Correlation between [18F]FDG PET/CT and volume perfusion CT in primary tumours and mediastinal lymph nodes of non-small-cell lung cancer

Sauter, Alexander; Spira, Daniel; Schulze, Maximilian; Pfannenberg, Christina; Hetzel, Jürgen; Reimold, Matthias; Klotz, Ernst; Claussen, Claus D.; Horger, Marius

doi:10.1007/s00259-012-2318-2

Cited by 30 publications

(21 citation statements)

References 25 publications

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“…This might be explained by necrotic areas in more aggressive or advanced tumors that have already spread to the regional lymph nodes. Such a possible correlation is partly supported by a recent study in which an inverse correlation between BF and SUV mean ( r = -0.51) and BF and SUV max ( r = -0.54) was found in the mediastinal lymph nodes [15]. Yet, these correlations were only observed for lymph nodes with a SUV max > 2.5, PET/CT and CT perfusion were not done on the same day, and histopathological verification was incomplete.…”

Section: Discussionmentioning

confidence: 66%

“…CTP has technical advantages over MR-perfusion in the lungs, concerning quantification of perfusion, motion artifacts, reproducibility, and resolution. Besides some recent studies [15,16], data about perfusion of the different types of lung cancer, being properly assessed by sufficient scan coverage and post-processing with motion-correction techniques, is still limited. Also, the relationship between CTP parameters, tumor size and stage, tumor location, 18 F-FDG-PET/CT parameters, and MVD is partly unclear.…”

Section: Introductionmentioning

confidence: 99%

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Multiparametric PET/CT-perfusion does not add significant additional information for initial staging in lung cancer compared with standard PET/CT

Huellner

Collen²,

Gut³

et al. 2014

EJNMMI Research

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BackgroundThe purpose of this study was to assess the relationship of CT-perfusion (CTP), 18F-FDG-PET/CT and histological parameters, and the possible added value of CTP to FDG-PET/CT in the initial staging of lung cancer.MethodsFifty-four consecutive patients (median age 65 years, 15 females, 39 males) with suspected lung cancer were evaluated prospectively by CT-perfusion scan and 18F-FDG-PET/CT scan. Overall, 46 tumors were identified. CTP parameters blood flow (BF), blood volume (BV), and mean transit time (MTT) of the tumor tissue were calculated. Intratumoral microvessel density (MVD) was assessed quantitatively. Differences in CTP parameters concerning tumor type, location, PET positivity of lymph nodes, TNM status, and UICC stage were analyzed. Spearman correlation analyses between CTP and 18F-FDG-PET/CT parameters (SUVmax, SUVmean, PETvol, and TLG), MVD, tumor size, and tumor stage were performed.ResultsThe mean BF (mL/100 mL min-1), BV (mL/100 mL), and MTT (s) was 35.5, 8.4, and 14.2, respectively. The BF and BV were lower in tumors with PET-positive lymph nodes (p = 0.02). However, the CTP values were not significantly different among the N stages. The CTP values were not different, depending on tumor size and location. No significant correlation was found between CTP parameters and MVD.ConclusionsOverall, the CTP information showed only little additional information for the initial staging compared with standard FDG-PET/CT. Low perfusion in lung tumors might possibly be associated with metabolically active regional lymph nodes. Apart from that, both CTP and 18F-FDG-PET/CT parameter sets may reflect different pathophysiological mechanisms in lung cancer.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Multiparametric PET/CT-perfusion does not add significant additional information for initial staging in lung cancer compared with standard PET/CT

Huellner

Collen²,

Gut³

et al. 2014

EJNMMI Research

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“…For example, whether DI-PCT is reliable in benign and malignant tumors, [30] and in lymph node evaluation, the correlation between DI-PCT, DE-CT, and gold standard FDG-PET/CT is controversial. [31] …”

Section: Discussionmentioning

confidence: 99%

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Chen

Duan

et al. 2017

Medicine

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To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 − 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726–0.9255, ICCInter = 0.8179–0.8842; ICCInter = 0.8881–0.9177, ICCInter = 0.9820–0.9970, ICCInter = 0.9780–0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P < .01) and 0.383 (P < .05). Correlation coefficient between λHU and AF, and PF were as follows: 0.564 (P < .01) and 0.388 (P < .05).Both the single-source DE-CT and dual-input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion parameters derived from DI-PCT.

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“…It was concluded, that DECT -derived iodine concentration might serve as a surrogate marker for tumor staging and in therapy response evaluation in NSCLC. When looking at mediastinal lymph nodes, FDG-PET derived average SUV values showed negative correlations with blood flow and blood volume from VPCT, while DECT iodine values showed no correlation with FDG uptake in thoracic lymph nodes [82]. However, one must question the use of a maximum iodine-related concentration value, because PET and DECT have different technical backgrounds and DECT is sensitive to scatter and noise.…”

Section: Lungmentioning

confidence: 95%

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Thaiss

Sauter

Bongers

et al. 2015

European Journal of Radiology

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Correlation between [18F]FDG PET/CT and volume perfusion CT in primary tumours and mediastinal lymph nodes of non-small-cell lung cancer

Abstract: Perfusion and glucose metabolism seemed to be uncoupled in large primary tumours, but an inverse correlation was observed in MLN. This information may help improve therapy planning and response evaluation.

Cited by 30 publications

References 25 publications

Multiparametric PET/CT-perfusion does not add significant additional information for initial staging in lung cancer compared with standard PET/CT

Multiparametric PET/CT-perfusion does not add significant additional information for initial staging in lung cancer compared with standard PET/CT

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

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