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Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules

Received: 15 December 2018     Accepted: 9 January 2019     Published: 13 February 2019
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Abstract

The current study aim is the role of multi-slice CT perfusion in assessment of pulmonary nodules. Eighty patients with pulmonary nodules underwent non contrast CT scan of the chest and dynamic CT perfusion of the chest. Dynamic CT chest perfusion of 80 patients with pulmonary nodules revealed 24 patients had benign nodules of low biological activity, 16 patients had benign nodules of high biological activity and 40 patients had malignant nodules (16 of them had multiple nodules in both lung fields and clinical history of primary extra pulmonary malignancy, so diagnosed as metastatic nodules). Perfusion flow, extraction fraction and blood volume; these indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P>0.0001) In addition, these indexes showed a significant difference between benign nodules with high biologic activity and those with low biologic activity (P>0.0001) and the perfusion flow was of high benefit for nodules characterization than ejection fraction and blood volume by the higher significant values. CT perfusion compared the effect of therapy (chemotherapy and or radiotherapy) on metastatic pulmonary nodules before and after start of treatment by perfusion parameters (perfusion flow, extraction fraction and blood volume) & colour maps with the clinical data and follow up revealed that both results closely near and raise the efficacy of CT perfusion study in follow up and assessment of treatment response in metastatic pulmonary nodules. It can be concluded that CT perfusion is a feasible non-invasive diagnostic technique able to evaluate the nature of pulmonary nodules and treatment response in patients with metastatic pulmonary nodules.

Published in International Journal of Medical Imaging (Volume 7, Issue 1)
DOI 10.11648/j.ijmi.20190701.11
Page(s) 1-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

CT Perfusion, Perfusion Flow, Extraction Fraction

References
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[2] Ohno Y, Koyama H, Matsumoto K, et al: Differentiation of Malignant and Benign Pulmonary Nodules with Quantitative First-Pass 320-Detector Row Perfusion CT versus FDG PET/CT. Radiology. 2011; 258:599-609.
[3] Kim SH. and Kamaya A. CT Perfusion: principles and applications in oncology. Radiology. 2014; 272(2):322–344.
[4] Yuan X, Zhang J, Quan C, et al. Differentiation of malignant andbenign pulmonary nodules with first-passdual-input perfusion CT. Eur Radiol 2013;23(9):2469–2474.
[5] Ohno Y, Koyama H, Fujisawa Y, et al. Dynamic contrast enhanced perfusion area detector CT for non-small cell lung cancer patients: influence of mathematical models on early prediction capabilities for treatment response and recurrence after chemoradiotherapy, Eur. J. Radiol. 2016; 85(1):176–186.
[6] Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest physicians evidence based clinical practice guidelines. Chest. 2013; 143(5Suppl):e93S-e120S.
[7] Ebenhan T, Schoeman I, Rossouw DD, et al. Evaluation of a Flexible NOTA-RGD Kit Solution Using Gallium-68 from Different 68Ge/68Ga-Generators: Pharmacokinetics and Biodistribution in Nonhuman Primatesand Demonstration of Solitary Pulmonary Nodule Imaging in Humans. Mol Imaging Biol. 2017; 19 (3): 469-482.
[8] Li Y, Yang ZG, Chen TW, et al: Whole tumour pertusion of peripheral lung carcinoma: evaluation with first-pass CT perfusion imaging at 64-detector row CT". Clin Radiol. 2008; 63: 629-35.
[9] Yi CA, Lee KS, Kim EA, et al: Solitary pulmonary nodules: dynamic enhanced multidetector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology 2004; 233: 191–9.
[10] Ng QS, Goh V, Klotz E, et al: Quantitative assessment of lung cancer perfusion using MDCT: does measurement reproducibility improve with greater tumour volume coverage? AJR Am J Roentgenol 2006; 187: 1079–84.
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[13] Erasmus JJ, Connolly JE, McAdams HP, et al: Solitary pulmonary nodules: Part I. Morphologic evaluation for differentiation of benign and malignant lesions. Radiographics. 2000; 20(1):43-58.
[14] Callister ME, Baldwin DR, Akram AR, et al: British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax. 2015; 70 Suppl 2:ii1-ii54.
[15] SitartchoukI, Roberts HC, Pereira AM, et al. Computed tomography perfusion using first pass methods for lung nodule characterization: limits and implications in radiologic practice. Invest Radiol. 2009; 44(2):124.
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    Naglaa Samy Fahmy, Mohamed Ahmed Yousef, Mohamed Abd El-Hamid Alm El-Din, Abd El Monem Nooman Darweesh. (2019). Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules. International Journal of Medical Imaging, 7(1), 1-10. https://doi.org/10.11648/j.ijmi.20190701.11

