Functional imaging of lung cancer using dual energy CT: how does iodine related attenuation correlate with standardized uptake value of 18FDG-PET-CT?
- 1k Downloads
To investigate the correlation between maximum standardized uptake value (SUVmax) of 18FDG PET-CT and iodine-related attenuation (IRA) of dual energy CT (DECT) of primary tumours and 18FDG PET-CT positive thoracic lymph nodes (LN) in patients with lung cancer.
37 patients with lung cancer (27 NSCLC, 10 SCLC, 86 18FDG PET-CT positive thoracic LN) who underwent both 18FDG PET-CT and DECT were analyzed. The mean study interval between 18FDG PET-CT and DECT was ≤21 days in 17 patients. The mean and maximum IRA of DECT as well as of virtual unenhanced and virtual 120 kV images of DECT was analyzed and correlated to the SUVmax of 18FDG PET-CT in all tumours and 18FDG PET-CT positive thoracic lymph nodes. Further subgroup analysis was performed for histological subtypes in all groups.
A moderate correlation was found between SUVmax and maximum IRA in all tumours (n = 37;r = 0.507;p = 0.025) whereas only weak or no correlation were found between SUVmax and all other DECT measurements. A strong correlation was found in patients with study intervals ≤21 days (n = 17; r = 0.768;p = 0.017). Analysis of histological subtypes of lung cancer showed a strong correlation between SUVmax and maximum IRA in the analysis of all patients with NSCLC (r = 0.785;p = 0.001) and in patients with NSCLC and study intervals ≤21 days (r = 0.876;p = 0.024).
Thoracic LN showed moderate correlation between SUVmax and maximum IRA in patients with study intervals ≤21 days (r = 0.654; p = 0.010) whereas a weak correlation was found between SUVmax and maximum IRA in patients with study intervals >21 days (r = 0.299; p = 0.035).
DECT could serve as a valuable functional imaging test for patients with NSCLC as the IRA of DECT correlates with SUVmax of 18FDG PET-CT.
KeywordsLung cancer Dual energy computed tomography 18FDG PET-CT Tumor vascularity Tumour staging
UJS is a consultant for and receives research support from Bayer-Schering, Bracco, General Electric, Medrad, and Siemens. The other authors have no conflict of interest to disclose. The study was approved by our Institutional Review Board and conducted in HIPAA compliance. Drs Henzler and Schmid-Bindert contributed equally to this study.
- 1.Berghmans T, Dusart M, Paesmans M, Hossein-Foucher C, Buvat I, Castaigne C, Scherpereel A, Mascaux C, Moreau M, Roelandts M, Alard S, Meert AP, Patz EF Jr, Lafitte JJ, Sculier JP (2008) Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project. J Thorac Oncol 3:6–12PubMedCrossRefGoogle Scholar
- 5.Eschmann SM, Friedel G, Paulsen F, Reimold M, Hehr T, Budach W, Scheiderbauer J, Machulla HJ, Dittmann H, Vonthein R, Bares R (2006) Is standardised (18)F-FDG uptake value an outcome predictor in patients with stage III non-small cell lung cancer? Eur J Nucl Med Mol Imaging 33:263–269PubMedCrossRefGoogle Scholar
- 13.Pansini V, Remy-Jardin M, Faivre JB, Schmidt B, Dejardin-Bothelo A, Perez T, Delannoy V, Duhamel A, Remy J (2009) Assessment of lobar perfusion in smokers according to the presence and severity of emphysema: preliminary experience with dual-energy CT angiography. Eur Radiol 19:2834–2843PubMedCrossRefGoogle Scholar
- 31.Kaira K, Oriuchi N, Shimizu K, Ishikita T, Higuchi T, Imai H, Yanagitani N, Sunaga N, Hisada T, Ishizuka T, Kanai Y, Endou H, Nakajima T, Endo K, Mori M (2009) Correlation of angiogenesis with 18 F-FMT and 18 F-FDG uptake in non-small cell lung cancer. Cancer Sci 100:753–758PubMedCrossRefGoogle Scholar
- 32.de Langen AJ, van den Boogaart V, Lubberink M, Backes WH, Marcus JT, van Tinteren H, Pruim J, Brans B, Leffers P, Dingemans AM, Smit EF, Groen HJ, Hoekstra OS (2010) Monitoring response to antiangiogenic therapy in non-small cell lung cancer using imaging markers derived from PET and dynamic contrast-enhanced MRI. J Nucl Med 52:48–55PubMedCrossRefGoogle Scholar
- 33.Lind JS, Meijerink MR, Dingemans AM, van Kuijk C, Ollers MC, de Ruysscher D, Postmus PE, Smit EF (2010) Dynamic contrast-enhanced CT in patients treated with sorafenib and erlotinib for non-small cell lung cancer: a new method of monitoring treatment? Eur Radiol 20:2890–2898PubMedCrossRefGoogle Scholar
- 36.Huang YE, Chen CF, Huang YJ, Konda SD, Appelbaum DE, Pu Y (2010) Interobserver variability among measurements of the maximum and mean standardized uptake values on (18)F-FDG PET/CT and measurements of tumor size on diagnostic CT in patients with pulmonary tumors. Acta Radiol 51:782–788PubMedCrossRefGoogle Scholar