The objective of this study was to investigate potential correlations between perfusion using arterial spin-labeled (ASL) magnetic resonance imaging (MRI) and dynamic contrast-enhanced (DCE) MRI-derived quantitative measures of vascularity in renal masses > 2 cm and to correlate these with microvessel density (MVD) in clear cell renal cell carcinoma (ccRCC).
Informed written consent was obtained from all patients before imaging in this Health Insurance Portability and Accountability Act-compliant, institutional review board-approved, prospective study. Thirty-six consecutive patients scheduled for surgery of a known renal mass > 2 cm underwent 3T ASL and DCE MRI. ASL perfusion measures (PASL) of mean, peak, and low perfusion areas within the mass were correlated to DCE-derived volume transfer constant (K(trans)), rate constant (Kep), and fractional volume of the extravascular extracellular space (Ve) in the same locations using a region of interest analysis. MRI data were correlated to MVD measures in the same tumor regions in ccRCC. Spearman correlation was used to evaluate the correlation between PASL and DCE-derived measurements, and MVD. P < . 05 was considered statistically significant.
Histopathologic diagnosis was obtained in 36 patients (25 men; mean age 58 ± 12 years). PASL correlated with K(trans) (ρ = 0. 48 and P = . 0091 for the entire tumor and ρ = 0. 43 and P = . 03 for the high flow area, respectively) and Kep (ρ = 0. 46 and P = . 01 for the entire tumor and ρ = 0. 52 and P = . 008 for the high flow area, respectively). PASL (ρ = 0. 66; P = . 0002), K(trans) (ρ = 0. 61; P = . 001), and Kep (ρ = 0. 64; P = . 0006) also correlated with MVD in high and low perfusion areas in ccRCC.
PASL correlated with the DCE-derived measures of vascular permeability and flow, K(trans) and Kep, in renal masses > 2 cm in size. Both measures correlated to MVD in clear cell histology.
Clinical genitourinary cancer. 2015 Aug 29 [Epub ahead of print]
Yue Zhang, Payal Kapur, Qing Yuan, Yin Xi, Ingrid Carvo, Sabina Signoretti, Ivan Dimitrov, Jeffrey A Cadeddu, Vitaly Margulis, Naira Muradyan, James Brugarolas, Ananth J Madhuranthakam, Ivan Pedrosa
Department of Radiology, UT Southwestern Medical Center, Dallas, TX. , Department of Urology, UT Southwestern Medical Center, Dallas, TX; Department of Pathology, UT Southwestern Medical Center, Dallas, TX. , Department of Radiology, UT Southwestern Medical Center, Dallas, TX. , Department of Radiology, UT Southwestern Medical Center, Dallas, TX. , Department of Pathology, Brigham and Women's Hospital, Boston, MA. , Department of Pathology, Brigham and Women's Hospital, Boston, MA. , Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX; Philips Medical Systems, Cleveland, OH. , Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Department of Urology, UT Southwestern Medical Center, Dallas, TX. , Department of Urology, UT Southwestern Medical Center, Dallas, TX. , iCAD, Nashua, NH. , Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX; Developmental Biology, UT Southwestern Medical Center, Dallas, TX. , Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX. , Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX.