Histological correlation of textural features of PET & ceCT in NSCLC
Research type
Research Study
Full title
Textural features of non-small cell lung cancer (NSCLC) on pre-treatment 18F-FDG PET/CT and contrast enhanced CT (ceCT): reproducibility and correlation with histological parameters.
IRAS ID
108632
Contact name
Gary Cook
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
1 years, 8 months, 0 days
Research summary
Research Summary
It has been known that malignant tumours exhibit biologic heterogeneity and this heterogeneity has been associated with histological features such as cellular proliferation, necrosis, replacement with fibrous tissue, differences in blood flow, cellular metabolism, oxygenation, and expression of specific receptors.
18F-FDG PET is routinely used in cancer imaging for diagnosis, staging, and in post therapy response assessment. 18F-FDG uptake has been associated with various factors such as perfusion, cell proliferation, tumour viability, aggressiveness, or hypoxia.
Textural analysis is emerging as a new tool in assessing tumour heterogeneity. A variety of textural features that describe the spatial variation of voxel intensities in ceCT and 18F-FDG PET/CT images of untreated NSCLC have been shown to predict treatment response and survival. Tumour heterogeneity in baseline imaging may predict survival and therapy response. However the correlation of tumor biology to textural features is largely not understood.As textural image features show promise in providing additional predictive and prognostic information about tumours, it is also important to understand how reproducible the measurement of textural features is, so that methodology can be used for monitoring treatment response and begin to be used in multicentre settings.
We therefore plan to prospectively measure textural parameters of baseline 18F-FDG PET/CT, ceCT and pCT (perfusion CT) images in 30 patients with untreated NSCLC and correlate these finding with histological parameters in order to obtain a better understanding of the biological factors that cause spatial heterogeneity of PET and CT images. Ex-vivo CT of the tumour specimen will be obtained to aid accurate registering of histology specimen to baseline 18F-FDG PET/CT, ceCT and pCT.
We will also assess the reproducibility of the measurement of textural parameters on 18F-FDG PET and non-contrast CT by repeating the 18F-FDG PET/CT within 6 weeks from the first baseline scan in 15 of these patients.Summary of results
The study aimed at determining if there is a correlation between features derived from positron emission scans of lung cancer with some of the underlying biological differences between cancers seen under the microscope. We were able to show that several imaging features corresponded with microscopic features such as tumour blood vessel formation, tumour cell proliferation and tumour hypoxia. These observations give incite into the differences between cancer subtypes seen on imaging of lung cancers.REC name
London - Chelsea Research Ethics Committee
REC reference
13/LO/0883
Date of REC Opinion
22 Jul 2013
REC opinion
Further Information Favourable Opinion