Abstract
A variety of tracer kinetic methods have been employed to assess tumor angiogenesis. The Standard two-Compartment model (SC) used in cervix carcinoma was less frequent, and Adiabatic Approximation to the Tissue Homogeneity (AATH) and Distributed Parameter (DP) model are lacking. This study compares two-compartment exchange models (2CXM) (AATH, SC, and DP) for determining dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in cervical cancer, with the aim of investigating the potential of various parameters derived from 2CXM for tumor diagnosis and exploring the possible relationship between these parameters in patients with cervix cancer. Parameters (tissue blood flow, F p; tissue blood volume, V p; interstitial volume, V e; and vascular permeability, PS) for regions of interest (ROI) of cervix lesions and normal cervix tissue were estimated by AATH, SC, and DP models in 36 patients with cervix cancer and 17 healthy subjects. All parameters showed significant differences between lesions and normal tissue with a P value less than 0.05, except for PS from the AATH model, F p from the SC model, and V p from the DP model. Parameter V e from the AATH model had the largest AUC (r = 0.85). Parameters F p and V p from SC and DP models and V e and PS from AATH and DP models were highly correlated, respectively, (r > 0.8) in cervix lesions. Cervix cancer was found to have a very unusual microcirculation pattern, with over-growth of cancer cells but without evident development of angiogenesis. V e has the best performance in identifying cervix cancer. Most physiological parameters derived from AATH, SC, and DP models are linearly correlated in cervix cancer.
Highlights
Neovascularization plays a fundamental role in the growth of solid tumors [1]
It is evident that three methods attain similar results in Ve and PS, and both estimates are smaller in tumor regions of interest (ROI) than in normal tissue ROI
For Fp, the estimate by Approximation to the Tissue Homogeneity (AATH) is smaller in tumor ROI and the estimates by Standard two-Compartment model (SC) and Distributed Parameter (DP) are apparently close between tumor and normal tissue ROI
Summary
Neovascularization plays a fundamental role in the growth of solid tumors [1]. Various experimental models as well as clinicopathological observations have shown that solid tumors (e.g., breast [2], lung [3], and cervical carcinoma [4, 5]). Contrast Media & Molecular Imaging kinetic methods have been employed to characterize various tumors and to assess the effects of antiangiogenic and antivascular drugs in clinical trials [6,7,8,9,10,11,12,13,14,15]. E relationship between parameters from various tracer kinetic methods [24, 25] has been reported These studies mainly focused on GK and EGK models, and application of the SC model to cervix cancer was less frequent. Three twocompartment models (AATH, SC, and DP) were applied in cervix carcinoma to investigate the potential of various parameters in tumor diagnosis and to examine the possible relationship between parameters of these tracer kinetic models
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