Abstract
Objectives To characterize tumour baseline blood flow (BF) in two lung cancer subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC), also investigating those “borderline” cases whose perfusion value is closer to the group mean of the other histotype. Materials and Methods 26 patients (age range 36-81 years) with primary Non-Small Cell Lung Cancer (NSCLC), subdivided into 19 AC and 7 SCC, were enrolled in this study and underwent a CT perfusion, at diagnosis. BF values were computed according to the maximum-slope method and unreliable values (e.g., arising from artefacts or vessels) were automatically removed. The one-tail Welch's t-test (p-value <0.05) was employed for statistical assessment. Results At diagnosis, mean BF values (in [mL/min/100g]) of AC group [(83.5 ± 29.4)] are significantly greater than those of SCC subtype [(57.0 ± 27.2)] (p-value = 0.02). However, two central SCCs undergoing artefacts from vena cava and pulmonary artery have an artificially increased mean BF. Conclusions The different hemodynamic behaviour of AC and SCC should be considered as a biomarker supporting treatment planning to select the patients, mainly with AC, that would most benefit from antiangiogenic therapies. The significance of results was achieved by automatically detecting and excluding artefactual BF values.
Highlights
Tumorigenesis involves angiogenesis, a complex mechanism consisting in the generation of a vascular network nourishing the tumour that is highly disorganized [1]
ID5, ID10, and ID15 are three AC examinations whose blood flow (BF) values are closer to the squamous cell carcinoma (SCC) group mean value, while ID23 and ID26 are two SCCs with mean values closer to AC group mean
We consider other studies aiming at assessing perfusion values of AC and SCC, besides these borderline cases, which are analysed to assess whether their mean value really reflects phenotypical features
Summary
Tumorigenesis involves angiogenesis, a complex mechanism consisting in the generation of a vascular network nourishing the tumour that is highly disorganized [1]. Their temporal changes, may be essential for tissue characterization [2]. To this purpose, the interest in CT perfusion (CTp) methodologies has been recently confirmed [3], since CTp supplies both high spatial and temporal resolution and allows computing perfusion parameters from the analysis of the time concentration curves (TCCs) [4], generated by the contrast agent reaching the tumour. Higher baseline BF values in patients with advanced lung carcinoma could suggest a better response to therapy [12]
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