Macrovasculature and positron emission tomography (PET) standardized uptake value in patients with lung cancer

Purpose To investigate the relationship between macrovasculature features and the standardized uptake value (SUV) of positron emission tomography (PET), which is a surrogate for the metabolic activity of a lung tumor. Methods We retrospectively analyzed a cohort of 90 lung cancer patients who had both chest CT and PET-CT examinations before receiving cancer treatment. The SUVs in the medical reports were used. We quantified three macrovasculature features depicted on CT images (i.e., vessel number, vessel volume, and vessel tortuosity) and several tumor features (i.e., volume, maximum diameter, mean diameter, surface area, and density). Tumor size (e.g., volume) was used as a covariate to adjust for possible confounding factors. Backward stepwise multiple regression analysis was performed to develop a model for predicting PET SUV from the relevant image features. The Bonferroni correction was used for multiple comparisons. Results PET SUV was positively correlated with vessel volume (R = 0.44, p < 0.001) and vessel number (R = 0.44, p < 0.001) but not with vessel tortuosity (R = 0.124, p > 0.05). After adjusting for tumor size, PET SUV was significantly correlated with vessel tortuosity (R = 0.299, p = 0.004) and vessel number (R = 0.224, p = 0.035), but only marginally correlated with vessel volume (R = 0.187, p = 0.079). The multiple regression model showed a performance with an R-Squared of 0.391 and an adjusted R-Squared of 0.355 (p < 0.001). Conclusions Our investigations demonstrate the potential relationship between macrovasculature and PET SUV and suggest the possibility of inferring the metabolic activity of a lung tumor from chest CT images.