Preoperative dynamic contrast-enhanced MRI correlates with molecular markers of hypoxia and vascularity in specific areas of intratumoral microenvironment and is predictive of patient outcome

Abstract

Our findings suggest that DCE-MRI may facilitate noninvasive preoperative predictions of areas of tumor with increased hypoxia and proliferation. Both imaging and hypoxia biomarkers are predictive of patient outcome. This has the potential to allow unprecedented prognostic decisions and to guide therapies to specific tumor areas.

Prognostic value of preoperative dynamic contrast-enhanced MRI perfusion parameters for high-grade glioma patients

“…These parameters provide additional information about physiological tumor properties and could afford independent insight about clinical tumor behavior, especially as DCE perfusion parameters were shown not to correlate with DSC [10] or diffusion parameters [11] closely. DCE perfusion parameters have already been demonstrated to be diagnostic for glioma grade [12–17] and correlate with several proxies of hypoxia like microvascular density [18, 19] and HIF-1α and vascular endothelial growth factor (VEGF) expression [20]. DCE perfusion also has predictive value for treatment with neoangiogenesis inhibitors [21, 22] and chemoradiotherapy [23].…”

“…Thus far, research on the prognostic value of DCE perfusion for HGG patient survival has been scarce—only a few studies have been conducted [10, 20, 24–26], some of them presenting contradicting results [27], focusing mostly on K trans and v p , and some of them employing the hot-spot method, where only tumor regions with subjectively highest parameter values are analyzed. We set out to partially fill this knowledge gap with a larger study sample and a comprehensive whole tumor volume histogram analysis of more DCE-MRI pharmacokinetic modeling parameters.…”

The assessment of immature microvascular density in brain gliomas with dynamic contrast-enhanced magnetic resonance imaging

“…The degree of microvascular proliferation is different based on different grades of glioma. In high-grade glioma (HGG), these new microvessels are usually immature and their permeability is increased [1,2]. CD105 is specifically expressed in new and immature tumor microvessels [3][4][5].…”

Pattern recognition and pharmacokinetic methods on DCE-MRI data for tumor hypoxia mapping in sarcoma

“…Well-perfused areas were defined as those having the Type 3 curve shape, hypoxic ones were assigned to the Type 2 shape and necrotic regions were those with enhancement profile similar to Type 1 curve. The classification of tumor areas has also been used in other studies investigating the role of DCE-MRI in defining hypoxia [9]. The proposed approach could be considered as a quantitative morphological analysis of the examined structures.…”