Iodine-related attenuation in contrast-enhanced dual-energy computed tomography in small-sized solid-type lung cancers is associated with the postoperative prognosis.

Abstract

BACKGROUND:

To investigate the correlation between iodine-related attenuation in contrast-enhanced dual-energy computed tomography (DE-CT) and the postoperative prognosis of surgically resected solid-type small-sized lung cancers.

METHODS:

We retrospectively reviewed the DE-CT findings and postoperative course of solid-type lung cancers ≤3 cm in diameter. After injection of iodinated contrast media, arterial phases were scanned using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation (3D-IRA) of primary tumors at the arterial phase was computed using the "lung nodule" application software. The corrected 3D-IRA normalized to the patient's body weight and contrast medium concentration was then calculated.

RESULTS:

A total of 120 resected solid-type lung cancers ≤3 cm in diameter were selected for analysis (82 males and 38 females; mean age, 67 years). During the observation period (median, 47 months), 32 patients showed postoperative recurrence. Recurrent tumors had significantly lower 3D-IRA and corrected 3D-IRA at early phase compared to non-recurrent tumors (p = 0.046 and p = 0.027, respectively). The area under the receiver operating characteristic curve for postoperative recurrence was 0.624 for the corrected 3D-IRA at early phase (p = 0.025), and the cutoff value was 5.88. Kaplan-Meier curves for disease-free survival indicated that patients showing tumors with 3D-IRA > 5.88 had a significantly better prognosis than those with tumors showing 3D-IRA < 5.88 (p = 0.017).

CONCLUSIONS:

The 3D-IRA of small-sized solid-type lung cancers on contrast-enhanced DE-CT was significantly associated with postoperative prognosis, and low 3D-IRA tumors showed a higher TNM stage and a significantly poorer prognosis.

• Authors: Shingo Iwano, Shinichiro Kamiya, Rintaro Ito, Shota Nakamura, Shinji Naganawa
• Journal: Cancer imaging : the official publication of the International Cancer Imaging Society (Cancer Imaging) Vol. 21 Issue 1 Pg. 7 (Jan 07 2021) ISSN: 1470-7330 [Electronic] England
• PMID: 33413669 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Iohexol
• iopromide
• Iopamidol

Topics

• Adult
• Aged
• Contrast Media (administration & dosage)
• Female
• Humans
• Iohexol (administration & dosage, analogs & derivatives)
• Iopamidol (administration & dosage)
• Lung Neoplasms (diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Prognosis
• Radiography, Dual-Energy Scanned Projection (methods)
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)