title: Rectal cancer: dynamic contrast-enhanced MRI correlates with lymph node status and epidermal growth factor receptor expression.
abstract: OBJECTIVE
  To evaluate correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinicopathologic data as well as immunostaining of the markers of angiogenesis epidermal growth factor receptor (EGFR) and CXC-motif chemokine receptor 4 (CXCR4) in patients with rectal cancer.
  
  
  METHODS
  Presurgical DCE-MRI was performed in 41 patients according to a standardized protocol. Two quantitative parameters (k21 , A) were derived from a pharmacokinetic two-compartment model, and one semiquantitative parameter (TTP) was assessed. Standardized surgery and histopathologic examinations were performed in all patients. Immunostaining for EGFR and CXCR4 was performed and evaluated with a standardized scoring system.
  
  
  RESULTS
  DCE-MRI parameter A correlated significantly with the N category (P = 0.048) and k21 with the occurrence of synchronous and metachronous distant metastases (P = 0.029). A trend was shown toward a correlation between k21 and EGFR expression (P = 0.107). A significant correlation was found between DCE-MRI parameter TTP and the expression of EGFR (P = 0.044). DCE-MRI data did not correlate with CXCR4 expression.
  
  
  CONCLUSIONS
  DCE-MRI is a noninvasive method which can characterize microcirculation in rectal cancer and correlates with EGFR expression. Given the relationship between the dynamic parameters and the clinicopathologic data, DCE-MRI data may constitute a prognostic indicator for lymph node and distant metastases in patients with rectal cancer.
authors.affiliation: Department of Radiology, University of Mainz, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Lollert
authors.forename: Theodor
authors.initials: T
authors.lastname: Junginger
authors.forename: Carl Christoph
authors.initials: CC
authors.lastname: Schimanski
authors.forename: Stefan
authors.initials: S
authors.lastname: Biesterfeld
authors.forename: Ines
authors.initials: I
authors.lastname: Gockel
authors.forename: Christoph
authors.initials: C
authors.lastname: Düber
authors.forename: Katja
authors.initials: K
authors.lastname: Oberholzer
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D000368:Aged; D003287:Contrast Media; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009389:Neovascularization, Pathologic / Q000473:pathology; D015588:Observer Variation; D011379:Prognosis; D011446:Prospective Studies; D019718:Receptors, CXCR4 / Q000378:metabolism; D012004:Rectal Neoplasms / Q000098:blood supply / Q000378:metabolism* / Q000473:pathology*
chemical_list: C527276:CXCR4 protein, human; D003287:Contrast Media; D019718:Receptors, CXCR4; D066246:ErbB Receptors; D019786:Gadolinium DTPA
keywords: CXCR4; DCE-MRI; EGFR; histopathology; immunohistochemistry; prognosis; rectal cancer; tumor microcirculation