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Original Research |
1 Department of Radiology, Tong Ji Hospital, Tong Ji University, Xin Cun Rd.
389, Shanghai 200065, China.
2 Department of Radiology, West China Hospital, Sichuan University, Shanghai,
China.
OBJECTIVE. The purpose of our study was to evaluate the correlation between the enhancement parameters of dynamic CT; the carcinoma tissue microvessel density (MVD, a hotspot method to provide a histologic assessment of tumor vascularity); and tumor nuclear grade in renal cell carcinomas.
SUBJECTS AND METHODS. Twenty-four patients with histologically
diagnosed renal cell carcinoma underwent dynamic enhanced CT. Enhancement
parameters, slope of the time-density curve, the density difference before and
after tissue enhancement (
H), tissue blood ratio (TBR), and area under
the time-density curve (AR), were calculated for all lesions. Pathology slides
corresponding to the CT plane were stained using mouse antihuman CD34
monoclonal antibody and H and E. Fuhrman nuclear grade was used. Vascular hot
spots of microvessels were recorded. Spearman's rank correlation was performed
to determine the strength of the relationship between enhancement parameters,
MVD determinations, and tumor nuclear grade.
RESULTS. MVD with CD34 staining revealed uneven distribution of
positively stained vascular endothelial cells in renal cell carcinoma lesions.
Heterogeneous distribution of contrast enhancement was seen among and within
individual tumors. The tumors appeared as uneven patterns on time-density
curves of renal cell carcinoma lesions. Enhancement parameters of H (median,
21.0 H; range, 2.2-105.8 H), TBR (median, 39%; range, 10.7-154.7%), AR
(median, 1.58 H x sec; range, 0.23-3.67 H x sec), and slope
(median, 2.76; range, 0.53-6.76) varied greatly. Renal cell carcinoma tissue
MVD significantly correlated with all enhancement parameters of dynamic CT.
The correlation coefficients (r) were 0.62, 0.54, 0.55, and 0.44,
respectively, for H, slope, TBR, and AR (p < 0.0 5). All
enhancement parameters did not significantly correlate with tumor nuclear
grade. They were not predictive of nuclear grade.
CONCLUSION. Enhancement parameters of dynamic CT may be suited to evaluate tumor vascularity in vivo. Dynamic enhanced CT images may reflect the heterogeneity of tumor angiogenesis on the basis of the correlation between enhancement parameters and MVD of renal cell carcinoma.
Keywords: dynamic CT • genitourinary imaging • kidney • renal cell carcinoma • research • tumor vascularity
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