Tumor vascularity evaluated by transrectal color Doppler US in predicting therapy outcome for low-lying rectal cancer.
OBJECTIVE
To evaluate the impact on T downstaging of the vasculature supplying blood flow to rectal cancer evaluated by color Doppler ultrasound.


METHODS
Color Doppler images were graded in 29 T3-staged rectal carcinoma patients sonographically just before chemoradiation. Any arterial vessels detected in rectal masses were assigned one of two grades: vascularity was considered as grade 1 for vessels feeding the periphery and as grade 2 for vessels coursing in all rectal masses within its peripheral and central portions. The pulsatility indices (PI = peak systolic velocity - end-diastolic velocity/time-averaged maximum velocity) were calculated in the central and peripheral portions.


RESULTS
The pathologic observations showed a change in stage in 15 of the 23 patients graded 2, positive predictive value 65.2% (p = 0.047), and in one of the six rectal cancers graded 1 (negative predictive value, 83.3%). The minimal peripheral PI values in rectal cancer graded 2 were higher in nonresponding (2.2 +/- 1.3) than in responding lesions (1.6 +/- 0.7) p = 0.01.


CONCLUSIONS
Vascularity graded 2 associated with low peripheral PI values are indicators of therapy outcome. Vascularity graded 1 and high peripheral PI values in graded 2 have negative predictive value.
Barbaro
Brunella
B
Department of Radiology, Università Cattolica, Policlinico Agostino Gemelli, Largo Agostino Gemelli, Rome, Italy. a.leonemed@tiscalinet.it
Valentini
Vincenzo
V
Coco
Claudio
C
Mancini
Anna Paola
AP
Gambacorta
Maria Antonietta
MA
Vecchio
Fabio Maria
FM
Bonomo
Lorenzo
L
D000230:Adenocarcinoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D012004:Rectal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color