269 270

71

POSSlBIL.ITY OF PULMONARY FUNCTION ASSESMENT USING COMPUTED TOMOGRAPHY OF THE CHEST. M. Saito. H. Kato, K. Uryu. T. Okunaka, T. Kobayashi, T. Tsuchida, H. Takahashi, N. Kawate, C. Konaka Department of Surgery, Tokyo Medical College, Tokyo.

The purpose of tbis study was to establish the possibility of pulmonary function assessment using computed tomography (ClJ of the chest. The CT values of varies normal intrathoracic areas and abnormal lung area, including tumor, fibrosis and emphysema, were analyzed in 34 subjects including 18 case of lung cancer. Density of normal peripheral lung was measured in 6 points on each slices. These scores were compared left vs. tight, slice number, and anterior vs. posterior. The CT numbers in this study following the no enhanced computed tomography scanner, GE9800 CT by using tbe regions of interest which limited in O.Olcm’ area.

There was no significant difference between left and right lung, among different slices, although between anterior and posterior in the normal lung. Attenuation of the normal lung (apparently normal by radiographic appearance on CT images) ranged between -859 and - 849 Hounsfwld units. These are different from mean density values of other structures and abnormal lung structures in the thorax. Correlation was found between the accumulation of the normal Cf values and the result of spirometry. It is suspected quantity of an effective ventilation capacity can be analyzed based this range of (X numbers.

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CLINICAL FEATURES OF SUPERIOR VENA CAVA SYNDROME ACCOMPANIED BY PRIMARY LUNG CANCER. M. Bando, Y. Ishii. S. Kitamura. Department of Pulmonary Medicine,

Jichi Medical School, Tochigi, Japan.

Superior vena cava syndrome(SVCS) is often accompanied by

malignant diseases and Its prognosis is very poor. We analyzed

clinical features, findings of digital subtraction angiography(DSA), CT

and MR images, and prognosis in fifty cases of SVCS accompanied

by primary lung cancer admitted to Jichi Medical School Hospital

from 1974 to 1993.

Histology Cases Age Sex Pv?* MST**

(mean) (M/F) (cmH,O) (months)

Small cell carcinoma 22 65.3 19/3 28.0 3.03

Adenocarcinoma 14 56.3 12/2 28.0 3.07

Squamous cell carcinoma 11 63.4 11/O 31.7 2.20

Large cell carcinoma 3 67.7 2/l 31.3 4.04 Mediastinal tumor 7 42.0 5/2 31 .I 6.28

*PVP:Peripheral venous pressure

* *MST:Median survival time

The primary tumor sites were in the rtght upper lobe in ten

cases(91%) of squamous cell carcinoma, but primary sites were

various in other types of lung cancer. In forty of fifty SVCS cases,

DSA, CT and/or MR images were performed. Twenty-seven

cases(67.5%) showed stenosis or obstruction of SVC. While, ten

cases(25%.) showed invasion of tumor to the SVC and three

cases(7.5%) showed thrombus formation m the SVC. Prognosis in

all cases was very poor (MST=4.0 months). However, compared

with non-small cell lung cancer, some cases of small cell lung

cancer showed effective responses to chemotherapy and prolonga-

tion of survival periods.

SrAGfNG KmfJmALoFTaBAHRcBAIt4o~LoNAL ANTlDODY-lNWNGC- Bnn&caFen+gno,G&mksvBnzheri,4kaBAQlrnD. Divisiins of ‘llwack Me&i. A. Carlo Haipjtal, & Service of Nuclear Medicine, S. Croce Geueral Hospital, Cuneq Italy.

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Assessment of Tumor Response to Radiotherapy (RT) or Chemoradiothorapy (CT+RT) Using PET 18.F-FDG in Lung Cancer. N.C. Choi, L.M. Hamberg, GJ. Hunter, J.T. Efird, N.M. Alpert, T.C. McLoud, J. Babitch, R.K. Jain, AJ. Fischman. Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.

Purpose: Accelerated glycolysis is a hallmark for neo@tic uansformation. Therefore, changes in tumor glucose utilization as a result of RT or CT+RT may have prognostic implication. The goals of Ibis study were (1) 10 de&mine the correkition between tumor control probability (TCP) and the gmdient of residual glucose metabolic rete (MRGk) in response to RT or CT+RT and (2) to define the level of residual MRGk that corresponds with 80% of TCP (FDG-TCP SO).

Patients and Methcdsz 28 patients with sage III non-small cell lung cancer were entend into this prospective study in which meabdic imaging of lung cancer was performed wore tratment using quantilative and dynamic positron emission mmogmphy (PET) with the glucose analog, 2-[18FHluom-2dwxy-D-glucose (FM;). Follow up PET I8F-FIX studies were obtained 2-3 weeks after RT or CT+RT in 22 patients. ‘IXteen patients who had adewate follow up for the status of local mm&are lhe subject of-this repoti Median a& was 66 y&s and male to female ratio was 2.1 to 1. Treatment moeram consisted of: 8) full dose RT ahme 160 Gy) in 7; b) a combination of full do& CT + CI in 3; and cj preoperarive RT aId& (48-50 Gy) in 3 patients. CT consisted of 2 - 3 cycles of etopnside and cisplatin during RT. Fiiken. 6 mm, axial slices were acquired over a r&cm that iacladed the tumor. Scanning wBs performed cominuolsly for two hours. From these data, decay corrected turn&and blood pool time-activity curves were obained. ?he glucose metabolic rate was cakulated for tissue usinn the Sokoloff model.

Resuhs: The mean value of tumor MGIc reprexnted by 18F-FIX metabolic rate prior to treatment was 0.4414 f 0.8% pmol/min/gm. After treatment, tumor showed marked decaae in ISF-PDG uptake. b a mean v&e of 0.0671 A 0.034 pmol/min/gm (15% of the initial value), p=O.Oll. Local tumor conbul was obtained in 5/5 with residual MRGk of 5 0.0412 pmol/min/gm. l/2 with MRGlc 0.0532 0.0542, l/4 with 0.0763-0.0888 and O/2 with 0.116-0.140 @mol/min/gm. MRGk of < 0.045 pmol/min/gm comsponded to FDG-TCP a30,

Conclusion: The presence of an inverse correlation between TCP and the gradient of residual MRGk after RT or CT+RT was confkmed. From this relation, FDG-TCP 280 is defmed ICI be a1 MRGlc of 5 0.045 ~ol/min/gm. FDG-TCP 280 is an important predictor of tumor response with which RT or CT+RT can be optimized.