Predicting the prognosis of non-small cell lung cancer patient treated with conservative therapy using contrast-enhanced MR imaging

The aim of this study was to evaluate the therapeutic effect more accuratel y and predict the prognosis of treated non-small cell lung cancer by contra st-enhanced magnetic resonance Imaging (CE-MRI) Contrast-enhanced computed tomography (CE-CT) and CE-MRI were examined 90 non-small cell lung cancer p atients treated with conservative therapies. Enhancement patterns of CE-MRI were classified into three types: peripheral; mottled; and homogeneous. Re duction ratio of tumor size (RRT) based on the World Health Organization re sponse criteria and a new response rate; reduction ratio of viable tumor si ze (RRVT) which evaluates not only the reduction of tumor size but also cha nges in necrosis and/or cavity size, were evaluated. Changes of enhancement pattern were compared and correlated with pathological diagnosis. The RRTs , RRVTs, and interobserver agreements evaluated by all modalities were comp ared. The RRTs and RRVTs in Bch subgroup were correlated and compared with prognoses. Change of enhancement pattern deed on therapy had no tendency (p = 0.06). Enhancement pattern had significant correlation with pathological diagnosis (p < 0.0001). Partial response (PR) case of RRVT had significant difference between imaging techniques (p = 0.04). The RRVT of other cases and RRT had no significant difference. Interobserver agreements of RRT and RRVT were almost perfect (n <greater than or equal to> 0.93). Prognosis had better correlation with RRVT than with RRT. Differences of relapse-free su rvival and survival between patients considered as having no change (NC) by RRT and PR by RRVT (NC-PR) and patients considered as having NC by RRT and RRVT were significant (p = 0.03, 0.01). There were no significant differen ces of relapse-free survival and survival between NC-PR patients and patien ts considered as having PR by RRT and RRVT. The CE-MRI technique could accu rately contrasts of treated non-small cell lung cancer.The aim of this stud y was to evaluate the therapeutic effect more accurately and predict the pr ognosis of treated non-small cell lung cancer by using contrast-enhanced ma gnetic resonance Imaging (CE-MRI). Contrast-enhanced computed tomography (C E-CT) and CE-MRI were examined 90 non-small cell lung cancer patients treat ed with conservative therapies. Enhancement patterns of CE-MRI were classif ied into three types: peripheral; mottled; and homogeneous. Reduction ratio of tumor size (RRT) based on the World Health Organization response criter ia and a new response rate; reduction ratio of viable tumor size (RRVT) whi ch evaluates not only the reduction of tumor size but also changes in necro sis and/or cavity size, were evaluated. Changes of enhancement pattern were compared and correlated with pathological diagnosis. The RRTs, RRVTs, and interobserver agreements evaluated by all modalities were compared. The RRT s and RRVTs in Bch subgroup were correlated and compared with prognoses. Ch ange of enhancement pattern deed on therapy had no tendency (p = 0.06). Enh ancement pattern had significant correlation with pathological diagnosis (p < 0.0001). Partial response (PR) case of RRVT had significant difference b etween imaging techniques (p = 0.04). The RRVT of other cases and RRT had n o significant difference. Interobserver agreements of RRT and RRVT were alm ost perfect (<kappa> greater than or equal to 0.93). Prognosis had better c orrelation with RRVT than with RRT. Differences of relapse-free survival an d survival between patients considered as having no change (NC) by RRT and PR by RRVT (NC-PR) and patients considered as having NC by RRT and RRVT wer e significant (p = 0.03, p = 0.01). There were no significant differences of relapse-free survival and survival between NC-PR patients and patients considered as having PR by RRT and RRV T. The CE-MRI technique could accurately evaluate the therapeutic effect an d predict the prognosis of treated non-small cell lung cancer.