title: Small peripheral pulmonary carcinomas evaluated with dynamic MR imaging: correlation with tumor vascularity and prognosis.
abstract: OBJECTIVE
  To correlate the findings at contrast material-enhanced dynamic magnetic resonance (MR) imaging of small peripheral pulmonary carcinomas with tumor vascularity and prognosis.
  
  
  METHODS
  Ninety-four patients with small peripheral pulmonary carcinomas who underwent surgical resection were examined retrospectively. Pathologic specimens were stained with hematoxylin-eosin and elastin-van Gieson. CD34 and vascular endothelial growth factor (VEGF) were assessed immunohistochemically. Delineated CD34-positive cells were counted as microvessels. Dynamic MR imaging was performed prior to and at 1, 2, 3, 4, 5, 6, and 8 minutes after injection of a bolus of gadopentetate dimeglumine. The two observers reviewed all images, and two pathologists performed all histologic analyses; a decision was determined with consensus. The maximum enhancement ratio (MER), the time lapse between the completion of the injection and the point of maximum signal intensity (Tmax), the washout ratio, and the slope value of the time-signal intensity curve were correlated with the microvessel density. VEGF-positive and VEGF-negative tumors were compared. All statistical analyses were performed by using nonparametric methods.
  
  
  RESULTS
  The MER and the slope value were positively correlated, and the Tmax was negatively correlated (Spearman rank test, P <.0001, all comparisons) with the microvessel counts. The distribution of elastic and collagen fibers correlated with the washout ratio (Kruskal-Wallis test, P <.001). There was a statistically significant difference between the slope value of VEGF-positive tumors and that of VEGF-negative tumors (Mann-Whitney U test, P <.0001). Patients with VEGF-positive tumors had a significantly shorter overall survival than did those with VEGF-negative tumors (log-rank test, P <.0001).
  
  
  CONCLUSIONS
  Dynamic MR imaging findings correlate with tumor vascularity and may be helpful in the prediction of prognosis.
authors.affiliation: Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan. kimichan@med.kurume-u.ac.jp
authors.forename: Kiminori
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Toshi
authors.initials: T
authors.lastname: Abe
authors.forename: Nestor L
authors.initials: NL
authors.lastname: Müller
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Terasaki
authors.forename: Seiya
authors.initials: S
authors.lastname: Kato
authors.forename: Junko
authors.initials: J
authors.lastname: Sadohara
authors.forename: Rei
authors.initials: R
authors.lastname: Kono
authors.forename: Osamu
authors.initials: O
authors.lastname: Edamitsu
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishitake
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashi
authors.forename: Toru
authors.initials: T
authors.lastname: Rikimaru
authors.forename: Naofumi
authors.initials: N
authors.lastname: Hayabuchi
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D003287:Contrast Media; D016228:Endothelial Growth Factors / Q000032:analysis; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis; D008175:Lung Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D008222:Lymphokines / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D020033:Protein Isoforms / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D003287:Contrast Media; D016228:Endothelial Growth Factors; D036341:Intercellular Signaling Peptides and Proteins; D008222:Lymphokines; D020033:Protein Isoforms; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D019786:Gadolinium DTPA