Circulation of Primary and Metastatic Pulmonary Neoplasms

Milne, Eric N. C.

doi:10.2214/ajr.100.3.603

Cited by 98 publications

(55 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 Consistent with the results of the recent study by Yuan et al, 22 our findings show that, in NSCLC, the bronchial contribution is higher than the pulmonary contribution. In addition, we have now demonstrated that there are also differences depending on the NSCLC subtype: LCC shows higher bronchial and pulmonary BV and BF compared with AC and SCC.…”

Section: Discussionsupporting

confidence: 93%

“…9,10 Hence, the evolving therapeutic field of vascular-modulating drugs requires new noninvasive methods for assessing tumor vascularity in vivo. [11][12][13][14][15] In 1967, Milne 16 showed that lung tumors may have a dual blood supply by the pulmonary and the aortic system, with a trend toward histological type-specific circulatory pattern. The advent of CT perfusion (CTP) within the last decade allowed for a direct, noninvasive quantification of the vascular function.…”

Section: Results: According To Biopsy 37 Patients Had Nsclc (22 Adenmentioning

confidence: 99%

“…In 1 of the first studies on this topic, Milne 16 demonstrated that the pulmonary circulation supplies the surface of the tumor, whereas the central portion is supplied by the bronchial artery system. With increasing tumor volume, hypoxia may occur in the central parts of the tumor as a result of insufficient blood supply due to an increasing diffusion distance between blood vessels and tumor cells, 26,39 explaining the need to recruit additional blood vessels from the pulmonary system, BF, mean ± SD, mL/100 mL/min 33.1 ± 16.7 36.4 ± 16.8 0.401 BF max , mean ± SD, mL/100 mL/min 46.2 ± 18.6 50.6 ± 19.4 0.263 BV, mean ± SD, mL/100 mL/min 6.4 ± 3.4 6.8 ± 3.2 0.889 MTT, mean ± SD, s 16.1 ± 3.2 11.5 ± 2.9 0.017 Large-cell carcinoma (n = 7)…”

Section: Nguyen-kim Et Almentioning

confidence: 99%

See 2 more Smart Citations

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Nguyen-Kim¹,

Frauenfelder²,

Strobel³

et al. 2015

Investigative Radiology

View full text Add to dashboard Cite

OBJECTIVES: The aim of this study was to investigate the dual blood supply of non-small cell lung cancer (NSCLC) and its association with tumor subtype, size, and stage, using computed tomography perfusion (CTP). MATERIALS AND METHODS: A total of 54 patients (median age, 65 years; range, 42-79 years; 15 women, 39 men) with suspected lung cancer underwent a CTP scan of the lung tumor. Pulmonary and bronchial vasculature regions of interest were used to calculate independently CTP parameters (blood flow [BF], blood volume [BV], and mean transit time [MTT]) of the tumor tissue. The mean and maximum pulmonary and bronchial perfusion indexes (PImean and PImax) were calculated. The tumoral volume and the largest tumoral diameter were assessed. Differences in CTP parameters and indexes among NSCLC subtypes, tumor stages and tumor dimensions were analyzed using non-parametric tests. RESULTS: According to biopsy, 37 patients had NSCLC (22 adenocarcinomas [ACs], 8 squamous cell carcinomas [SCCs], 7 large-cell carcinomas [LCC]). The mean bronchial BF/pulmonary BF, bronchial BV/pulmonary BV, and bronchial MTT/pulmonary MTT was 41.2 ± 30.0/36.9 ± 24.2 mL/100 mL/min, 11.4 ± 9.7/10.4 ± 9.4 mL/100 mL, and 11.4 ± 4.3/14.9 ± 4.4 seconds, respectively. In general, higher bronchial BF than pulmonary BF was observed in NSCLC (P = 0.014). Using a tumoral volume cutoff of 3.5 cm, a significant difference in pulmonary PImax was found (P = 0.028). There was a significantly higher mean pulmonary BF in LCCs and SCCs compared with ACs (P = 0.018 and P = 0.044, respectively), whereas the mean bronchial BF was only significantly higher in LCCs compared with ACs (P = 0.024). Correspondingly, the PImax was significantly higher in LCCs and SCCs than in ACs (P = 0.001 for both). Differences between bronchial and pulmonary PImean and PImax among T stages and Union Internationale Contre le Cancer stages were not statistically significant (P values ranging from 0.691 to 0.753). CONCLUSIONS: The known dual blood supply of NSCLC, which depends on tumor size and histological subtype, is reflected in CTP parameters, with parameters depending both on tumor size and histological subtype. This has to be accounted for when analyzing NSCLC with CTP.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Results: According To Biopsy 37 Patients Had Nsclc (22 Adenmentioning

confidence: 99%

Section: Nguyen-kim Et Almentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Nguyen-Kim¹,

