title: Correlation of dynamic contrast-enhanced MRI perfusion parameters with angiogenesis and biologic aggressiveness of rectal cancer: Preliminary results.
abstract: OBJECTIVE
  To investigate whether quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are correlated with angiogenesis and biologic aggressiveness of rectal cancer.
  
  
  METHODS
  A total of 46 patients with rectal cancer underwent DCE-MRI. Using a two-compartmental model, quantitative parameters (K(trans) , kep , ve , and iAUC) were calculated from the whole-transverse region of interest (ROI) and high K(trans) area ROI of entire tumors. Histological specimens were analyzed for tumor size; T/N stage; lymphatic, vascular, perineural invasion; expression of epidermal growth factor receptor (EGFR); and KRAS gene mutations. Tumor angiogenesis was evaluated based on the microvessel density (MVD) and the expression level of the vascular endothelial growth factor. Correlations of the DCE-MRI parameters with histological markers and angiogenesis were determined using Student's t-test and analysis of variance (ANOVA).
  
  
  RESULTS
  The mean kep from high K(trans) area ROIs showed a significantly positive correlation with MVD (P  =  0.030, r  =  0.514, R(2)   =  0.264). The mean kep from the whole-transverse ROIs showed a significant inverse correlation with T stage (T1 vs. T2-4, P  =  0.021). EGFR-positive cancer displayed higher mean K(trans) (P  =  0.045) and kep (P  =  0.038) than EGFR-negative cancer in whole-transverse ROIs.
  
  
  CONCLUSIONS
  These preliminary results suggest that the determination of kep of high K(trans) area permits the noninvasive estimation of tumor angiogenesis in rectal cancer and that DCE-MRI parameters can be used as imaging biomarkers to predict the biologic aggressiveness of the tumor and patient prognosis.
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dong-Myung
authors.initials: DM
authors.lastname: Yeo
authors.forename: Soon Nam
authors.initials: SN
authors.lastname: Oh
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Oh
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Rha
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Jung
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Byun
authors.forename: Peter
authors.initials: P
authors.lastname: Gall
authors.forename: Yohan
authors.initials: Y
authors.lastname: Son
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D009942:Organometallic Compounds; D012004:Rectal Neoplasms / Q000473:pathology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D042461:Vascular Endothelial Growth Factor A; C090600:gadobutrol; D066246:ErbB Receptors
keywords: dynamic contrast-enhanced magnetic resonance imaging; perfusion parameters; rectal cancer