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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.


Figure 1
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  		Fig. 1A —72-year-old man with lung tumor. Region of interest (ROI) is drawn freehand around lung tumor.

 

Figure 2
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  		Fig. 1B —72-year-old man with lung tumor. Color parametric map of vascular blood volume or permeability is automatically generated by perfusion software. Each pixel within ROI corresponds to single perfusion value, allowing for pixel-by-pixel analysis.

 

Figure 3
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  		Fig. 1C —72-year-old man with lung tumor. Color parametric maps of vascular blood volume or permeability for four contiguous 10-mm axial levels. By amalgamating data from all individual pixels from four levels, tumor perfusion values can be derived for 40-mm z-axis coverage.

 

Figure 4
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  		Fig. 2A —Bland-Altman agreement plots of permeability (mL/100 mL/min). Plots show difference in permeability between two scans against mean of permeability values for 10-mm (A) and 40-mm (B) tumor coverage. Narrowing of 95% limits of agreement with 40-mm coverage indicates improvement in measurement reproducibility.

 

Figure 5
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  		Fig. 2B —Bland-Altman agreement plots of permeability (mL/100 mL/min). Plots show difference in permeability between two scans against mean of permeability values for 10-mm (A) and 40-mm (B) tumor coverage. Narrowing of 95% limits of agreement with 40-mm coverage indicates improvement in measurement reproducibility.

 

Figure 6
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  		Fig. 3A —Bland-Altman agreement plots of blood volume (mL/100 mL). Plots show difference in blood volume between two scans against mean of blood volume values for 10-mm (A) and 40-mm (B) tumor coverage. Narrowing of 95% limits of agreement with 40-mm coverage indicates improvement in measurement reproducibility.

 

Figure 7
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  		Fig. 3B —Bland-Altman agreement plots of blood volume (mL/100 mL). Plots show difference in blood volume between two scans against mean of blood volume values for 10-mm (A) and 40-mm (B) tumor coverage. Narrowing of 95% limits of agreement with 40-mm coverage indicates improvement in measurement reproducibility.

 

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