Assessment of Non-Small Cell Lung Cancer Perfusion: Pathologic-CT Correlation in 15 Patients

Purpose: 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. Materials and 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 chi(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. Conclusion: Whole-tumor perfusion analysis is technically feasible with 64-detector row CT, with two patterns suggestive of high tumoral vascularity. (C) RSNA, 2010