Lihua Chen1,2, Xianchun Zeng3, Youli Wu4, Xiaochu Yan4, Xuequan Huang1, Hui Chen1, Jiuquan Zhang5,6, Jian Wang1, Li Feng7. 1. Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China. 2. Department of Radiology, PLA 101st Hospital, Wuxi Jiangsu, P.R. China. 3. Department of Radiology, Guizhou Provincial People's Hospital, Guizhou, P.R. China. 4. Department of Pathology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China. 5. Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, P.R. China. 6. Key Laboratory for Biorheological Science and Technology of Ministry of Education (Chongqing University), Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, P.R. China. 7. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Abstract
BACKGROUND: The histological count of microvascular density (MVD) is the current clinical standard for assessing tumor angiogenesis. Although it is hypothesized that perfusion MRI can be a noninvasive alternative to MVD, there have been few studies to validate their correlations, particularly in lung cancer. PURPOSE: To investigate the correlation between MVD and perfusion parameters obtained from high-resolution GRASP (Golden-angle RAdial Sparse Parallel) dynamic contrast-enhanced (DCE)-MRI in a cohort of lung cancer patients, and to validate that GRASP MRI can serve as a free-breathing, noninvasive imaging approach for studying tumor angiogenesis. STUDY TYPE: Prospective. POPULATION: Twenty-five lung cancer patients (16 male, 9 female, mean age = 57.3 ± 11.7 years). FIELD STRENGTH/SEQUENCE: 3T MRI; a prototype golden-angle stack-of-stars sequence. ASSESSMENT: Contrast-enhanced MR data were acquired during free breathing and were reconstructed using GRASP with a temporal resolution of ∼3 sec/phase. For all data, perfusion analysis was performed using a standard Tofts model to generate the volume transfer coefficient (Ktrans ) and the interstitial volume (Ve ). The MVD of corresponding tumor specimens, obtained from Computed Tomography-guided biopsies, were counted with CD34 staining. STATISTICAL TESTS: Pearson correlation analysis; one-way analysis of variance analysis; least significant difference-t method of multiple comparisons. RESULTS: The correlation coefficient was 0.983 and 0.972 for the measurement and remeasurement of Ktrans and Ve . The mean values of Ktrans , Ve , and MVD were 0.33 ± 0.22 min-1 , 0.25 ± 0.12, and 49.68 ± 27.08 vessels/0.723 mm2 , respectively, in all patients (n = 25); 0.36 ± 0.26 min-1 , 0.27 ± 0.13, and 49.09 ± 29.84 vessels/0.723 mm2 , respectively, in adenocarcinoma (n = 15); 0.34 ± 0.17 min-1 , 0.26 ± 0.12, and 53.85 ± 23.53 vessels/0.723 mm2 , respectively, in squamous cell carcinoma (n = 8); and 0.13 ± 0.15 min-1 , 0.14 ± 0.06, and 37.20 ± 28.28 vessels/0.723 mm2 , respectively, in small-cell carcinoma (n = 2). There was a positive relationship between the Ktrans and MVD in all patients (r = 0.738, P < 0.001). DATA CONCLUSION: High spatiotemporal resolution DCE-MRI using GRASP is a promising noninvasive alternative to the histological count of MVD for assessing tumor angiogenesis in lung cancer. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1186-1194.
BACKGROUND: The histological count of microvascular density (MVD) is the current clinical standard for assessing tumor angiogenesis. Although it is hypothesized that perfusion MRI can be a noninvasive alternative to MVD, there have been few studies to validate their correlations, particularly in lung cancer. PURPOSE: To investigate the correlation between MVD and perfusion parameters obtained from high-resolution GRASP (Golden-angle RAdial Sparse Parallel) dynamic contrast-enhanced (DCE)-MRI in a cohort of lung cancerpatients, and to validate that GRASP MRI can serve as a free-breathing, noninvasive imaging approach for studying tumor angiogenesis. STUDY TYPE: Prospective. POPULATION: Twenty-five lung cancerpatients (16 male, 9 female, mean age = 57.3 ± 11.7 years). FIELD STRENGTH/SEQUENCE: 3T MRI; a prototype golden-angle stack-of-stars sequence. ASSESSMENT: Contrast-enhanced MR data were acquired during free breathing and were reconstructed using GRASP with a temporal resolution of ∼3 sec/phase. For all data, perfusion analysis was performed using a standard Tofts model to generate the volume transfer coefficient (Ktrans ) and the interstitial volume (Ve ). The MVD of corresponding tumor specimens, obtained from Computed Tomography-guided biopsies, were counted with CD34 staining. STATISTICAL TESTS: Pearson correlation analysis; one-way analysis of variance analysis; least significant difference-t method of multiple comparisons. RESULTS: The correlation coefficient was 0.983 and 0.972 for the measurement and remeasurement of Ktrans and Ve . The mean values of Ktrans , Ve , and MVD were 0.33 ± 0.22 min-1 , 0.25 ± 0.12, and 49.68 ± 27.08 vessels/0.723 mm2 , respectively, in all patients (n = 25); 0.36 ± 0.26 min-1 , 0.27 ± 0.13, and 49.09 ± 29.84 vessels/0.723 mm2 , respectively, in adenocarcinoma (n = 15); 0.34 ± 0.17 min-1 , 0.26 ± 0.12, and 53.85 ± 23.53 vessels/0.723 mm2 , respectively, in squamous cell carcinoma (n = 8); and 0.13 ± 0.15 min-1 , 0.14 ± 0.06, and 37.20 ± 28.28 vessels/0.723 mm2 , respectively, in small-cell carcinoma (n = 2). There was a positive relationship between the Ktrans and MVD in all patients (r = 0.738, P < 0.001). DATA CONCLUSION: High spatiotemporal resolution DCE-MRI using GRASP is a promising noninvasive alternative to the histological count of MVD for assessing tumor angiogenesis in lung cancer. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1186-1194.
Authors: Marieke A Stammes; Ji Hyun Lee; Lisette Meijer; Thibaut Naninck; Lara A Doyle-Meyers; Alexander G White; H Jacob Borish; Amy L Hartman; Xavier Alvarez; Shashank Ganatra; Deepak Kaushal; Rudolf P Bohm; Roger le Grand; Charles A Scanga; Jan A M Langermans; Ronald E Bontrop; Courtney L Finch; JoAnne L Flynn; Claudia Calcagno; Ian Crozier; Jens H Kuhn Journal: Trends Mol Med Date: 2021-12-07 Impact factor: 15.272