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- Title
Integrated <sup>18</sup>F-Fluorodeoxyglucose-Positron Emission Tomography/Dynamic Contrast-Enhanced Computed Tomography to Phenotype Non-Small Cell Lung Carcinoma.
- Authors
Shastry, Manu; Miles, Kenneth A.; Win, Thida; Janes, Sam M.; Endozo, Raymond; Meagher, Marie; Ell, Peter J.; Groves, Ashley M.
- Abstract
We applied modern molecular and functional imaging to the pretreatment assessment of lung cancer using combined dynamic contrast-enhanced computed tomography (DCE-CT) and 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) to phenotype tumors. Seventy-four lung cancer patients were prospectively recruited for 18F- FDG-PET/DCE-CT using PET/64-detector CT. After technical failures, there were 64 patients (35 males, 29 females; mean age [± SD] 67.5 ± 7.9 years). DCE-CT yielded tumor peak enhancement (PE) and standardized perfusion value (SPV). The uptake of 18F- FDG quantified on PET as the standardized uptake value (SUVmax) assessed tumor metabolism. The median values for SUVmax and SPV were used to define four vascular-metabolic phenotypes. There were associations (Spearman rank correlation [rs]) between tumor size and vascular-metabolic parameters: SUVmax versus size (rs = .40, p = .001) and SUV/PE versus size (r = .43, p , .001). Patients with earlier-stage (I-IIA, n = 30) disease had mean (± SD) SUV/PE 0.36 ± 0.28 versus 0.56 ± 0.32 in later-stage (stage IIB-IV, n = 34) disease (p = .007). The low metabolism with high vascularity phenotype was significantly more common among adenocarcinomas (p = .018), whereas the high metabolism with high vascularity phenotype was more common among squamous cell carcinomas (p = .024). Other non-small cell lung carcinoma tumor types demonstrated a high prevalence of the high metabolism with low vascularity phenotype (p = .028). We show that tumor subtypes have different vascular-metabolic associations, which can be helpful clinically in managing lung cancer patients to hone targeted therapy.
- Subjects
POSITRON emission tomography; CONTRAST media; LUNG cancer diagnosis; PHENOTYPES; TUMORS; ADENOCARCINOMA; METABOLISM
- Publication
Molecular Imaging, 2012, Vol 11, Issue 5, p353
- ISSN
1535-3508
- Publication type
Article
- DOI
10.2310/7290.2011.00052