Pancreatic Endocrine Tumors: Tumor Blood Flow Assessed with Perfusion CT Reflects Angiogenesis and Correlates with Prognostic Factors
Pancreatic Endocrine Tumors: Tumor Blood Flow Assessed with Perfusion CT Reflects Angiogenesis and Correlates with Prognostic Factors
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DOI：
10.1148/radiol.2501080291
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发表时间：
2009-02-01
期刊：
影响因子：
19.7
通讯作者：
Vilgrain, Valerie
中科院分区：
文献类型：
--
作者：
d'Assignies, Gaspard;Couvelard, Anne;Vilgrain, Valerie
目的：前瞻性地将胰腺内分泌肿瘤的多排计算机断层扫描 (CT) 灌注测量与使用组织学技术评估的肿瘤微血管密度 (MVD) 相关联，并确定灌注 CT 参数在肿瘤级别之间是否存在差异。材料和方法：获得了机构审查委员会的批准和知情同意。 36 名可切除胰腺内分泌肿瘤患者（15 名男性，21 名女性；平均年龄，53 岁；范围，18-78 岁）接受了术前动态灌注 CT。 36 名患者中的 28 名 (78%) 被纳入研究组；由于与灌注后处理不兼容，八个被排除。分析多排 CT 灌注数据，计算肿瘤和正常胰腺血流量、血容量、平均通过时间和渗透性表面积乘积。使用 Spearman 相关系数将多排 CT 灌注参数与瘤内 MVD 进行比较，并使用 Mann-Whitney 检验与世界卫生组织 (WHO) 分类、肿瘤大小、肿瘤增殖指数、激素谱和是否存在转移进行比较。 结果：在肿瘤血流量和瘤内 MVD 之间观察到高度相关性 (r = 0.620，P < .001)。良性肿瘤组 (WHO 1) 的血流量显着高于预后不确定的肿瘤组 (WHO 2) 或高分化癌组 (WHO 3)。增殖指数为 2% 或更低的肿瘤 (P = .005) 和没有显微血管受累组织学迹象的肿瘤 (P = .008) 的血流量显着较高。具有淋巴结（P = .02）或肝（P = .05）转移的肿瘤的平均通过时间较长。结论：灌注CT对于胰腺内分泌肿瘤患者是可行的，并且反映了MVD。灌注 CT 测量与组织预后因素相关，例如增殖指数和 WHO 分类。 (C) 北美放射学会，2008 年
Purpose: To prospectively correlate multidetector computed tomographic (CT) perfusion measurement of pancreatic endocrine tumors with tumor microvascular density (MVD) assessed by using histologic techniques and to determine whether perfusion CT parameters differ between tumor grades.Materials and Methods: Institutional review board approval and informed consent were obtained. Thirty-six patients (15 men, 21 women; mean age, 53 years; range, 18-78 years) with resectable pancreatic endocrine tumors underwent presurgical dynamic perfusion CT. Twenty-eight (78%) of 36 patients were included in the study group; eight were excluded because of artifacts that were not compatible with perfusion postprocessing. Multidetector CT perfusion data were analyzed to calculate tumor and normal pancreatic blood flow, blood volume, mean transit time, and permeability surface area product. Multidetector CT perfusion parameters were compared with intratumoral MVD by using the Spearman correlation coefficient and with World Health Organization (WHO) classification, tumor size, tumor proliferation index, hormonal profile, and presence of metastases by using Mann-Whitney tests.Results: High correlation (r = 0.620, P < .001) was observed between tumor blood flow and intratumoral MVD. Blood flow was significantly higher (P = .02) in the group of benign tumors (WHO 1) than in the groups of tumors of indeterminate prognosis (WHO 2) or well-differentiated carcinomas (WHO 3). Blood flow was significantly higher in tumors with a proliferation index of 2% or less (P = .005) and in those without histologic signs of microscopic vascular involvement (P = .008). Mean transit time was longer in tumors with lymph node (P = .02) or liver (P = .05) metastasis.Conclusion: Perfusion CT is feasible in patients with pancreatic endocrine tumors and reflects MVD. Perfusion CT measurements are correlated with histoprognostic factors, such as proliferation index and WHO classification. (C) RSNA, 2008