In this case study we used the quantitative CT approach called Functional Respiratory Imaging (FRI) to assess the effect of immunotherapy on nodule volume and blood vessel volume.
The female patient in this study was diagnosed with Non-Small Cell Lung Cancer (NSCLC) in the right upper lobe (RUL) and presented with no other respiratory disease.
The patient was treated with a new type of immunotherapy to reduce the size of tumors. An HRCT scan at total lung capacity (TLC) was taken at baseline and after 4 months of treatment with immunotherapy. The baseline analysis clearly showed the nodule in the right upper lobe with a volume of 21.04 ml.
The blood vessel volume in the right upper lobe was 117% predicted so 17% above the normal value likely caused by the additional vascularization of the tumor. The blood vessel volumes in the other lobes ranged from 103% predicted in the right lower lobe (RLL) to 116% predicted in the left upper lobe (LUL) with the average blood vessel volume at 110% predicted.
After three months of therapy, the second analysis was performed to detect changes in the volume of the nodule and the blood vessel volumes. The volume of the nodule was approximately 50% reduced compared to baseline which demonstrates the effect of this new drug administration for this patient.
Interestingly also the blood vessel volumes were significantly reduced over all lobes with an average 90% predicted (reduction of around 20% predicted!) with a low of 73% in the right middle lobe (RML).
This finding begs the question what are the side effects of effective immunotherapies and how does this affect the patient in the short and long term? Novel imaging approaches such as FRI especially in combination with machine learning can provide valuable insights using a holistic approach leading to early and effective treatments. This is especially true when associated with a ramp up of CT based screening programs for lung cancer.