Dynamic contrast-enhanced MR imaging of uterine cervical cancer: Pharmacokinetic analysis with histopathologic correlation and its importance in predicting the outcome of radiation therapy
Dynamic contrast-enhanced MR imaging of uterine cervical cancer: Pharmacokinetic analysis with histopathologic correlation and its importance in predicting the outcome of radiation therapy
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DOI：
10.1148/radiology.216.3.r00se07803
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发表时间：
2000-09-01
期刊：
影响因子：
19.7
通讯作者：
Okamura, H
中科院分区：
文献类型：
--
作者：
Yamashita, Y;Baba, T;Okamura, H
目得：探讨宫颈癌动态增强磁共振（MR）图像不同增强模式的组织病理学基础，并评估其在预测放疗后患者预后中的重要性。材料与方法：对26例子宫切除术后的宫颈癌患者和36例宫颈癌患者进行了动态增强MR成像和药代动力学分析她接受了放射治疗结果：手术患者的动态MR图像上，强化均匀区的通透性（k = 27.4 x 10（-3））高于强化不均匀区（k = 19.0 x 10（-3））。强化良好的区域主要由癌细胞束组成，而强化较差的区域由散在癌细胞的纤维组织组成。放射治疗对动态MR图像上组织渗透性高（k = 31.3 × 10（-3））的肿瘤比组织渗透性低（k = 18.3 × 10（-3））的肿瘤更有效。结论：增强区主要由丰富的癌细胞束组成，而灌注差区则由散在癌细胞的纤维组织组成。放射治疗在增强的肿瘤中更有效，从而改善局部控制。
PURPOSE: To investigate the histopathologic bases of different enhancement patterns on dynamic contrast material-enhanced magnetic resonance (MR) images of cervical cancer and to assess their importance in predicting the outcome of patients after radiation therapy.MATERIALS AND METHODS: Dynamic enhanced MR imaging and pharmacokinetic analyses were performed in 26 patients with cervical cancer who subsequently underwent hysterectomy and in 36 patients with cervical cancer who received radiation therapy. Histopathologic findings and clinical outcomes were correlated with results of dynamic MR imaging and pharmacokinetic analysis.RESULTS: On dynamic MR images of the surgical patients, areas with intense homogenous enhancement showed increased permeability (k = 27.4 x 10(-3)) compared with areas with poor enhancement (k = 19.0 x 10(-3)). Well-enhanced areas were predominantly composed of cancer cell fascicles, whereas poorly enhanced areas were composed of fibrous tissue with scattered cancer cells. Radiation therapy was more effective in tumors with higher tissue permeability (k = 31.3 x 10(-3)) on dynamic MR images than in those with lower tissue permeability (k = 18.3 x 10(-3)).CONCLUSION: Areas of increased contrast enhancement are mainly composed of abundant cancer cell fascicles, whereas poorly perfused areas are composed of fibrous tissue with scattered cancer cells. Radiation therapy is more effective in well-enhanced tumors, resulting in improved local control.