-treatment tumor enhancement area LD on the images obtained at 90 sec after injection of contrast medium,there were 5 of 22(22.73%) PRs,15 of 22(68.18%) SDs,2 of 22(9.09%) PDs and response rate was 22.73%.Ten cases among 22 appeared homogeneous enhancement at 90 sec prior to treatment.At 25 sec,there were 6 cases with heterogeneous enhancement,2 cases with homogeneous enhancement,1 case with central enhancement,and 1 case with peripheral enhancement among the 10 cases.Six cases appeared homogeneous enhancement and 16 cases heterogeneous enhancement at 90 sec after treatment.At 25 sec,there were 3 cases with heterogeneous enhancement,2 cases with homogeneous enhancement,and 1 case with central enhancement among the six cases.Conclusion:Therapeutic effect may be underestimated with use of changes in sum of the tumor LD.The changes in sum of tumor enhancement area LD is suggested to be used in assessing no-surgical treatment response in bronchogenic carcinoma.The no-surgical treatment kill bronchogenic carcinoma cell and tumor after no-surgical treatment shows a gradual increase to the peak height after administration of contrast material.