title: Quantitative assessment of first-pass perfusion using a low-dose method at multidetector CT in oesophageal squamous cell carcinoma: correlation with VEGF expression.
abstract: OBJECTIVE
  To investigate the correlation between vascular endothelial cell growth factor (VEGF) expression and first-pass perfusion parameters at multidetector computed tomography (MDCT) using a low-dose technique, and to determine how to discriminate VEGF positivity from VEGF negativity by perfusion CT in oesophageal squamous cell carcinomas.
  
  
  METHODS
  Thirty-two patients with oesophageal squamous cell carcinomas underwent first-pass perfusion with 64-section MDCT at 50 mAs. Perfusion parameters, including perfusion, peak enhanced density (PED), time to peak (TTP), and blood volume (BV), were measured. Postoperative specimens were assessed for VEGF expression. Correlation tests were performed to determine the associations between each CT perfusion parameter and VEGF expression. The cut-off values of perfusion parameters were obtained statistically to discriminate VEGF positivity from VEGF negativity.
  
  
  RESULTS
  Mean perfusion, PED, TTP, and BV were 38.47 ± 30.26 ml/min/ml, 24.68 ± 9.65 HU, 28.35 ± 9.03 s, and 11.82 ± 6.06 ml/100 g, respectively. PED or BV were significantly higher in the VEGF-positive group than in the VEGF-negative group (all p < 0.05), but no significant difference in perfusion or TTP was found between the VEGF-positive and VEGF-negative groups (all p > 0.05). In VEGF positivity, PED and BV were correlated with VEGF expression (r = 0.576 and 0.765, respectively; all p < 0.05), whereas perfusion and TTP were not (r = 0.361 and 0.239, respectively; all p > 0.05). A threshold of BV (10.23 ml/100 g) achieved a sensitivity of 94.4%, and a specificity of 92.9% for discriminating VEGF positivity from VEGF negativity.
  
  
  CONCLUSIONS
  BV could reflect tumour VEGF expression, and could be an indicator for evaluating angiogenesis in oesophageal tumours.
authors.affiliation: Department of Radiology, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: T-w
authors.initials: TW
authors.lastname: Chen
authors.forename: Z-g
authors.initials: ZG
authors.lastname: Yang
authors.forename: H-j
authors.initials: HJ
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: S-s
authors.initials: SS
authors.lastname: Tang
authors.forename: J
authors.initials: J
authors.lastname: Yao
authors.forename: Z-h
authors.initials: ZH
authors.lastname: Dong
authors.forename: D
authors.initials: D
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume / Q000502:physiology; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000378:metabolism; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000378:metabolism; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D003287:Contrast Media; D042461:Vascular Endothelial Growth Factor A; D007472:Iohexol; C038192:iopromide