title: Perfusion estimated with rapid dynamic contrast-enhanced magnetic resonance imaging correlates inversely with vascular endothelial growth factor expression and pimonidazole staining in head-and-neck cancer: a pilot study.
abstract: OBJECTIVE
  To analyze, in a pilot study, rapidly acquired dynamic contrast-enhanced (DCE)-MRI data with a general two-compartment exchange tracer kinetic model and correlate parameters obtained with measurements of hypoxia and vascular endothelial growth factor (VEGF) expression in patients with squamous cell carcinoma of the head and neck.
  
  
  METHODS
  Eight patients were scanned before surgery. The DCE-MRI data were acquired with 1.5-s temporal resolution and analyzed using the two-compartment exchange tracer kinetic model to obtain estimates of parameters including perfusion and permeability surface area. Twelve to 16 h before surgery, patients received an intravenous injection of pimonidazole. Samples taken during surgery were used to determine the level of pimonidazole staining using immunohistochemistry and VEGF expression using quantitative real-time polymerase chain reaction. Correlations between the biological and imaging data were examined.
  
  
  RESULTS
  Of the seven tumors fully analyzed, those that were poorly perfused tended to have high levels of pimonidazole staining (r = -0.79, p = 0.03) and VEGF expression (r = -0.82, p = 0.02). Tumors with low permeability surface area also tended to have high levels of hypoxia (r = -0.75, p = 0.05). Hypoxic tumors also expressed higher levels of VEGF (r = 0.82, p = 0.02).
  
  
  CONCLUSIONS
  Estimates of perfusion obtained with rapid DCE-MRI data in patients with head-and-neck cancer correlate inversely with pimonidazole staining and VEGF expression.
authors.affiliation: School of Cancer and Enabling Sciences, University of Manchester, Manchester, United Kindom. Stephanie.donaldson@physics.cr.man.ac.uk
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Donaldson
authors.forename: Guy
authors.initials: G
authors.lastname: Betts
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Bonington
authors.forename: Jarrod J
authors.initials: JJ
authors.lastname: Homer
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Slevin
authors.forename: Lucy E
authors.initials: LE
authors.lastname: Kershaw
authors.forename: Helen
authors.initials: H
authors.lastname: Valentine
authors.forename: Catharine M L
authors.initials: CM
authors.lastname: West
authors.forename: David L
authors.initials: DL
authors.lastname: Buckley
mesh_terms: D000368:Aged; D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D015687:Cell Hypoxia; D004396:Coloring Agents / Q000378:metabolism*; D003287:Contrast Media; D005260:Female; D006258:Head and Neck Neoplasms / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007700:Kinetics; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009363:Neoplasm Proteins / Q000378:metabolism*; D009389:Neovascularization, Pathologic / Q000209:etiology; D009593:Nitroimidazoles / Q000378:metabolism*; D010865:Pilot Projects; D060888:Real-Time Polymerase Chain Reaction; D047368:Tumor Burden; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D009363:Neoplasm Proteins; D009593:Nitroimidazoles; D042461:Vascular Endothelial Growth Factor A; C033815:pimonidazole