Value of Dynamic Contrast-Enhanced MRI and Correlation with Tumor Angiogenesis in Bladder Cancer

Tunçbilek, Nermin; Kaplan, Mustafa; Altaner, Semsi; Atakan, İrfan Hüseyin; Süt, Necdet; İnci, Osman; Demir, Mustafa Kemal

doi:10.2214/ajr.08.1332

Cited by 72 publications

(42 citation statements)

References 33 publications

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“…30 Foremost, for each tumor type or body site, a set of PCs used in calculation of the coefficient maps can be achieved offline and are available before a new patient is scanned. Also, we address the heterogeneous distributions of the principal Table III. component coefficients within a tumor by using fuzzy clustering analysis to determine the probability membership functions of classes that the principal component coefficients belong to.…”

Section: Discussionmentioning

confidence: 99%

DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

Farjam¹,

Tsien²,

Lawrence³

et al. 2013

Med. Phys.

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Purpose: To develop a pharmacokinetic modelfree framework to analyze the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data for assessment of response of brain metastases to radiation therapy. Methods: Twenty patients with 45 analyzable brain metastases had MRI scans prior to whole brain radiation therapy (WBRT) and at the end of the 2-week therapy. The volumetric DCE images covering the whole brain were acquired on a 3T scanner with approximately 5 s temporal resolution and a total scan time of about 3 min. DCE curves from all voxels of the 45 brain metastases were normalized and then temporally aligned. A DCE matrix that is constructed from the aligned DCE curves of all voxels of the 45 lesions obtained prior to WBRT is processed by principal component analysis to generate the principal components (PCs). Then, the projection coefficient maps prior to and at the end of WBRT are created for each lesion. Next, a pattern recognition technique, based upon fuzzy-c-means clustering, is used to delineate the tumor subvolumes relating to the value of the significant projection coefficients. The relationship between changes in different tumor subvolumes and treatment response was evaluated to differentiate responsive from stable and progressive tumors. Performance of the PCdefined tumor subvolume was also evaluated by receiver operating characteristic (ROC) analysis in prediction of nonresponsive lesions and compared with physiological-defined tumor subvolumes. Results: The projection coefficient maps of the first three PCs contain almost all response-related information in DCE curves of brain metastases. The first projection coefficient, related to the area under DCE curves, is the major component to determine response while the third one has a complimentary role. In ROC analysis, the area under curve of 0.88 ± 0.05 and 0.86 ± 0.06 were achieved for the PC-defined and physiological-defined tumor subvolume in response assessment. Conclusions: The PC-defined subvolume of a brain metastasis could predict tumor response to therapy similar to the physiological-defined one, while the former is determined more rapidly for clinical decision-making support.

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Section: Discussionmentioning

confidence: 99%

DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

Farjam¹,

Tsien²,

Lawrence³

et al. 2013

Med. Phys.

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“…Gadoliniumenhanced MRI studies elegantly portray tumoral neovascularization characterized by increased capillary surface permeability, microvessel vasodilation, and abnormal vessel sprouting with a high sensitivity. [200][201][202] Surrogate end points such as blood volume, blood flow, transit time, and capillary permeability can be quantified by dynamic contrastenhanced MR perfusion and diffusion imaging for accurate diagnosis of early ischemia or abnormal tumor enhancement. 199 Calculation of sophisticated parameters such as ADC with dedicated magnetic resonance diffusion sequences is of utmost sensitivity for detection of early cell membrane disruption by ischemia.…”

Section: Mri Contrast Agentsmentioning

confidence: 99%

“…120 It is impressing that calculated doses, although lower than the lethal, are more than ten times higher than for human PET studies. For example, in a typical injection of 200 Ci of FDG, absorbed dose ranges from 19 mGy for skin to 4000 mGy for bladder wall. Depending on the application, a large variation in radiation dose is observed since some tissues can accumulate tracer, while others are involved in the clearance of the tracer from circulation and receive higher radiation doses.…”

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confidence: 99%

In vivo small animal imaging: Current status and future prospects

et al. 2010

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The use of small animal models in basic and preclinical sciences constitutes an integral part of testing new pharmaceutical agents prior to commercial translation to clinical practice. Whole-body small animal imaging is a particularly elegant and cost-effective experimental platform for the timely validation and commercialization of novel agents from the bench to the bedside. Biomedical imaging is now listed along with genomics, proteomics, and metabolomics as an integral part of biological and medical sciences. Miniaturized versions of clinical diagnostic modalities, including but not limited to microcomputed tomography, micromagnetic resonance tomography, microsinglephoton-emission tomography, micropositron-emission tomography, optical imaging, digital angiography, and ultrasound, have all greatly improved our investigative abilities to longitudinally study various experimental models of human disease in mice and rodents. After an exhaustive literature search, the authors present a concise and critical review of in vivo small animal imaging, focusing on currently available modalities as well as emerging imaging technologies on one side and molecularly targeted contrast agents on the other. Aforementioned scientific topics are analyzed in the context of cancer angiogenesis and innovative antiangiogenic strategies under-the-way to the clinic. Proposed hybrid approaches for diagnosis and targeted site-specific therapy are highlighted to offer an intriguing glimpse of the future.

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“…CT and MRI are accurate techniques for bladder cancer detection when they are performed with the injection of intravascular contrast agents. Detection relies on the identification of bladder cancer neovascularisation and recent studies have shown high accuracy with both techniques [6,7]. The introduction of microbubble contrast agents and the development of contrast-specific software have increased the value of ultrasound in the field of oncology [8,9].…”

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confidence: 99%

Accuracy of contrast-enhanced ultrasound in the detection of bladder cancer

Nicolau¹,

Buñesch²,

Peri³

et al. 2011

BJR

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Objective: To assess the accuracy contrast-enhanced ultrasound (CEUS) in bladder cancer detection using transurethral biopsy in conventional cystoscopy as the reference standard and to determine whether CEUS improves the bladder cancer detection rate of baseline ultrasound. Methods: 43 patients with suspected bladder cancer underwent conventional cystoscopy with transurethral biopsy of the suspicious lesions. 64 bladder cancers were confirmed in 33 out of 43 patients. Baseline ultrasound and CEUS were performed the day before surgery and the accuracy of both techniques for bladder cancer detection and number of detected tumours were analysed and compared with the final diagnosis. Results: CEUS was significantly more accurate than ultrasound in determining presence or absence of bladder cancer: 88.37% vs 72.09%. Seven of eight uncertain baseline ultrasound results were correctly diagnosed using CEUS. CEUS sensitivity was also better than that of baseline ultrasound per number of tumours: 65.62% vs 60.93%. CEUS sensitivity for bladder cancer detection was very high for tumours larger than 5 mm (94.7%) but very low for tumours ,5 mm (20%) and also had a very low negative predictive value (28.57%) in tumours ,5 mm. Conclusion: CEUS provided higher accuracy than baseline ultrasound for bladder cancer detection, being especially useful in non-conclusive baseline ultrasound studies.

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Value of Dynamic Contrast-Enhanced MRI and Correlation with Tumor Angiogenesis in Bladder Cancer

Abstract: The contrast enhancement patterns on DCE-MRI are influenced by tumor angiogenesis, as reflected by elevated microvessel density expression. Therefore, they are valuable indicators for assessing tumor angiogenic activity and tumor neovascularization in bladder cancers.

Cited by 72 publications

References 33 publications

DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

In vivo small animal imaging: Current status and future prospects

Accuracy of contrast-enhanced ultrasound in the detection of bladder cancer

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