Squamous cell carcinoma and adenocarcinoma show different perfusion in DCE-CT studies of lung cancer

Purpose: The main objective of this study is to explore possible significant differences in blood flow (BF) values between two subtypes of lung cancers before treatments. Methods and Materials: 34 patients (age range 36-81 years) with primary NSCLS, subdivided in 28 adenocarcinoma and 6 squamous cell carcinoma, were enrolled in this study and underwent a CT perfusion (CTp) at the diagnosis stage. BF values were computed according to the maximum slope method and values undergoing high fitting errors have been automatically removed. The mean value for each group was computed and the difference was assessed by employing the one-tail Welch's t-test and statistical significance was achieved for p-value < 0.001. Results: At baseline, BF values of adenocarcinoma group [84.4±57.9 (5.3-274.9)] result significantly greater than the BF values of squamous carcinoma subtype [60.5±47.1 (4.9-192.6)], with a p-value << 10-5. It is also worth noting that the mean coefficient of variation (CV) of BF maps is substantially the same for adenocarcinoma (CV=0.70) and squamous carcinoma (CV=0.69), this providing a comparable regularity to the subgroups. Conclusions: The greater mean BF values of the adenocarcinoma subtype could be ascribed to its more aggressiveness, although the literature presents discordant results. However, the outcome of this study is also enforced by BF values being computed on perfusion maps where unreliable BF values were automatically excluded. These findings on lung lesion subtypes may be of relevant importance for treatment strategies, where the CTp technique could hold a crucial role.