title: Characterization of tumor heterogeneity using dynamic contrast enhanced CT and FDG-PET in non-small cell lung cancer.
abstract: OBJECTIVE
  Dynamic contrast-enhanced CT (DCE-CT) quantifies vasculature properties of tumors, whereas static FDG-PET/CT defines metabolic activity. Both imaging modalities are capable of showing intra-tumor heterogeneity. We investigated differences in vasculature properties within primary non-small cell lung cancer (NSCLC) tumors measured by DCE-CT and metabolic activity from FDG-PET/CT.
  
  
  METHODS
  Thirty three NSCLC patients were analyzed prior to treatment. FDG-PET/CT and DCE-CT were co-registered. The tumor was delineated and metabolic activity was segmented on the FDG-PET/CT in two regions: low (<50% maximum SUV) and high (≥50% maximum SUV) metabolic uptake. Blood flow, blood volume and permeability were calculated using a maximum slope, deconvolution algorithm and a Patlak model. Correlations were assessed between perfusion parameters for the regions of interest.
  
  
  RESULTS
  DCE-CT provided additional information on vasculature and tumor heterogeneity that was not correlated to metabolic tumor activity. There was no significant difference between low and high metabolic active regions for any of the DCE-CT parameters. Furthermore, only moderate correlations between maximum SUV and DCE-CT parameters were observed.
  
  
  CONCLUSIONS
  No direct correlation was observed between FDG-uptake and parameters extracted from DCE-CT. DCE-CT may provide complementary information to the characterization of primary NSCLC tumors over FDG-PET/CT imaging.
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: van Elmpt
authors.affiliation: Department of Radiology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Das
authors.affiliation: Department of Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Hüllner
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Sharifi
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Zegers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Reymen
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Lambin
authors.affiliation: Department of Radiology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: E G C
authors.initials: EGC
authors.lastname: Troost
authors.affiliation: Department of Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Veit-Haibach
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Radiation Oncology, University Hospitals Leuven/ KU Leuven, Leuven, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: De Ruysscher
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D019788:Fluorodeoxyglucose F18; D008175:Lung Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Dynamic contrast enhanced (DCE) CT; FDG-PET; Image analysis; NSCLC; Perfusion CT imaging
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