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Journal Article Ppublish 5 citations

PubMed: 35242369 DOI: 10.21037/jtd-21-967

CT perfusion imaging can detect residual lung tumor early after radiofrequency ablation: a preliminary animal study on both tumoral and peri-tumoral region assessment.

J Thorac Dis 14(1):64-75

Authors: Zenghui Cheng, Yixue Wang, Min Yuan, Jianxiao Liang, Yanling Feng, Yuxin Shi, Zhiyong Zhang, Fei Shan

Affiliations

  • Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
  • Department of Critical Care Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
  • Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
  • Department of Radiology, Dongying People's Hospital, Dongying, China.
  • Department of Pathology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
  • Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) is a minimally invasive procedure to treat lung cancer. Timely evaluation on residual lung tumor after RFA is crucial to the prognosis, hence, our objective is to assess CT perfusion (CTP) on detection of residual lung tumor early after RFA.

METHODS

CTP imaging was performed in 24 lung VX2 tumor models 1 day before and within 1 hour after RFA. CTP maps with dual-input (n=24) and single-input [n=13, with predominant ground glass opacity (GGO) after RFA] models were generated using the maximal slope method. Regions of interest were independently placed on the maximal cross-sectional tumor before and after RFA and on GGO after RFA by two thoracic radiologists. The bronchial flow (BF), pulmonary flow (PF) and perfusion index (PI) were compared between pre-RFA and post-RFA images. The parameters (BF, PF and PI of tumor; PF of GGO) of the complete and incomplete RFA groups were compared based on nicotinamide adenine dinucleotide hydrogen (NADH) and TdT-mediated dUTP nick-end labeling (TUNEL) staining and were correlated with the microvascular density (MVD).

RESULTS

The BF and PF decreased after RFA (all P values <0.03). The decrease in BF and PF (ΔBF and ΔPF) in the complete RFA group was higher (P=0.01; 0.02). The areas under the curve (AUC) of ΔBF and ΔPF at 14.85 and 17.25 mL/min/100 mL in determination of tumor with complete ablation were 0.80 and 0.78, respectively. ΔBF was positively correlated with MVD (P=0.046, r=0.468). PF of GGO with incomplete RFA was higher (P=0.001). The AUC of PF ≤29.4 mL/min/100 mL in determination of tumor with complete ablation was 0.99.

CONCLUSIONS

CTP could detect residual lung tumor early after RFA in a rabbit model, which might provide a clinical solution to early treatment assessment after RFA.

MeSH

Neoplasms, Lung, Nad, Perfusion Imaging, Cytidine Triphosphate, Radiofrequency Ablation

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