Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
Nat Rev Urol. 2010 Feb;7(2):69-82. doi: 10.1038/nrurol.2009.262. Epub 2010 Jan 19.
Angiogenesis is a key process in the growth and metastasis of cancer, and genitourinary tumors are no exception. The evolution of angiogenesis as an important target for novel anticancer therapeutics has brought with it new challenges for in vivo imaging. Most imaging techniques quantify physiological parameters, such as blood volume and capillary endothelial permeability. Although CT, PET and ultrasonography have shown promise, MRI is the most common method used to evaluate angiogenesis in clinical trials of genitourinary tumors. Pilot studies of MRI, CT and ultrasonography in patients with renal cancer have produced promising results; reductions in vascular permeability and blood flow have been correlated with progression-free survival. The vascular characteristics of prostate cancer have been evaluated by MRI, and this has been suggested as a means of assessing tumor response to hormone deprivation therapy. Current evidence highlights the potential of angiogenesis imaging in the diagnosis, staging and possibly response monitoring of bladder cancer. In the future, assessment of the angiogenic process at the structural, functional and molecular levels, before, during and after antiangiogenic therapy will undoubtedly be integrated into wider clinical practice.
血管生成是癌症生长和转移的关键过程，泌尿生殖系统肿瘤也不例外。血管生成作为新型抗癌治疗的重要靶点的发展，给体内成像带来了新的挑战。大多数成像技术都定量评估生理参数，如血容量和毛细血管内皮通透性。尽管 CT、PET 和超声检查显示出了一定的前景，但 MRI 是评估泌尿生殖系统肿瘤临床试验中血管生成的最常用方法。在肾癌患者的 MRI、CT 和超声检查的初步研究中，取得了有前景的结果；血管通透性和血流量的降低与无进展生存期相关。MRI 评估了前列腺癌的血管特征，这被认为是评估肿瘤对激素剥夺治疗反应的一种手段。目前的证据强调了血管生成成像在膀胱癌的诊断、分期和可能的反应监测中的潜力。在未来，在接受抗血管生成治疗之前、期间和之后，对血管生成过程进行结构、功能和分子水平的评估无疑将被整合到更广泛的临床实践中。
