Non-small cell lung cancer: histopathologic correlates for texture parameters at CT.

Abstract

PURPOSE:

To correlate computed tomographic (CT) texture in non-small cell lung cancer (NSCLC) with histopathologic markers for angiogenesis and hypoxia.

MATERIALS AND METHODS:

The study was institutional review board approved, and informed consent was obtained. Fourteen patients with NSCLC underwent CT prior to intravenous administration of pimonidazole (0.5 g/m(2)), a marker of hypoxia, 24 hours before surgery. Texture was assessed for unenhanced and contrast material-enhanced CT images by using a software algorithm that selectively filters and extracts texture at different anatomic scales (1.0 [fine detail] to 2.5 [coarse features]), with quantification of the standard deviation (SD) of all pixel values and the mean value of positive pixels (MPP) and uniformity of distribution of positive gray-level pixel values (UPP). After surgery, matched tumor sections were stained for angiogenesis (CD34 expression) and for markers of hypoxia (glucose transporter protein 1 [Glut-1] and pimonidazole). The percentage and average intensity of the tumor stained were assessed. A linear mixed-effects model was used to assess the correlations between CT texture and staining intensity.

RESULTS:

SD and MPP quantified from medium to coarse texture on contrast-enhanced CT images showed significant associations with the average intensity of tumor staining with pimonidazole (for SD: filter value, 2.5; slope = 0.003; P = .0003). UPP (medium to coarse texture) on unenhanced CT images showed a significant inverse association with tumor Glut-1 expression (filter value, 2.5; slope = -115.13; P = .0008). MPP quantified from medium to coarse texture on both unenhanced and contrast-enhanced CT images showed significant inverse associations with tumor CD34 expression (unenhanced CT: filter value, 1.8; slope = -0.0008; P = .003; contrast-enhanced CT: filter value, 1.8; slope = -0.0006; P = .004).

CONCLUSION:

Texture parameters derived from CT images of NSCLC have the potential to act as imaging correlates for tumor hypoxia and angiogenesis.

SUPPLEMENTAL MATERIAL:

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112428/-/DC1.

• Authors: Balaji Ganeshan, Vicky Goh, Henry C Mandeville, Quan Sing Ng, Peter J Hoskin, Kenneth A Miles
• Journal: Radiology (Radiology) Vol. 266 Issue 1 Pg. 326-36 (Jan 2013) ISSN: 1527-1315 [Electronic] United States
• PMID: 23169792 (Publication Type: Journal Article)
• Copyright: RSNA, 2012

Topics

• Aged
• Aged, 80 and over
• Algorithms
• Biopsy
• Carcinoma, Non-Small-Cell Lung (diagnosis)
• Female
• Humans
• Lung Neoplasms (diagnosis)
• Male
• Middle Aged
• Pattern Recognition, Automated (methods)
• Radiographic Image Enhancement (methods)
• Radiographic Image Interpretation, Computer-Assisted (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Statistics as Topic
• Tomography, X-Ray Computed (methods)