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DOI:10.2214/AJR.08.1332
AJR 2009; 192:949-955
© American Roentgen Ray Society

Original Research

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

Nermin Tuncbilek1, Mustafa Kaplan2, Semsi Altaner3, Irfan H. Atakan2, Necdet Süt4, Osman Inci2 and Mustafa Kemal Demir1

1 Radiology Department, Trakya University School of Medicine, Kocasinan mah, Dr. Sadik Ahmet caddesi, Uzunoglu 2 Apt. No:60 Daire: 4/13, 22030 Edirne, Turkey.
2 Urology Department, Trakya University School of Medicine, Edirne, Turkey.
3 Pathology Department, Trakya University School of Medicine, Edirne, Turkey.
4 Department of Biostatistics, Trakya University School of Medicine, Edirne, Turkey.

OBJECTIVE. The aim of this study was to investigate dynamic contrast-enhanced MRI (DCE-MRI) for the noninvasive measurement of bladder cancer angiogenesis by correlation with microvessel density, histologic grade, and tumor staging, and to predict the outcome of local recurrence.

MATERIALS AND METHODS. Twenty-four patients with bladder cancer were examined using DCE-MRI. Hemodynamic parameters obtained by DCE-MRI included peak time enhancement in the first minute (Emax/1) after contrast administration, second minute (Emax/2), third minute (Emax/3), fourth minute (Emax/4), and fifth minute (Emax/5), and the steepest slope. Microvessel density was identified by immunostaining of endothelial cells using FVIII-related antigen. The Mann-Whitney U test, multivariate discriminant analysis, Spearman's correlation coefficient, and analysis of variance were used for statistical analysis.

RESULTS. Correlation was seen between DCE-MRI parameters (Emax/1 and steepest slope) and microvessel density (p < 0.05). Emax/1 and steepest slope were found to have a statistically significant correlation with histologic grade (p < 0.05 and p < 0.01, respectively). A significant difference was seen between groups of patients with and without local recurrence with regard to two of the DCE-MRI parameters (p < 0.05 for Emax/1 and Emax/2).

CONCLUSION. 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.

Keywords: angiogenesis • bladder cancer • dynamic enhancement • MRI


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