Hawighorst H, Knapstein P G, Knopp M V, Weikel W, Schaeffer U, Zuna I, Schönberg S O, Essig M, Hoffmann U, Brix G, van Kaick G
Forschungsschwerpunkt: Radiologische Diagnostik und Therapie des Deutschen Krebsforschungszentrums (DKFZ), Heidelberg.
Radiologe. 1998 Jan;38(1):50-7. doi: 10.1007/s001170050323.
It was the aim of this project to examine (i) the relationships between contrast-enhanced dynamic MR imaging derived characteristics and histologic microvessel density counts--a recognized surrogate of tumor angiogenesis--from tumors in patients with primary or recurrent cancer of the uterine cervix, and (ii) to correlate these parameters with lymphatic involvement (i.e. lymphatic channels) to assess tumor biological aggressiveness in terms of lymphatic spread.
Pharmacokinetic MR imaging parameters (amplitude A, exchange rate constant k21) were derived from contrast-enhanced dynamic MR imaging in thirty-three patients with biopsy proven cancer of the uterine cervix. The pharmacokinetic MR imaging characteristics were correlated to histologic capillary density counts obtained from whole mount specimen. In addition, these data were correlated to the angiogenic activity as a marker for lymphatic system involvement.
Pharmacokinetic MR imaging derived parameters (A, k21) showed a weak but significant (p < 0.05) correlation with microvessel density counts. Lymphatic involvement was more comprehensively assessed by the pharmacokinetic parameter k21 compared with histologic microvessel density, resulting in a significantly (p < 0.05) higher overall accuracy (85% vs. 64%), sensitivity (83% vs. 54%), and comparable specificity (89% vs. 89%), respectively.
Our first results show that the signal-time curves measured by contrast-enhanced MR imaging are only in part influenced by microvessel density. In addition, MR imaging derived characteristics may assess tumor biological aggressiveness in terms of lymphatic spread (i.e. lymphatic channels) more comprehensively than histologic microvessel density in patients with primary or recurrent cancer of the uterine cervix.
本项目旨在研究（i）原发性或复发性宫颈癌患者肿瘤的对比增强动态磁共振成像（MRI）衍生特征与组织学微血管密度计数（一种公认的肿瘤血管生成替代指标）之间的关系，以及（ii）将这些参数与淋巴受累情况（即淋巴管）相关联，以评估肿瘤在淋巴转移方面的生物学侵袭性。
对33例经活检证实为宫颈癌的患者进行对比增强动态MRI检查，获取药代动力学MRI参数（幅度A、交换率常数k21）。将药代动力学MRI特征与从整装标本获得的组织学毛细血管密度计数相关联。此外，将这些数据与作为淋巴系统受累标志物的血管生成活性相关联。
药代动力学MRI衍生参数（A、k21）与微血管密度计数呈弱但显著（p<0.05）的相关性。与组织学微血管密度相比，药代动力学参数k21对淋巴受累情况的评估更全面，总体准确率（85%对64%）、敏感性（83%对54%）显著更高（p<0.05），特异性相当（89%对89%）。
我们的初步结果表明，对比增强MRI测量的信号-时间曲线仅部分受微血管密度影响。此外，在原发性或复发性宫颈癌患者中，MRI衍生特征在评估肿瘤淋巴转移方面的生物学侵袭性（即淋巴管）可能比组织学微血管密度更全面。
