6533b831fe1ef96bd129972c

RESEARCH PRODUCT

Angiogenesis of cancer of the cervix. Contrast-enhanced dynamic MRT, histological quantification of capillary density and lymph system infiltration

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Purpose: 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 tumorbiological aggressiveness in terms of lymphatic spread. Materials and methods: Pharmacokinetic MR imaging parameters (amplitude A, exchange rate constant k 21) 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. Results: Pharmacokinetic MR imaging derived parameters (A, k 21) showed a weak but signifikant (p < 0.05) correlation with microvessel density counts. Lymphatic involvement was more comprehensibly assessed by the pharmacokinetic parameter k 21 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. Conclusion: 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 tumorbiological 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.