[Detection of angiogenesis-dependent parameters by functional MRI: correlation with histomorphology and evaluation of clinical relevance as prognostic factor using cervix carcinoma as an example].
OBJECTIVE
Purpose of this study is to compare functional MRI parameters with histomorphological markers of tumor microvessel density (MVD) and permeability (vascular endothelial growth factor) and to determine the ultimate value of both approaches by correlation with disease outcome in patients with primary cancer of the uterine cervix.


METHODS
Pharmacokinetic parameters were calculated from contrast-enhanced dynamic MR imaging series in 37 patients with biopsy-proven primary cervical cancer. On the operative whole mount specimens, histomorphological markers of tumor angiogenesis (MVD, VEGF) were compared with the MRI-derived parameters. For MRI and histomorphological data, Kaplan-Meier survival curves were calculated and compared using logrank statistics.


RESULTS
Significant (p < 0.05-0.01) associations were found between MVD and dynamic MRI parameters. No significant relationships were observed between VEGF expression and dynamic MRI parameters. Disease outcome was better assessed with dynamic MRI parameters than with the histomorphological approach.


CONCLUSIONS
It is concluded that 1) the pathophysiological basis for the amplitude A in dynamic MRI is MVD but not VEGF expression; and 2) a functional, dynamic MRI approach may be more suited to assess angiogenic activity in terms of patient survival than current histomorphological-based markers of tumor angiogenesis.
Hawighorst
H
H
Deutschen Krebsforschungszentrums (dkfz), Heidelberg. H.Hawighorst@dkfz-heidelberg.de
Schaeffer
U
U
Knapstein
P G
PG
Knopp
M V
MV
Weikel
W
W
Schönberg
S O
SO
Essig
M
M
van Kaick
G
G
D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers; D001706:Biopsy; D002196:Capillaries / Q000473:pathology; D016228:Endothelial Growth Factors / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008222:Lymphokines / Q000032:analysis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D015415:Biomarkers; D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D005169:Factor VIII
Erfassung angiogeneseabhängiger Parameter mittels funktioneller MRT: Korrelation mit der Histomorphologie sowie Abklärung der klinischen Relevanz als Prognosefaktor am Beispiel des Zervixkarzinomes.