The evaluation of MDCT and quantitative first-pass perfusion in lung cancers

I.O. Yildirim, T. Baysal, M.R. Celik

Department of Radiology, Kecioren Training and Research Hospital, Ankara, Turkey. ioyildirim@gmail.com

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• Oncology

OBJECTIVES: The aim of this study was the in vivo evaluation of tumor angiogenesis in lung cancers grouped according to their histopathological diagnosis, localization and necrosis characteristics determined using CT first-pass parameters.

MATERIALS AND METHODS: The study was performed between January and April 2012 on 44 patients consisting of 38 males and 6 females who were diagnosed with lung cancer as a result of cytological and/or histopathological evaluations. Patients who had not received radiotherapy and/or chemotherapy previously were included in the study. Images were obtained for each patient by using the 64-detector MDCT scanner. Colored perfusion maps were created from the obtained images. Perfusion parameter measurements were performed by placing ROI at 3 different locations in the solid sections, avoiding the necrotic cystic areas of the masses. Obtained BV, BF, TTP, and MTT perfusion parameters were recorded.

RESULTS: The BF values of central and peripherally located lung cancers that showed normal distribution were found to be statistically significantly different. No statistically significant difference was found between TTP values. The BV values of central and peripherally located lung cancers that did not show normal distribution showed a statistically significant difference. There was a statistically significant difference between the BV and BF values of lung cancer with and without necrosis that did not show a normal distribution and the BV and BF values of lung cancers with and without necrosis.

CONCLUSIONS: Non-invasive evaluation of tumor perfusion of first-pass perfusion CT in lung cancers provides valuable information about tumor angiogenesis. However, we believe that peripheral and solid lung cancers will benefit more from treatments such as anti-angiogenetic drugs, radiotherapy and chemotherapy more than the centrally located and necrotic lung cancers and that perfusion CT will play a greater role in the evaluation of the efficiency of these treatments in the future.

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