Characterization of tumor heterogeneity using dynamic contrast enhanced CT and FDG-PET in non-small cell lung cancer

Wouter van Elmpt*, Marco Das, Martin Huellner, Hoda Sharifi, Catharina M. L. Zegers, Bart Reymen, Philippe Lambin, Joachim E. Wildberger, Esther G. C. Troost, Patrick Veit-Haibach, Dirk De Ruysscher

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

35 Citations (Web of Science)
25 Downloads (Pure)


Purpose: Dynamic contrast-enhanced CT (DCE-CT) quantifies vasculature properties of tumors, whereas static FDG-PET/CT defines metabolic activity. Both imaging modalities are capable of showing intra-tumor heterogeneity. We investigated differences in vasculature properties within primary non-small cell lung cancer (NSCLC) tumors measured by DCE-CT and metabolic activity from FDG-PET/CT. Methods: Thirty three NSCLC patients were analyzed prior to treatment. FDG-PET/CT and DCE-CT were co-registered. The tumor was delineated and metabolic activity was segmented on the FDG-PET/CT in two regions: low (= 50% maximum SUV) metabolic uptake. Blood flow, blood volume and permeability were calculated using a maximum slope, deconvolution algorithm and a Patlak model. Correlations were assessed between perfusion parameters for the regions of interest. Results: DCE-CT provided additional information on vasculature and tumor heterogeneity that was not correlated to metabolic tumor activity. There was no significant difference between low and high metabolic active regions for any of the DCE-CT parameters. Furthermore, only moderate correlations between maximum Shy and DCE-CT parameters were observed. Conclusions: No direct correlation was observed between FOG-uptake and parameters extracted from DCE-CT. DCE-CT may provide complementary information to the characterization of primary NSCLC tumors over FDG-PET/CT imaging.
Original languageEnglish
Pages (from-to)65-70
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - Oct 2013


  • Dynamic contrast enhanced (DCE) CT
  • Perfusion CT imaging
  • Image analysis

Cite this