Related Experiment Video
Updated: Jan 22, 2026
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Tumour response in non-small-cell lung cancer patients treated with chemoradiotherapy - Can spectral CT predict
Uli Fehrenbach1, Felix Feldhaus1, Johannes Kahn1
1Radiology, Charité University Medicine Berlin, Berlin, Germany.
Introduction:
Tumour response in lung cancer treatment is monitored by measuring lesion size in computed tomography (CT). Spectral CT (SCT) offers additional information on tumour tissue besides morphology. We evaluated SCT iodine content (IC) and performed spectral slope analysis to assess the response of non-small-cell lung cancer (NSCLC) to chemoradiotherapy (CRT).
Methods:
Eighty-three patients with advanced NSCLC treated by CRT prospectively underwent single-phase, contrast-enhanced SCT. Evaluation of all patients included treatment response (RECIST 1.1), quantitative measurements as well as SCT IC determination and spectral slope analysis in NSCLC primaries. Measurements were performed at the maximum cross-diameter of tumours and in areas with high iodine values (hotspot analysis). Iodine difference (ΔIC) was calculated. Secondary outcome parameters were IC and spectral slopes in mediastinal lymph nodes (n = 61).
Results:
Twenty-four patients (29%) showed complete remission after CRT. Thirty-four patients (41%) had stable disease (SDSCT ) or partial regression (PRSCT ). Progressive disease (PDSCT ) was seen in 25 patients (30%). Hotspot analysis showed significantly higher iodine values in PDSCT than in SDSCT /PRSCT (P < 0.001). Ten patients (12%) with initially stable disease in SCT showed progressive disease during follow-up for up to 18 months (PDFU ). These patients also had significantly higher hotspot iodine values and ΔIC in the initial scan compared to patients with SD throughout the follow-up period (SDFU ) (29%) (P < 0.001). Enlarged lymph nodes showed significantly lower iodine content and a lower spectral slope pitch than normal-sized nodes (P = 0.003 to 0.029).
Conclusion:
Spectral CT-derived iodine content of NSCLC following CRT may help in predicting recurrence. Hotspot analysis and iodine heterogeneity allow the identification of residual vascularisation as an indicator of vital tumour tissue, indicating that IC might be a suitable imaging biomarker for predicting tumour progression. Iodine content and spectral slope analysis might also help in identifying metastatic lymph nodes.
More Related Videos
Related Concept Videos
02:27Predicting Molecular Geometry
01:47Lung Capacity
01:03Prediction Intervals
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y.
01:30Radiological Investigation I: X-ray and CT
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:07End Point Prediction: Gran Plot
For potentiometric titration, the Gran plot is created by plotting...