Role of Immature Microvessels in Assessing the Relationship between CT Perfusion Characteristics and Differentiation Grade in Lung Cancer

Background and Aims We undertook this study to investigate the association between CT perfusion characteristics and differentiation grade in lung cancer, as well as the pathological basis of this association. Methods Seventy three patients received CT perfusion scan and pathological biopsy, and 30 of them were available for comparison. In these 30 patients, the region detected with pathological biopsy was consistent with the region of interest of CT perfusion. We compared the CT perfusion parameters [blood volume (BV), blood flow (BF), and peak enhancement intensity (PEI)] of these patients with their differentiation grade of lung cancer and microvessel count, which includes microvessel density (MVD) and maturity. Results The lower the grade of differentiation of the nodules, the more drastically perfusion parameters decreased. BF was best correlated with differentiation grade ( r = −0.845, p = 0.000), compared to BV and PEI ( r = −0.674, −0.438, p = 0.000, 0.015, respectively). Poorly differentiated lung cancer showed significantly higher density of immature microvessels than that of highly differentiated lung cancer ( p = 0.001). There was a correlation between the differentiation grade and the density of immature microvessels ( r = 0.669, p = 0.000), but there was no significant correlation with MVD and the density of mature microvessel ( r = 0.345, 0.269, p = 0.062, 0.150, respectively). The density of immature microvessels still increased with declining BF value in the nodules when the grade of differentiation of lung cancer was under control ( r = −0.748, p = 0.000). Conclusions CT perfusion characteristics are helpful to differentiate lung cancer differentiation, pathologically basing on the density of immature microvessels rather than MVD.