Cervical carcinoma: standard and pharmacokinetic analysis of time–intensity curves for assessment of tumor angiogenesis and patient survival

• Published in: Magma (New York, N.Y.) N.Y.), 1999-02, Vol.8 (1), p.55-62
• Main Authors: Hawighorst, Hans, Knapstein, Paul G., Knopp, Michael V., Vaupel, Peter, van Kaick, Gerhard
• Format: Article
• Language: English
• Subjects: Cervical carcinoma; Microvessel density; Standard and pharmacokinetic MRI; Vascular endothelial growth factor
• ISSN: 1352-8661; 1352-8661
• DOI: 10.1016/S1352-8661(99)00007-1

Since detailed knowledge regarding the pathophysiological properties—which in turn are responsible for differences in contrast enhancement—remain fairly undetermined, it was the aim of this study (i) to examine the association of standard and pharmacokinetic analysis of time–intensity curves in dynamic MRI with histomorphological markers of tumor angiogenesis (microvessel density [MVD]; vascular endothelial growth factor [VEGF]); and (ii) to determine the ultimate value of a histomorphological and a dynamic MRI approach by correlation of those data with disease outcome in patients with primary cancer of the uterine cervix. Pharmacokinetic parameters (amplitude A, exchange rate constant k21) and standard parameters (maximum signal intensity (SI)-increase [SI–I] over baseline and steepest SI-upslope per second [SI-U/s]) were calculated from contrast-enhanced dynamic MR imaging series in 37 patients with biopsy-proven primary cervical cancer. On the surgical whole mount specimens, histomorphological markers of tumor angiogenesis (MVD, VEGF) were compared with similar sized and positioned regions-of-interest (ROIs) on the MRI-derived parameters. For MRI and histomorphological data, Kaplan–Meier survival curves were calculated and compared using log-rank statistics. A significant association was found between MVD and amplitude A (P