[Angiogenesis of cervix carcinoma. Contrast enhanced dynamic MRI, histologic quantification of capillary density and lymphatic system infiltration].
OBJECTIVE
It was the aim of this project to examine (i) the relationships between contrast-enhanced dynamic MR imaging derived characteristics and histologic microvessel density counts--a recognized surrogate of tumor angiogenesis--from tumors in patients with primary or recurrent cancer of the uterine cervix, and (ii) to correlate these parameters with lymphatic involvement (i.e. lymphatic channels) to assess tumor biological aggressiveness in terms of lymphatic spread.


METHODS
Pharmacokinetic MR imaging parameters (amplitude A, exchange rate constant k21) were derived from contrast-enhanced dynamic MR imaging in thirty-three patients with biopsy proven cancer of the uterine cervix. The pharmacokinetic MR imaging characteristics were correlated to histologic capillary density counts obtained from whole mount specimen. In addition, these data were correlated to the angiogenic activity as a marker for lymphatic system involvement.


RESULTS
Pharmacokinetic MR imaging derived parameters (A, k21) showed a weak but significant (p < 0.05) correlation with microvessel density counts. Lymphatic involvement was more comprehensively assessed by the pharmacokinetic parameter k21 compared with histologic microvessel density, resulting in a significantly (p < 0.05) higher overall accuracy (85% vs. 64%), sensitivity (83% vs. 54%), and comparable specificity (89% vs. 89%), respectively.


CONCLUSIONS
Our first results show that the signal-time curves measured by contrast-enhanced MR imaging are only in part influenced by microvessel density. In addition, MR imaging derived characteristics may assess tumor biological aggressiveness in terms of lymphatic spread (i.e. lymphatic channels) more comprehensively than histologic microvessel density in patients with primary or recurrent cancer of the uterine cervix.
Hawighorst
H
H
Forschungsschwerpunkt: Radiologische Diagnostik und Therapie des Deutschen Krebsforschungszentrums (DKFZ), Heidelberg.
Knapstein
P G
PG
Knopp
M V
MV
Weikel
W
W
Schaeffer
U
U
Zuna
I
I
Schönberg
S O
SO
Essig
M
M
Hoffmann
U
U
Brix
G
G
van Kaick
G
G
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002196:Capillaries / Q000473:pathology; D003287:Contrast Media; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology
D014408:Biomarkers, Tumor; D003287:Contrast Media; D005169:Factor VIII
Angiogenese des Zervixkarzinomes. Kontrastverstärkte dynamische MRT, histologische Quantifizierung der Kapillardichte und Lymphsysteminfiltration.