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Non-small cell lung cancer evaluated with quantitative contrast-enhanced CT and PET-CT: Net enhancement and standardized uptake values are related to tumour size and histology

Luca Brunese, Barbara Greco, Francesca Rosa Setola, Francesco Lassandro, Mario Rosario Guarracino, Marialiusa De Rimini, Sergio Piccolo, Nicolina De Rosa, Roberto Muto, Andrea Bianco, Pietro Muto, Roberto Grassi, Antonio Rotondo

Med Sci Monit 2013; 19:95-101

DOI: 10.12659/MSM.883759

Available online:

Published: 2013-02-07


Background: Personalized cancer therapy remains a challenge. In this context, we attempted to identify correlations between tumour angiogenesis, tumour metabolism and tumour cell type. To this aim, we used single=phase multidetector computed tomography (MDCT) and hybrid positron emission tomography-computed tomography (PET/CT) to determine whether net enhancement and standardized uptake value (SUVmax) were correlated with tumour size and cytology in patients affected by non-small cell lung cancer (NSCLC).
Material and Methods: Our study included 38 patients (30 men, 8 women, mean age 70) with a NSCLC measuring between 3 cm and 7 cm, using a 16-slice multidetector CT (Brilliance Philips) and with PET-CT (Biograph 16 Siemens Medical Solutions). The following lesion parameters were evaluated: maximum diameter, medium density before contrast injection (CTpre), medium density after contrast injection (CTpost average), density in the most enhanced part of the lesion after contrast (CTpost max), net enhancement, SUVmax, age, and cytology. Correlation coefficient
and p-value were computed for each pair of variables. In addition, correlations were computed for each pair of variables, and for all combinations of tumour types. We focused on subsets of data with more than 10 observations, and with correlation r>0.500 and p<0.05.
Results: A weak correlation (r=0.32; p=0.048) was found between SUVmax and tumour size; the correlation was stronger for masses larger than 31 mm (r=0.4515; p=0.0268). No other correlations were found among the variables examined.
Conclusions: Our data may have prognostic significance, and could lead to more appropriate surgical treatment and better treatment outcome.

Keywords: Positron-Emission Tomography, Lung Neoplasms - radionuclide imaging, Multimodal Imaging, Fluorodeoxyglucose F18 - pharmacokinetics, Contrast Media - diagnostic use, Carcinoma, Non-Small-Cell Lung - radionuclide imaging, Adenocarcinoma - radionuclide imaging, Tomography, X-Ray Computed, Tumor Burden



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