Angiogenesis is a fundamental process in various physiologic and pathologic processes. The ability to visualize and quantify angiogenesis will allow early diagnosis and monitoring for clinical determination of angiogenesis states before, during, and after adjuvant antiangiogenic and therapeutic angiogenesis treatments.Key Words: angiogenesis; volumetric computed tomography (VCT); dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); integrin; vascular endothelial growth factor receptor (VEGFR) In recent years, angiogenesis has become one of the most important and intensely studied areas of cancer research, with the future holding great promise. Angiogenesis is a fundamental process in various physiologic and pathologic processes. The ability to visualize and quantify angiogenesis will allow early diagnosis and monitoring for clinical determination of angiogenesis states before, during, and after adjuvant antiangiogenic and therapeutic angiogenesis treatments. Investigators have identified more than 20 angiogenic growth factors, their receptors, and the details of their signal transduction pathways. Achievements with the vascular endothelial growth factor (VEGF) antibody bevacizumab (Avastin; Genentech) in combination with standard cytotoxic chemotherapy in metastasized colorectal cancer, breast cancer, and non-small cell lung cancer (1) are among them. However, although new antiangiogenic therapies are continually being introduced into clinical trials, we believe that the future success of these therapies will require the codevelopment of high-throughput, cost-effective imaging techniques with highly specific biomarkers of angiogenesis to determine optimal doses and individual response to therapy on a structural, functional, and molecular level. In the future, we believe that angiogenesis imaging will serve as an early diagnostic and monitoring tool for the clinical determination of angiogenesis states before, during, and after adjuvant antiangiogenic cancer therapy.J
STRUCTURAL IMAGING OF ANGIOGENESISSeveral research and clinical imaging modalities are available for visualizing the structure of microvasculature such as intravital microscopy, CT angiography, contrast-enhanced ultrasound, and high-resolution magnetic resonance angiography. Multidetector CT angiography allows for larger scan volumes in less time with improved spatial and temporal resolution, making it possible to image different vascular phases using the same contrast bolus to compare the vasculature of tumors with that of normal organs. In addition, CT angiography provides a quick, noninvasive, low-dose alternative to conventional digital subtraction angiography in a research setting, and CT angiography has the potential to provide invaluable information about surrounding nonvascular structures and both arterial and venous systems. However, the spatial resolution of MDCT is still not enough for microvasculature visualization (2). To improve the number of photons produced per unit-area per second of benchtop x-ray sources, radiation micr...