title: Evaluation of colon cancer vascularity by flash echo imaging.
abstract: OBJECTIVE
  Tumor vascularity is strongly related to the prognoses of patients with various malignant primary tumors, including colorectal cancer. The aim of this study was to confirm the usefulness of harmonic flash echo imaging (H-FEI) for the preoperative evaluation of tumor vascularity in colorectal cancer by comparison with CD34 staining of resected specimens.
  
  
  METHODS
  Seventeen patients undergoing surgical resection for advanced colorectal cancer (9 M, 8 F) were enrolled in this study. An ultrasound system transmitting ultrasound pulses at 2.3 MHz and receiving them at 4.6 MHz (second harmonic) was used for H-FEI. After intravenous injection of ultrasonic contrast medium (SHU 508A), intermittent harmonic scanning was carried out for 120 s at intervals of 4 s. On the tumor image of the strongest enhancement in each patient, 5 regions of interest were taken to decide the mean echo intensity of the tumor. Immunohistochemistry using antibodies against CD34 was carried out on resected specimens. The mean microvessel density was decided by counting microvessels on 5 fields (x 400) of CD34-stained specimens.
  
  
  RESULTS
  The mean value of H-FEI intensity was 5.44+/-1.10, and the mean microvessel count with CD34 staining was 35.0+/-7.95. A significant positive linear correlation was observed between the intensity of H-FEI determined preoperatively and the microvessel count in CD34-stained specimens (r=0.741, p=0.0006).
  
  
  CONCLUSIONS
  Vascularity of colon cancer can be evaluated non-invasively using H-FEI.
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Nakao
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Hideharu
authors.initials: H
authors.lastname: Okanobu
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism; D001706:Biopsy; D003110:Colonic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012044:Regression Analysis; D014463:Ultrasonography / Q000379:methods*
chemical_list: D018952:Antigens, CD34; D003287:Contrast Media