Neovascular Perfusion in Lung Cancer: Qualitative and Quantitative Study using MR Perfusion Imaging

The value of phase‐tracking subtraction MR pulmonary perfusion technique in the evaluation of the neovascular perfusion of lung cancer was investigated in 25 patients with lung cancer. All patients were examined with a GE Signa Horizon LX 1.5 T MR system with 2D fast spoiled gradient‐recalled‐echo and first‐pass images after bolus injection of contrast agents were obtained. The first‐pass images of pulmonary artery (PA), pulmonary parenchyma (PP) and pulmonary vein (PV)/ aorta phases and their time‐signal intensity curves (TSC) were calculated, subtracted and analyzed on a GE Advantage workstation with Functool software. The signal intensity changes of tumors occurred simultaneous to, or slightly later than the signal intensity changes of the descending aorta, whereas the signal intensity changes of corresponding regions of normal lung were simultaneous with those of the PA. Thus the TSCs of tumors matched those of the descending aorta, whereas the TSCs of corresponding regions of normal lung matched those of the PA. These findings indicate that the blood supply of these lung cancers comes from the aorta. On the other hand, the maximum slope of the TSC of the tumors was larger than that of normal lung, indicating that the blood supply to the tumor was larger in quantity and that the tumor probably had a higher density of vessels compared to normal lung tissue. It is concluded that MR perfusion imaging of differential phase subtraction of the pulmonary circulation can help to evaluate the angiogenesis of lung cancer by showing the source of the blood supply, its quantity and its hemodynamics.