Assessment of non-small cell lung cancer perfusion: pathologic-CT correlation in 15 patients.
OBJECTIVE
To assess tumor perfusion with multi-detector row computed tomography (CT) in patients with non-small cell lung carcinoma and to correlate CT findings with pathologic results.


METHODS
This study was approved by the local Ethics Committee, and all patients provided written informed consent, which included information on the radiation exposure at the CT examinations. Fifteen consecutive patients (mean age, 60.5 years ± 7.7 [standard deviation]), including 14 men (mean age, 59.9 years ± 7.5) and one woman (age, 70 years) with histologically proved non-small cell lung carcinoma were prospectively enrolled. Overall, pathologic-CT correlations were examined in 31 focal tumoral zones. Comparative analysis was performed by using the χ(2) or the Fisher exact test for categoric data. For numeric data, group comparisons were performed by using the Mann-Whitney test.


RESULTS
Whole-tumor coverage (mean height, 4.3 cm ± 2.1) was possible in all patients with generation of colored parametric maps of volume transfer constant (K(trans)) and blood volume (BV) by using Patlak analysis. Of the 12 areas that showed high BV, 10 (83%) had a high K(trans); in all 12 cases, the vascular score was high, confirming the presence of numerous tumoral vessels. Nineteen areas showed low BV; when observed concurrently with a high K(trans) (seven of 19), the mean vessel number per area was significantly higher than that seen in areas with low BV and low K(trans) (12 of 19) (P = .038), suggestive of tumoral vessels associated with high interstitial pressure.


CONCLUSIONS
Whole-tumor perfusion analysis is technically feasible with 64-detector row CT, with two patterns suggestive of high tumoral vascularity.


BACKGROUND
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100181/-/DC1.
Tacelli
Nunzia
N
Department of Thoracic Imaging and Pulmonary at Hospital Calmette, University Lille Nord de France (EA 2694 Boulevard Jules Leclercq, 59037 Lille, France.
Remy-Jardin
Martine
M
Copin
Marie-Christine
MC
Scherpereel
Arnaud
A
Mensier
Eric
E
Jaillard
Sophie
S
Lafitte
Jean-Jacques
JJ
Klotz
Ernst
E
Duhamel
Alain
A
Remy
Jacques
J
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008175:Lung Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide