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DOI:10.2214/AJR.05.0889
AJR 2006; 187:1079-1084
© American Roentgen Ray Society

Original Research

Quantitative Assessment of Lung Cancer Perfusion Using MDCT: Does Measurement Reproducibility Improve with Greater Tumor Volume Coverage?

Quan Sing Ng1, Vicky Goh2, Ernst Klotz3, Heinz Fichte3, Michele I. Saunders1, Peter J. Hoskin1 and Anwar R. Padhani2

1 Marie Curie Research Wing, Mount Vernon Hospital, Northwood, Middlesex, United Kingdom.
2 Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Rd., Northwood, Middlesex, United Kingdom HA6 2RN.
3 Siemens Medical Solutions, Forchheim, Germany.

OBJECTIVE. To date, quantitative assessment of tumor vascularity using perfusion CT has been limited to a single tumor level, with the potential for measurement error in heterogeneous tumors. We aimed to determine if greater z-axis tumor coverage improves the reproducibility of perfusion CT measurements in lung cancer.

SUBJECTS AND METHODS. Paired perfusion studies were performed on 10 patients who had histologically confirmed advanced non-small cell lung cancer. Using 16-MDCT, multiple sequential volumetric acquisitions encompassing the entire tumor were acquired after infusion of IV contrast material. Using Patlak analysis, median values of tumor permeability (mL/100 mL/min) and blood volume (mL/100 mL) were measured for 10-mm z-axis coverage, and for 40-mm z-axis coverage in each of the paired perfusion studies. Measurement reproducibility was evaluated using Bland-Altman statistics.

RESULTS. Mean difference (95% limits of agreement) for tumor permeability was 1.4 (-4.0 to 6.8) for 10-mm coverage and 0.8 (-3.6 to 5.2) for 40-mm coverage. Mean difference (95% limits of agreement) for blood volume was 1.9 (-5.1 to 8.9) for 10-mm coverage and 1.4 (-3.7 to 6.6) for 40-mm coverage. The coefficient of variation for permeability was 18.7% for 10-mm coverage, improving to 11.9% for 40-mm coverage. The coefficient of variation for blood volume was 41.7% for 10-mm coverage, improving to 32.6% for 40-mm coverage.

CONCLUSION. Our results show that an improvement in tumor perfusion measurement reproducibility may be achieved with greater z-axis coverage.

Keywords: lung • lung diseases • MDCT • neoplasms • oncologic imaging • perfusion CT


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