Value of dynamic contrast-enhanced MRI and correlation with tumor angiogenesis in bladder cancer.
OBJECTIVE
The aim of this study was to investigate dynamic contrast-enhanced MRI (DCE-MRI) for the noninvasive measurement of bladder cancer angiogenesis by correlation with microvessel density, histologic grade, and tumor staging, and to predict the outcome of local recurrence.


METHODS
Twenty-four patients with bladder cancer were examined using DCE-MRI. Hemodynamic parameters obtained by DCE-MRI included peak time enhancement in the first minute (E(max/1)) after contrast administration, second minute (E(max/2)), third minute (E(max/3)), fourth minute (E(max/4)), and fifth minute (E(max/5)), and the steepest slope. Microvessel density was identified by immunostaining of endothelial cells using FVIII-related antigen. The Mann-Whitney U test, multivariate discriminant analysis, Spearman's correlation coefficient, and analysis of variance were used for statistical analysis.


RESULTS
Correlation was seen between DCE-MRI parameters (E(max/1) and steepest slope) and microvessel density (p < 0.05). E(max/1) and steepest slope were found to have a statistically significant correlation with histologic grade (p < 0.05 and p < 0.01, respectively). A significant difference was seen between groups of patients with and without local recurrence with regard to two of the DCE-MRI parameters (p < 0.05 for E(max/1) and E(max/2)).


CONCLUSIONS
The contrast enhancement patterns on DCE-MRI are influenced by tumor angiogenesis, as reflected by elevated microvessel density expression. Therefore, they are valuable indicators for assessing tumor angiogenic activity and tumor neovascularization in bladder cancers.
Tuncbilek
Nermin
N
Radiology Department, Trakya University School of Medicine, Kocasinan mah, Dr. Sadik Ahmet caddesi, Uzunoglu 2 Apt. No:60 Daire: 4/13, 22030 Edirne, Turkey. drtuncbilek@hotmail.com
Kaplan
Mustafa
M
Altaner
Semsi
S
Atakan
Irfan H
IH
Süt
Necdet
N
Inci
Osman
O
Demir
Mustafa Kemal
MK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003287:Contrast Media / Q000493:pharmacokinetics*; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009389:Neovascularization, Pathologic / Q000473:pathology* / Q000601:surgery; D018709:Statistics, Nonparametric; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
D003287:Contrast Media