Abstract
To date, only a few studies have investigated relationships between Diffusion-weighted imaging (DWI) and Vascular endothelial growth factor (VEGF) expression in tumors. The reported results are contradictory. The aim of the present analysis was to review the published results and to perform a meta-analysis regarding associations between apparent diffusion coefficients (ADC) derived from DWI and VEGF expression. MEDLINE library was screened for relationships between ADC and VEGF expression up to January 2019. Overall, 14 studies with 578 patients were identified. In 10 studies (71.4%) 3 T scanners were used and in four studies (28.6%) 1.5 T scanners. Furthermore, seven studies (50%) had a prospective design and seven studies (50%) had a retrospective design. Most frequently, prostate cancer, followed by rectal cancer, cervical cancer and esophageal cancer were identified. The pooled correlation coefficient of all tumors was r = −0.02 [95% CI −0.26–0.21]. ADC values derived from routinely acquired DWI do not correlate with VEGF expression in various tumors. Therefore, DWI is not sensitive enough to reflect angiogenesis-related microstructure of tumors.
Highlights
Diffusion-weighted imaging (DWI), quantified by apparent diffusion coefficients (ADC) besides diagnostic potential can provide information regarding tumor microstructure [1,2,3,4]
ADC is widely acknowledged to be mainly influenced by the cellularity of tumors and is inversely correlated with cell density in tissues [3]
MEDLINE and SCOPUS library were screened for associations between ADC values and Vascular endothelial growth factor (VEGF)
Summary
Diffusion-weighted imaging (DWI), quantified by apparent diffusion coefficients (ADC) besides diagnostic potential can provide information regarding tumor microstructure [1,2,3,4]. This method utilizes the constant random movement of water molecules, called Brownian motion [4]. ADC is widely acknowledged to be mainly influenced by the cellularity of tumors and is inversely correlated with cell density in tissues [3] The principle of this is that the cell membrane might hinder the water movement and, lead to a restriction of diffusion [5]. It was shown that water molecules are hindered by extracellular components, such as collagen fibers and extracellular matrix [6]
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