Frauenfelder²,

Strobel³

et al. 2015

Investigative Radiology

View full text Add to dashboard Cite

show abstract

“…Recent work by Nguyen-Kim has shown that, in NSCLC, the bronchial contribution to pulmonary circulation is higher than the pulmonary (17). Thus, a volume of interest (VOI) was drawn over the aortic arch on the CT avg image, well within the edges of the structure to avoid spillover effects (Fig.…”

Section: Image Postprocessing and Preliminary Measurementsmentioning

confidence: 99%

Pharmacokinetic Analysis of Dynamic ¹⁸F-Fluoromisonidazole PET Data in Non–Small Cell Lung Cancer

et al. 2017

View full text Add to dashboard Cite

Hypoxic tumors exhibit increased resistance to radiation, chemical, and immune therapies. 18 F-fluoromisonidazole ( 18 F-FMISO) PET is a noninvasive, quantitative imaging technique used to evaluate the magnitude and spatial distribution of tumor hypoxia. In this study, pharmacokinetic analysis (PKA) of 18 F-FMISO dynamic PET extended to 3 h after injection is reported for the first time, to our knowledge, in stage III-IV non-small cell lung cancer (NSCLC) patients. Methods: Sixteen patients diagnosed with NSCLC underwent 2 PET/CT scans (1-3 d apart) before radiation therapy: a 3-min static 18 F-FDG and a dynamic 18 F-FMISO scan lasting 168 6 15 min. The latter data were acquired in 3 serial PET/CT dynamic imaging sessions, registered with each other and analyzed using pharmacokinetic modeling software. PKA was performed using a 2-tissue, 3-compartment irreversible model, and kinetic parameters were estimated for the volumes of interest determined using coregistered 18 F-FDG images for both the volume of interest-averaged and the voxelwise time-activity curves for each patient's lesions, normal lung, and muscle. Results: We derived average values of 18 F-FMISO kinetic parameters for NSCLC lesions as well as for normal lung and muscle. We also investigated the correlation between the trapping rate (k 3 ) and delivery rate (K 1 ), influx rate (K i ) constants, and tissue-to-blood activity concentration ratios (TBRs) for all tissues. Lesions had trapping rates 1.6 times larger, on average, than those of normal lung and 4.4 times larger than those in muscle. Additionally, for almost all cases, k 3 and K i had a significant strong correlation for all tissue types. The TBR-k 3 correlation was less straightforward, showing a moderate to strong correlation for only 41% of lesions. Finally, K 1 -k 3 voxelwise correlations for tumors were varied, but negative for 76% of lesions, globally exhibiting a weak inverse relationship (average R 5 20.23 6 0.39). However, both normal tissue types exhibited significant positive correlations for more than 60% of patients, with 41% having moderate to strong correlations (R . 0.5). Conclusion: All lesions showed distinct 18 F-FMISO uptake. Variable 18 F-FMISO delivery was observed across lesions, as indicated by the variable values of the kinetic rate constant K 1 . Except for 3 cases, some degree of hypoxia was apparent in all lesions based on their nonzero k 3 values.

show abstract

“…In the early 1970s it was discovered through necropsy that lung tumours have a dual vascular supply [8]; however in vivo quantification of the dual blood supply in lung cancer with CT perfusion has not been possible due in large part to the limitations of the technology. The respective proportion of the dual blood supply in lung tumours has not been previously described with CT perfusion, to our knowledge.…”

mentioning

confidence: 99%

Lung cancer perfusion: can we measure pulmonary and bronchial circulation simultaneously?

Yuan

Zhang

et al. 2012

Eur Radiol

View full text Add to dashboard Cite

show abstract

Circulation of Primary and Metastatic Pulmonary Neoplasms

Cited by 98 publications

References 21 publications

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Pharmacokinetic Analysis of Dynamic ¹⁸F-Fluoromisonidazole PET Data in Non–Small Cell Lung Cancer

Lung cancer perfusion: can we measure pulmonary and bronchial circulation simultaneously?

Contact Info

Product

Resources

About

Circulation of Primary and Metastatic Pulmonary Neoplasms

Cited by 98 publications

References 21 publications

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Assessment of Bronchial and Pulmonary Blood Supply in Non-Small Cell Lung Cancer Subtypes Using Computed Tomography Perfusion

Pharmacokinetic Analysis of Dynamic 18F-Fluoromisonidazole PET Data in Non–Small Cell Lung Cancer

Lung cancer perfusion: can we measure pulmonary and bronchial circulation simultaneously?

Contact Info

Product

Resources

About

Pharmacokinetic Analysis of Dynamic ¹⁸F-Fluoromisonidazole PET Data in Non–Small Cell Lung Cancer