期刊
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
卷 43, 期 2, 页码 240-248出版社
SPRINGER
DOI: 10.1007/s00259-015-3169-4
关键词
DCECT; Hypoxia PET; HX4; FDGPET; Image analysis; Multiparametric
资金
- EU 7th Framework Program (ARTFORCE)
- Kankeronderzoekfonds Limburg from the Health Foundation Limburg
- Dutch Cancer Society [KWF MAC 2011-5020, KWF MAC 2011-4970]
- Dutch Technology Foundation STW [10696 DuCAT]
- Technology Programme of the Ministry of Economic Affairs
Purpose Multiple imaging techniques are nowadays available for clinical in-vivo visualization of tumour biology. FDG PET/CT identifies increased tumour metabolism, hypoxia PET visualizes tumour oxygenation and dynamic contrast-enhanced (DCE) CT characterizes vasculature and morphology. We explored the relationships among these biological features in patients with non-small-cell lung cancer (NSCLC) at both the patient level and the tumour subvolume level. Methods A group of 14 NSCLC patients from two ongoing clinical trials (NCT01024829 and NCT01210378) were scanned using FDG PET/CT, HX4 PET/CT and DCE CT prior to chemoradiotherapy. Standardized uptake values (SUV) in the primary tumour were calculated for the FDG and hypoxia HX4 PET/CT scans. For hypoxia imaging, the hypoxic volume, fraction and tumour-to-blood ratio (TBR) were also defined. Blood flow and blood volume were obtained from DCE CT imaging. A tumour subvolume analysis was used to quantify the spatial overlap between subvolumes. Results At the patient level, negative correlations were observed between blood flow and the hypoxia parameters (TBR > 1.2): hypoxic volume (-0.65, p = 0.014), hypoxic fraction (-0.60, p = 0.025) and TBR (-0.56, p = 0.042). At the tumour subvolume level, hypoxic and metabolically active subvolumes showed an overlap of 53 +/- 36 %. Overlap between hypoxic sub-volumes and those with high blood flow and blood volume was smaller: 15 +/- 17 % and 28 +/- 28 %, respectively. Half of the patients showed a spatial mismatch (overlap < 5 %) between increased blood flow and hypoxia. Conclusion The biological imaging features defined in NSCLC tumours showed large interpatient and intratumour variability. There was overlap between hypoxic and metabolically active subvolumes in the majority of tumours, there was spatial mismatch between regions with high blood flow and those with increased hypoxia.
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