Perfusion evaluation of lung cancer: assessment using dual-input perfusion computed tomography

The aim of this study was to investigate the feasibility of separately evaluating bronchial (BAP) and pulmonary arterial perfusion (PAP) of lung cancers using dual-input perfusion computed tomography.

Twenty-nine lesions from 28 patients [19 men and 9 women; age, 65.8±11.3 y (mean±SD); range, 39 to 85 y] were included in this study (1 patient had 2 tumors). From computed tomography data, quantitative maps of PAP and BAP were created using the dual-input maximum-slope method. Total blood perfusion (TBP) was defined as the sum of PAP and BAP, and the percentage of PAP to TBP was defined as %PAP. Correlation of these values with tumor size, location, and pathologic type was statistically analyzed.

PAP ranged from 2.0 to 93.1 mL/min/100 mL (mean±SD, 26.8±26.4), BAP was 0 to 65.4 (25.1±19.12), TBP was 20.7 to 132.0 (52.0±29.0), and %PAP was 4% to 100% (48.8%±31.9%). PAP, TBP, and %PAP correlated negatively with tumor size (P<0.05). PAP and %PAP were higher in the peripheral zone than in the central zone (P<0.05). There was significant correlation between pathologic type and the respective perfusion parameters (P>0.05).

We were successful in separating the dual vascular supply to assess dual-input perfusion of lung cancer. We found perfusion of lung cancers to depend on tumor size and location. Acknowledging and assessing the dual vascular supply in lung perfusion may have clinical implications in the management of lung cancer treatment.