Role of Multi-Slice Computed Tomography Perfusion in Evaluation of the Pulmonary Nodules

The current study aim is the role of multi-slice CT perfusion in assessment of pulmonary nodules. Eighty patients with pulmonary nodules underwent non contrast CT scan of the chest and dynamic CT perfusion of the chest. Dynamic CT chest perfusion of 80 patients with pulmonary nodules revealed 24 patients had benign nodules of low biological activity, 16 patients had benign nodules of high biological activity and 40 patients had malignant nodules (16 of them had multiple nodules in both lung fields and clinical history of primary extra pulmonary malignancy, so diagnosed as metastatic nodules). Perfusion flow, extraction fraction and blood volume; these indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P>0.0001) In addition, these indexes showed a significant difference between benign nodules with high biologic activity and those with low biologic activity (P>0.0001) and the perfusion flow was of high benefit for nodules characterization than ejection fraction and blood volume by the higher significant values. CT perfusion compared the effect of therapy (chemotherapy and or radiotherapy) on metastatic pulmonary nodules before and after start of treatment by perfusion parameters (perfusion flow, extraction fraction and blood volume) & colour maps with the clinical data and follow up revealed that both results closely near and raise the efficacy of CT perfusion study in follow up and assessment of treatment response in metastatic pulmonary nodules. It can be concluded that CT perfusion is a feasible non-invasive diagnostic technique able to evaluate the nature of pulmonary nodules and treatment response in patients with metastatic pulmonary nodules.