title: Assessment of tumor vascularity in lung cancer using volume perfusion CT (VPCT) with histopathologic comparison: a further step toward an individualized tumor characterization.
abstract: OBJECTIVE
  To measure perfusion in different lung cancer subtypes and compare results with histopathological/immunohistochemical results.
  
  
  METHODS
  Seventy-two consecutive untreated patients with lung cancer (40 adenocarcinomas, 20 squamous cell, and 12 small cell lung cancers) were enrolled. A 40-second volume perfusion computed tomography of the tumor bulk was obtained. Blood flow (BF), blood volume (BV), and transit constant were determined. Tumor volume and tumor necrosis were determined on contrast-enhanced computed tomography. Pathologic specimens were assessed for microvessel density (MVD), hypoxia-induced transcription (hif-1/-2), and proliferation (Ki-67).
  
  
  RESULTS
  Higher MVD is associated with higher BF and BV. Higher tumor grade leads to lower BF but increased necrosis and tumor volume. Markers of hypoxia were independent from perfusion parameters, extent of necrosis or MVD. Blood flow, BV, and MVD were not significantly different among lung cancer subtypes. Transit constant was significantly reduced in small cell lung cancer versus adenocarcinoma.
  
  
  CONCLUSIONS
  Perfusion values are related to MVD and tumor grade but vary considerably among lung cancer subtypes.
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Hoppe-Seyler-Strasse 3, Tübingen, Germany. daniel.spira@med.uni-tuebingen.de
authors: Daniel
authors: D
authors: Spira
authors: Helge
authors: H
authors: Neumeister
authors: Sven Michael
authors: SM
authors: Spira
authors: Jürgen
authors: J
authors: Hetzel
authors: Werner
authors: W
authors: Spengler
authors: Claus Hann
authors: CH
authors: von Weyhern
authors: Marius
authors: M
authors: Horger
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001810:Blood Volume; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007472:Iohexol / Q000031:analogs & derivatives; D016018:Least-Squares Analysis; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide