Inspiratory/expiratory xenon-enhanced area-detector CT: Capability for quantitative assessment of lung ventilation changes in surgically treated non-small cell lung cancer patients

Yoshiharu Ohno; Yasuko Fujisawa; Takeshi Yoshikawa; Daisuke Takenaka; Hisanobu Koyama; Hidetkazu Hattori; Kazuhiro Murayama; Kenji Fujii; Naoki Sugihara; Hiroshi Toyama

doi:10.1016/j.ejrad.2021.109574

Inspiratory/expiratory xenon-enhanced area-detector CT: Capability for quantitative assessment of lung ventilation changes in surgically treated non-small cell lung cancer patients

Eur J Radiol. 2021 Mar:136:109574. doi: 10.1016/j.ejrad.2021.109574. Epub 2021 Jan 29.

Authors

Affiliations

¹ Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan; Joint Laboratory Research of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yohno@fujita-hu.ac.jp.
² Canon Medical Systems Corporation, Otawara, Japan.
³ Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Japan.
⁴ Department of Radiology, Hyogo Cancer Center, Akashi, Japan.
⁵ Department of Radiology, Osaka Police Hospital, Osaka, Japan.
⁶ Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
⁷ Joint Laboratory Research of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan.

PMID: 33548852
DOI: 10.1016/j.ejrad.2021.109574

Abstract

Purpose: To evaluate the capability of inspiratory/expiratory Xe-enhanced ADCT for assessment of changes in pulmonary function and regional ventilation of surgically treated NSCLC patients.

Method and materials: Forty consecutive surgically treated NSCLC patients underwent pre- and postoperative inspiratory/expiratory Xe-enhanced ADCT and pulmonary function tests. For each patient, pre- and post-operative data were analyzed and pre- and post-operative wash-in (WI) and wash-out (WO) indexes and ventilation ratio (VR=[WI-WO]/WI) maps generated by means of pixel-by-pixel analyses. Differences between pre- and postoperative WI (ΔWI), WO (ΔWO) and VR (ΔVR) were also determined. To determine the relationship between all ventilation index changes and pulmonary functional loss, Pearson's correlation was used to correlate each ventilation index change with the corresponding pulmonary functional parameter change. In addition, stepwise regression analysis was performed for all ventilation index changes and each corresponding pulmonary functional parameter change.

Results: FEV₁/FVC% change showed fair or good and significant correlations with ΔWI (r = 0.39, p = 0.01) and ΔVR (r = 0.68, p = 0.001), %FEV₁ change good or moderate and significant correlations with ΔWI (r = 0.56, p = 0.0001) and ΔVR (r = 0.76, p < 0.0001), and %VC change moderate yet significant correlation with ΔWI (r = 0.65, p < 0.0001) and ΔVR (r = 0.67, p < 0.0001). Stepwise regression analysis demonstrated that FEV₁/FVC% change (r² = 0.56, p < 0.0001) significantly affected two factors, ΔVR (p < 0.0001) and ΔWI (p = 0.006), as did %FEV₁ change (r² = 0.68, p < 0.0001) [ΔVR (p < 0.0001) and ΔWI (p = 0.0001)], and %VC change (r² = 0.63, p < 0.0001) [ΔVR (p < 0.0001) and ΔWI (p = 0.0001)].

Conclusion: Inspiratory/expiratory Xe-enhanced ADCT has the potential to demonstrate that pre- and postoperative ventilation status of surgically treated NSCLC patients correlates with pulmonary function.

Keywords: CT; Lung; Lung cancer; Ventilation; Xenon.

MeSH terms

Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
Carcinoma, Non-Small-Cell Lung* / surgery
Humans
Lung / diagnostic imaging
Lung / surgery
Lung Neoplasms* / diagnostic imaging
Lung Neoplasms* / surgery
Tomography, X-Ray Computed
Xenon

Substances

Xenon