Bullitt Elizabeth, Ewend Matthew G, Aylward Stephen, Lin Weili, Gerig Guido, Joshi Sarang, Jung Inkyung, Muller Keith, Smith J Keith
Department of Surgery, University of North Carolina, 349 Wing C, CB #7062, Chapel Hill, NC 27599, USA.
Technol Cancer Res Treat. 2004 Dec;3(6):577-84. doi: 10.1177/153303460400300607.
Despite multiple advances in medical imaging, noninvasive monitoring of therapeutic efficacy for malignant gliomas remains problematic. An underutilized observation is that malignancy induces characteristic abnormalities of vessel shape. These characteristic shape abnormalities affect both capillaries and much larger vessels in the tumor vicinity, involve larger vessels prior to sprout formation, and are generally not present in hypervascular benign tumors. Vessel shape abnormalities associated with malignancy thus may appear independently of increase in vessel density. We hypothesize that an automated, computerized analysis of vessel shape as defined from high-resolution MRA can provide valuable information about tumor activity during the treatment of malignant gliomas. This report describes vessel shape properties in 10 malignant gliomas prior to treatment, in 2 patients in remission during treatment, and in 2 patients with recurrent disease. One subject was scanned multiple times. The method involves an automated, statistical analysis of vessel shape within a region of interest for each tumor, normalized by the values obtained from the vessels within the same region of interest of 34 healthy subjects. Results indicate that untreated tumors display statistically significant vessel tortuosity abnormalities. These abnormalities involve vessels not only within the tumor margins as defined from MR but also vessels in the surrounding tissue. The abnormalities resolve during effective treatment and recur with tumor recurrence. We conclude that vessel shape analysis could provide an important means of assessing tumor activity.
尽管医学成像技术取得了多项进展，但对恶性胶质瘤治疗效果的无创监测仍然存在问题。一个未得到充分利用的观察结果是，恶性肿瘤会引发血管形状的特征性异常。这些特征性形状异常影响肿瘤附近的毛细血管和大得多的血管，在新生血管形成之前就影响较大的血管，并且一般不存在于高血管化的良性肿瘤中。因此，与恶性肿瘤相关的血管形状异常可能独立于血管密度的增加而出现。我们假设，根据高分辨率磁共振血管造影（MRA）定义的血管形状进行自动化、计算机化分析，可以为恶性胶质瘤治疗期间的肿瘤活性提供有价值的信息。本报告描述了10例恶性胶质瘤治疗前、2例治疗期间缓解患者以及2例复发患者的血管形状特征。对一名受试者进行了多次扫描。该方法包括对每个肿瘤感兴趣区域内的血管形状进行自动化统计分析，并通过从34名健康受试者相同感兴趣区域内的血管获得的值进行归一化处理。结果表明，未经治疗的肿瘤显示出具有统计学意义的血管迂曲异常。这些异常不仅涉及磁共振成像（MR）定义的肿瘤边缘内的血管，还涉及周围组织中的血管。这些异常在有效治疗期间消失，并随着肿瘤复发而再次出现。我们得出结论，血管形状分析可以提供评估肿瘤活性的重要手段。
