Ohno Yoshiharu, Fujisawa Yasuko, Yoshikawa Takeshi, Seki Shinichiro, Takenaka Daisuke, Fujii Kenji, Ito Yuya, Kimata Hirona, Akino Naruomi, Nagata Hiroyuki, Nomura Masahiko, Ueda Takahiro, Ozawa Yoshiyuki
Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Mediciine, Toyoake, Japan.
Eur Radiol. 2025 May 22. doi: 10.1007/s00330-025-11653-7.
To determine the capability of dynamic contrast-enhanced (CE-) perfusion area-detector CT (ADCT) for detecting pathological structural changes in stage I non-small cell lung cancer (NSCLC) patients.
Sixty-three consecutive stage I NSCLC patients with progressive fibrosing interstitial lung disease (PF-ILD) underwent dynamic CE-perfusion ADCT analyzed by dual-input maximum slope (DMS) methods for total, pulmonary arterial and systemic arterial perfusion (TP, PAP and SAP) maps, surgical treatment and pathological examination. Multicentric ROIs were then placed over sites assessed as normal lung, pulmonary emphysema, GGO or reticular pattern without traction bronchiectasis, reticular pattern with traction bronchiectasis and honeycombing in the resected lung. Next, an analysis of variance (ANOVA) followed by Tukey's honest significant difference (HSD) multiple comparison test was performed for a comparison of each of the perfusion parameters for five groups. Finally, discrimination accuracy for evaluation of lung parenchymal change was compared for all indexes and combined methods.
PAPs of abnormal lungs were significantly lower than that of normal lungs (p < 0.0001). SAPs of normal or emphysematous lungs were significantly lower than those of others (p < 0.0001). SAP of GGO or reticular pattern without traction bronchiectasis was significantly lower than that for reticular pattern with traction bronchiectasis and honeycombing (p < 0.0001). Discrimination accuracy of combined perfusion index was significantly higher than that of each index (p < 0.0001).
Dynamic CE-perfusion ADCT is useful for detecting pathological structural changes in stage I NSCLC patients with PF-ILD.
Question Can dynamic first-pass contrast-enhanced perfusion matrices evaluate parenchymal lung changes and disease severity of parenchymal diseases in stage I non-small cell lung cancer (NSCLC) patients? Findings Perfusion indexes differentiated significantly among normal lung, emphysema, GGO or reticular pattern without traction bronchiectasis, reticular pattern with traction bronchiectasis and honeycombing and significantly improved discrimination accuracy by combined methods. Clinical relevance Dynamic first-pass contrast-enhanced perfusion area-detector CT has the potential to assess underlying pathologies and pulmonary functional changes in stage I non-small cell carcinoma patients with progressive fibrosing interstitial lung disease.
确定动态对比增强（CE）灌注面积探测器CT（ADCT）检测I期非小细胞肺癌（NSCLC）患者病理结构变化的能力。
63例连续的I期NSCLC合并进行性纤维化间质性肺疾病（PF-ILD）患者接受了动态CE灌注ADCT检查，采用双输入最大斜率（DMS）方法分析总灌注、肺动脉灌注和体动脉灌注（TP、PAP和SAP）图，并接受手术治疗和病理检查。然后在切除肺中评估为正常肺、肺气肿、磨玻璃影（GGO）或无牵拉支气管扩张的网状影、有牵拉支气管扩张的网状影和蜂窝状影的部位放置多中心感兴趣区（ROI）。接下来，进行方差分析（ANOVA），随后进行Tukey真实显著性差异（HSD）多重比较检验，以比较五组中每个灌注参数。最后，比较所有指标和联合方法评估肺实质变化的判别准确性。
异常肺的PAP显著低于正常肺（p < 0.0001）。正常或肺气肿肺的SAP显著低于其他肺（p < 0.0001）。无牵拉支气管扩张的GGO或网状影的SAP显著低于有牵拉支气管扩张和蜂窝状影的网状影（p < 0.0001）。联合灌注指数的判别准确性显著高于每个指数（p < 0.0001）。
动态CE灌注ADCT有助于检测I期NSCLC合并PF-ILD患者的病理结构变化。
问题 动态首过对比增强灌注矩阵能否评估I期非小细胞肺癌（NSCLC）患者的肺实质变化和实质疾病的严重程度？ 发现 灌注指数在正常肺、肺气肿、无牵拉支气管扩张的GGO或网状影、有牵拉支气管扩张的网状影和蜂窝状影之间有显著差异，联合方法显著提高了判别准确性。 临床意义 动态首过对比增强灌注面积探测器CT有潜力评估I期非小细胞癌合并进行性纤维化间质性肺疾病患者的潜在病理和肺功能变化。
