Vessel Tortuosity and Brain Tumor Malignancy

Abstract

Rationale-Malignancy provokes regional changes to vessel shape. Characteristic vessel tortuosity abnormalities appear early during tumor development, affect initially healthy vessels, spread beyond the confines of tumor margins, and do not simply mirror tissue perfusion. The ability to detect and quantify tortuosity abnormalities on high-resolution MRA images offers a new approach to the noninvasive diagnosis of malignancy. This report evaluates a computerized, statistical method of analyzing the shapes of vessels extracted from MRA in diagnosing cancer.Materials and Methods-The regional vasculature of 34 healthy subjects was compared to the tumor-associated vasculature of 30 brain tumors prior to surgical resection. The operator performing the analysis was blinded to the diagnosis. Vessels were segmented from an MRA of each subject, a region of interest was defined in each tumor patient and was mapped to all healthy controls, and a statistical analysis of vessel shape measures was then performed over the region of interest. Many difficult cases were included, such as pinpoint, hemorrhagic, and irradiated tumors, as were hypervascular benign tumors. Tumors were identified as benign or malignant on the basis of histological evaluation.Results-A discriminant analysis performed at the study's conclusion successfully classified all but one of the 30 tumors as benign or malignant on the basis of vessel tortuosity.Discussion-Quantitative, statistical measures of vessel shape offer a new approach to the diagnosis and staging of disease. Although the methods developed under the current report must be tested against a new series of cases, initial results are promising.

Nonlinear Modeling and Simulation of Tumor Growth

“…Figure 16 shows a mm-sized glioblastoma during early stages of growth simulated using our 3-D multiscale model. The model predicts regions of viable cells, necrosis in inner tumor areas, and a tortuous neovasculature as observed in vivo [34]. Conducting vessels are capable of releasing nutrient.…”

“…The vasculature architecture, i.e., interconnectedness and anastomoses, is captured via a set of rules, e.g., a leading endothelial cell has a fixed probability of branching at each time step while anastomosis occurs if a leading endothelial cell crosses a vessel trailing path. Glioma vessels are more tortuous than normal vessels [34]. This can be quantified by various means including a "Sum of Angles Metric" (SOAM) that sums total curvature along a space curve and normalizes by path length, indicating high frequency, low-amplitude sine waves or coils [34].…”

“…Glioma vessels are more tortuous than normal vessels [34]. This can be quantified by various means including a "Sum of Angles Metric" (SOAM) that sums total curvature along a space curve and normalizes by path length, indicating high frequency, low-amplitude sine waves or coils [34].…”

Tumor Therapeutic Response and Vessel Tortuosity: Preliminary Report in Metastatic Breast Cancer

“…The MP equation was derived from an earlier, blinded study of benign and malignant tumors. This earlier study concluded via discriminant analysis of multiple vessel shape parameters that only a combination of two tortuosity metrics appeared effective in generically separating benign from malignant disease [9]. One of these metrics, the "Sum of Angles Metric" (SOAM), sums curvature along a space curve and normalizes by vessel length [10].…”

Fast and Robust 3-D MRI Brain Structure Segmentation

“…The first one is a subset of the "Designed Database of MR Brain Images of Healthy Volunteers" 1 [11] (DDHV) containing 20 scans. The associated ground-truth annotations were manually recovered from automatically generated segmentations [12] of the structures of interest.…”