Whole-Tumor Perfusion CT Parameters and Glucose Metabolism Measurements in Head and Neck Squamous Cell Carcinomas: A Pilot Study Using Combined Positron-Emission Tomography/CT Imaging

S. Bisdas; K. Spicer; Z. Rumboldt

doi:10.3174/ajnr.A1111

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Fig 1.
Tissue perfusion CT map (A) and PET/CT SUV_mean map (B) of a 54-year-old woman with a SCCA in the skin on the left temporal side. Blood flow (A) map shows a hypervascularized area in the subcutaneous region with infiltration of the cutis (arrows). The increased perfusion of the neoplastic tissue is coupled with increased SUV uptake (B) in the FDG PET/CT imaging (arrows).
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Fig 2.
Regression analysis of the mean BF values in the tumor (triangles) and healthy tissue (circles) with the SUV_mean. There is a positive significant correlation (r = 0.63; P = .011) in the tumor ROIs. Linear regression analysis showed SUV_mean = 0.05 × BF + 2.22 (R² = 0.45; P = .011) (regression line). The curved dashed lines show the 95% confidence intervals for the tumor ROIs means. The dashed line depicts the line of perfect agreement (equation line).
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Fig 3.
Regression analysis of the mean BF values in the tumor with the SUV_mean ratios of tumor-to-nontumor tissue. There is a positive significant correlation (r = 0.64; P = .01) in the tumor ROIs. Linear regression analysis showed Ratio SUV_mean = 0.14 × BF–3.48 (R² = 0.42; P = .01) (regression line). The curved dashed lines show the 95% confidence intervals for means. The dashed line depicts the line of perfect agreement (equation line).

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Table 1:

Summary statistics mean (SD) and 95% confidence interval of the SUV values (SUV_max and SUV_mean) and mean tissue perfusion parameters in healthy-appearing muscle tissue and neoplastic lesions

Tissue	SUV_max	SUV_mean	BF	BV	MTT	PS
Muscle	1.1 (± 0.43)	0.93 (± 0.47)	6.45 (± 2.09)	1.24 (± 0.77)	22.75 (± 3.31)	1.68 (± 1.03)
	(0.82, 1.37)	(0.63, 1.23)	(5.12, 7.78)	(0.75, 1.73)	(20.39, 25.11)	(1.02, 2.34)
Tumor	15.39 (± 2.54)	6.56 (± 1.2)	94.52 (± 16.7)	5.46 (± 1.24)	6.05 (± 1.38)	24.11 (± 8.39)
	(13.98, 16.8)	(5.89, 7.22)	(85.27, 103.77)	(4.77, 6.14)	(5.28, 6.81)	(19.46, 28.76)

Note:—SUV_max and SUV_mean indicate maximal and mean standardized uptake values of glucose (g/mL); BF, blood flow (mL/min/100 g); BV, blood volume (mL/100 g); MTT, mean transit time (s); PS, permeability (mL/min/100 g).

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Table 2:

Pearson correlation coefficients between SUV values (SUV_max and SUV_mean) and mean tissue perfusion parameters in healthy-appearing muscle tissue and neoplastic lesions

	BF	BV	MTT	PS	SUV_max	SUV_mean
BF		0.91^*	−0.94^*	0.87^*	0.97^*	0.97^*
BV	0.91^*		−0.86^*	0.82^*	0.89^*	0.88^*
MTT	−0.94^*	−0.86^*		−0.84^*	−0.92^*	−0.92^*
PS	0.87^*	0.82^*	−0.84^*		0.92^*	0.89^*
SUV_max	0.97^*	0.89^*	−0.92^*	0.92^*		0.97^*
SUV_mean	0.97^*	0.88^*	−0.92^*	0.89^*	0.97^*

Note:—SUV_max and SUV_mean indicate maximal and mean standardized uptake values of glucose (g/mL); BF, blood flow (mL/min/100 g); BV, blood volume (mL/100 g); MTT, mean transit time (s); PS, permeability (mL/min/100 g).
* Correlation is significant at the 0.01 level (2-tailed).