Open AccessLow tumor blood flow assessed with perfusion CT correlates with lymphatic involvement in patients with stage T1b non‐small cell lung cancer
Author(s) -
Zhou Hui,
Xiong Zeng,
Liu JinKang,
Chen ShenXi,
Zhou MoLing,
Zhou Jianhua,
Chen Wei,
Liu Yangtengyu,
Fan Fan
Publication year - 2013
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/j.1759-7714.2012.00142.x
Subject(s) - medicine , lymphatic system , blood flow , perfusion , stage (stratigraphy) , lung cancer , lymph node , receiver operating characteristic , lymph , lymphatic vessel , metastasis , perfusion scanning , area under the curve , pathology , radiology , cancer , nuclear medicine , paleontology , biology
Background: To investigate the correlation of computed tomography (CT) perfusion parameters and lymphatic involvement in patients with stage T1b non‐small cell lung cancer (NSCLC). Methods: Forty‐six patients (30 men and 16 women; age range, 36–73 years; mean age, 57 years), with stage T1b non‐small cell lung cancer, underwent perfusion CT before surgery. The correlations between CT perfusion parameters (blood flow, blood volume, peak enhancement intensity), tumor angiogenesis (microvessel density and maturity of microvessels of surgical specimens) and lymphatic involvement were retrospectively investigated. Receiver operator curve (ROC) analysis was used to identify the parameter threshold at which tumors had or did not have lymph node metastasis, and the corresponding sensitivity and specificity were calculated. Results: A significant tendency for tumors with low blood flow and high density of immature microvessels to show lymphatic involvement was found (all P < 0.001). High correlation (r =−0.769, P < 0.001) was observed between tumor blood flow and immature microvessels. The area under ROC curves (AUC) for blood flow to detect lymph node metastasis was 0.866 (95% confidence interval, 0.766–0.966). For blood flow, the sensitivity, specificity, and accuracy of predicting lymph node metastasis were 88.9, 64.3, and 73.9% respectively, if the cutoff point was set at 43.05 mL/100 g/minute. Conclusions: Blood flow may be useful to predict lymphatic involvement before surgery in stage T1b NSCLC.