Niermann Kenneth J, Fleischer Arthur C, Huamani Jessica, Yankeelov Thomas E, Kim Dong W, Wilson Wendy D, Hallahan Dennis E
Departments of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA.
J Ultrasound Med. 2007 Jun;26(6):749-56. doi: 10.7863/jum.2007.26.6.749.
The purpose of this study was to evaluate the ability of dynamic microbubble contrast-enhanced sonography (MCES), in comparison with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET), to quantitatively characterize tumor perfusion in implanted murine tumors before and after treatment with a variety of regimens.
Seventeen mice with Lewis lung carcinoma implants were categorized to control, radiation therapy alone, antiangiogenic chemotherapy alone, and combined chemoradiation. On day 0 of each treatment regimen, MCES and DCE-MRI of each tumor were performed. On day 5 of treatment, dynamic FDG-PET, MCES, and DCE-MRI were performed.
Microbubble contrast-enhanced sonography showed that intratumoral perfusion, blood volume, and blood velocity were highest in the untreated control group and successively lower in each of the treatment groups: radiation therapy alone resulted in a two-thirds reduction of perfusion; antiangiogenic chemotherapy resulted in a relatively larger reduction; and combined chemoradiotherapy resulted in the largest reduction. Microbubble contrast-enhanced sonography revealed longitudinal decreases in tumor perfusion, blood volume, and microvascular velocity over the 5-day course of chemoradiotherapy (all P < .01); conversely, these values rose significantly for the untreated control tumors (P < .01). Dynamic contrast-enhanced MRI showed a smaller and statistically insignificant average decrease in relative tumor perfusion for treated tumors. Dynamic PET revealed delayed uptake of FDG in the tumors that underwent chemoradiotherapy.
Microbubble contrast-enhanced sonography is an effective tool in the noninvasive, quantitative, longitudinal characterization of neovascularization in murine tumor models and is correlative with DCE-MRI and FDG-PET. Microbubble contrast-enhanced sonography has considerable potential in the clinical assessment of tumor neovascularization and in the assessment of the response to treatment.
本研究旨在评估动态微泡对比增强超声检查（MCES）与动态对比增强磁共振成像（DCE-MRI）和氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）相比，在多种治疗方案治疗前后对植入性小鼠肿瘤灌注进行定量表征的能力。
将17只植入Lewis肺癌的小鼠分为对照组、单纯放射治疗组、抗血管生成化疗组和放化疗联合组。在每种治疗方案的第0天，对每个肿瘤进行MCES和DCE-MRI检查。在治疗的第5天，进行动态FDG-PET、MCES和DCE-MRI检查。
微泡对比增强超声检查显示，未治疗的对照组肿瘤内灌注、血容量和血流速度最高，各治疗组依次降低：单纯放射治疗使灌注减少三分之二；抗血管生成化疗导致相对更大程度的减少；放化疗联合导致最大程度的减少。微泡对比增强超声检查显示，在放化疗的5天疗程中，肿瘤灌注、血容量和微血管速度呈纵向下降（均P < 0.01）；相反，未治疗的对照肿瘤这些值显著升高（P < 0.01）。动态对比增强MRI显示，治疗后肿瘤的相对灌注平均下降较小且无统计学意义。动态PET显示，接受放化疗的肿瘤中FDG摄取延迟。
微泡对比增强超声检查是对小鼠肿瘤模型新生血管进行无创、定量、纵向表征的有效工具，与DCE-MRI和FDG-PET相关。微泡对比增强超声检查在肿瘤新生血管的临床评估和治疗反应评估方面具有相当大的潜力。
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