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    ACS Style

    Naglaa Samy Fahmy; Mohamed Ahmed Yousef; Mohamed Abd El-Hamid Alm El-Din; Abd El Monem Nooman Darweesh. Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules. Int. J. Med. Imaging 2019, 7(1), 1-10. doi: 10.11648/j.ijmi.20190701.11

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    AMA Style

    Naglaa Samy Fahmy, Mohamed Ahmed Yousef, Mohamed Abd El-Hamid Alm El-Din, Abd El Monem Nooman Darweesh. Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules. Int J Med Imaging. 2019;7(1):1-10. doi: 10.11648/j.ijmi.20190701.11

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  • @article{10.11648/j.ijmi.20190701.11,
      author = {Naglaa Samy Fahmy and Mohamed Ahmed Yousef and Mohamed Abd El-Hamid Alm El-Din and Abd El Monem Nooman Darweesh},
      title = {Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules},
      journal = {International Journal of Medical Imaging},
      volume = {7},
      number = {1},
      pages = {1-10},
      doi = {10.11648/j.ijmi.20190701.11},
      url = {https://doi.org/10.11648/j.ijmi.20190701.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20190701.11},
      abstract = {The current study aim is the role of multi-slice CT perfusion in assessment of pulmonary nodules. Eighty patients with pulmonary nodules underwent non contrast CT scan of the chest and dynamic CT perfusion of the chest. Dynamic CT chest perfusion of 80 patients with pulmonary nodules revealed 24 patients had benign nodules of low biological activity, 16 patients had benign nodules of high biological activity and 40 patients had malignant nodules (16 of them had multiple nodules in both lung fields and clinical history of primary extra pulmonary malignancy, so diagnosed as metastatic nodules). Perfusion flow, extraction fraction and blood volume; these indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P>0.0001) In addition, these indexes showed a significant difference between benign nodules with high biologic activity and those with low biologic activity (P>0.0001) and the perfusion flow was of high benefit for nodules characterization than ejection fraction and blood volume by the higher significant values. CT perfusion compared the effect of therapy (chemotherapy and or radiotherapy) on metastatic pulmonary nodules before and after start of treatment by perfusion parameters (perfusion flow, extraction fraction and blood volume) & colour maps with the clinical data and follow up revealed that both results closely near and raise the efficacy of CT perfusion study in follow up and assessment of treatment response in metastatic pulmonary nodules. It can be concluded that CT perfusion is a feasible non-invasive diagnostic technique able to evaluate the nature of pulmonary nodules and treatment response in patients with metastatic pulmonary nodules.},
     year = {2019}
    }
    

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    T1  - Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules
    AU  - Naglaa Samy Fahmy
    AU  - Mohamed Ahmed Yousef
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    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
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    EP  - 10
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20190701.11
    AB  - The current study aim is the role of multi-slice CT perfusion in assessment of pulmonary nodules. Eighty patients with pulmonary nodules underwent non contrast CT scan of the chest and dynamic CT perfusion of the chest. Dynamic CT chest perfusion of 80 patients with pulmonary nodules revealed 24 patients had benign nodules of low biological activity, 16 patients had benign nodules of high biological activity and 40 patients had malignant nodules (16 of them had multiple nodules in both lung fields and clinical history of primary extra pulmonary malignancy, so diagnosed as metastatic nodules). Perfusion flow, extraction fraction and blood volume; these indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P>0.0001) In addition, these indexes showed a significant difference between benign nodules with high biologic activity and those with low biologic activity (P>0.0001) and the perfusion flow was of high benefit for nodules characterization than ejection fraction and blood volume by the higher significant values. CT perfusion compared the effect of therapy (chemotherapy and or radiotherapy) on metastatic pulmonary nodules before and after start of treatment by perfusion parameters (perfusion flow, extraction fraction and blood volume) & colour maps with the clinical data and follow up revealed that both results closely near and raise the efficacy of CT perfusion study in follow up and assessment of treatment response in metastatic pulmonary nodules. It can be concluded that CT perfusion is a feasible non-invasive diagnostic technique able to evaluate the nature of pulmonary nodules and treatment response in patients with metastatic pulmonary nodules.
    VL  - 7
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Author Information
  • Radio-diagnosis & Medical Imaging Department, Faculty of Medicine, Tanta University, Tanta, Egypt

  • Radio-diagnosis & Medical Imaging Department, Faculty of Medicine, Tanta University, Tanta, Egypt

  • Oncology & Nuclear Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

  • Radio-diagnosis & Medical Imaging Department, Faculty of Medicine, Tanta University, Tanta, Egypt

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