CT Measurement of Perfusion and Permeability Within Lymphoma Masses and Its Ability to Assess Grade, Activity, and Chemotherapeutic Response

Dugdale, Piers; Miles, Kenneth A.; Bunce, Ian; Kelley, Benjamin; Leggett, D. A. C.

doi:10.1097/00004728-199907000-00010

Cited by 97 publications

(53 citation statements)

References 14 publications

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“…There are a number of reports in the past that have shown the dynamics of contrast enhancement can reflect the microenvironment. Dugdale et al [18] reported a correlation between increased tumor blood flows with the higher grade of lymphoma. Another study on cervical cancer observed a correlation between oxygen pressure and tumor blood flow [19] .…”

Section: Discussionmentioning

confidence: 99%

Role of Perfusion CT in Assessing Tumor Blood Flow and Malignancy Level of Gastric Cancer

et al. 2010

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Decreased blood flow value acquired from P-CT may reflect a progressive state of gastric cancer. The pathological background for this relation involves the tumor stroma. Tumor perfusion decreased as the stage and malignant character of the tumor advanced, and therefore P-CT could be a better strategy to estimate the malignancy level of cancer.Copyright © 2010 S. Karger AG, Basel IntroductionGastric cancer is one of the most common malignancies worldwide and although diagnosed at a high frequency, it is still characterized by a poor prognosis [1][2][3] . A curative resection is the best treatment method to achieve cure in gastric cancer, but less than half are expected to survive for more than 5 years [4] . It is important to identify those cases at significant risk for recurrence and poor prognosis that could be treated with adjuvant therapy. The need for more reliable prognostic factors for gastric cancer has resulted in reports on new methods to predict the patient outcome, but the classification based on stage is still the mainstream parameter of choice.The assessment of tumor perfusion and hemodynamic changes is useful in understanding the pathological Key WordsPerfusion computed tomography ؒ Blood flow ؒ Tumor stroma ؒ Angiogenesis ؒ Intratumoral hemodynamics Abstract Background/Aims: Intratumoral hemodynamics or tumor perfusion is useful in understanding the pathological background of the cancer. A parameter for a non-invasive, preoperative assessment of tumor perfusion has yet to be developed. Methods: The study included 50 patients who underwent surgery for gastric cancer. Perfusion computed tomography (P-CT) was performed using a 16-row multidetector CT, and tumor blood flow (ml/min/100 g tissue) values were measured. We compared blood flow with histopathological characteristics and evaluated its correlation with microvessel density and tumor stromal density and calculated the ratio of vessels and stromal tissue. Results: There was a significant decrease in blood flow in advanced tumor depth, peritoneal dissemination and undifferentiated subtypes. Cases with Lauren's diffuse type carcinoma were found to have decreased blood flow compared to the mixed or intestinal type. As for the stromal structure, despite the lack of correlation with microvessel density, blood flow significantly decreased with increased stromal density. Conclusions: background of the cancer and determining prognosis. Malignant tumor growth and metastasis require a constant new blood supply and tumor-associated angiogenesis plays a critical role in development and spread of malignant tumors [5] . Clinical trials have succeeded in improving the patient survival with various anti-angiogenesis agents [6,7] . In addition, intratumoral neovascularization is a significant prognostic factor in some types of cancers, such as breast, colorectal and lung cancer [8][9][10] .Preoperative gastric histopathology has almost always been diagnosed using conventional endoscopic specimens. These are, however, inadequate for assessing angiogenesis because...

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Section: Discussionmentioning

confidence: 99%

Role of Perfusion CT in Assessing Tumor Blood Flow and Malignancy Level of Gastric Cancer

et al. 2010

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“…Lack of enhancement may also be seen in posttherapy CT, likely indicating treatment response. 26 There was no CT evidence of marked central necrosis or abnormal calcifications, features that might be useful for suggesting submucosal laryngeal lesions such as chondrosarcoma or other more aggressive neoplasms. Extralaryngeal tumor extension was most frequently noted to involve the hypopharynx and, less commonly, the oropharynx and strap muscles.…”

Section: Figmentioning

confidence: 91%

Imaging Characteristics of Primary Laryngeal Lymphoma

Siddiqui¹,

Branstetter²,

Hamilton³

et al. 2010

AJNR Am J Neuroradiol

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“…As it is becoming increasingly important that preoperative imaging may noninvasively select high-risk patients who could truly benefit from more aggressive multimodality treatment approaches in the preoperative setting (12,13), there is a growing interest on functional imaging techniques that can help monitor treatment effects. Both magnetic resonance imaging (MRI) and computed tomography (CT) have shown potential to act as functional biomarkers (14)(15)(16)(17). Perfusion CT is able to assess vascular physiology within tumors retrieving information about tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and vascular permeability-surface area product (PS) (18)(19)(20).…”

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confidence: 99%

Usefulness of Perfusion CT to Assess Response to Neoadjuvant Combined Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer

Curvo-Semedo¹,

Portilha²,

Ruivo³

et al. 2012

Academic Radiology

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Rationale and Objectives: To prospectively evaluate perfusion computed tomography (CT) for assessment of changes in tumor vascularity after chemoradiation therapy (CRT) in locally advanced rectal cancer and to analyze the correlation between baseline perfusion parameters and tumor response. Materials and Methods:Twenty patients with rectal cancer underwent baseline perfusion CT before CRT, and in 11 an examination after CRT was also performed. For each tumor, blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface area product (PS) were quantified. The Mann-Whitney U test compared baseline perfusion parameters of responders and nonresponders and pre-and post-CRT measurements were compared by the Wilcoxon signed-rank test (P < .05 statistically significant for both tests).Results: Baseline BF was significantly lower (P = .013) and MTT was significantly higher (P = .006) in responders. Both were able to discriminate responders from nonresponders with a sensitivity of 80% and 100% and a specificity of 73.3% and 86.7%, respectively, for BF and MTT. Baseline BV and PS were not significantly different in responders and nonresponders. Perfusion parameters changed significantly in post-CRT scans compared to baseline: BF (P = .003), BV (P = .003), and PS (P = .008) decreased, whereas MTT increased (P = .006).Conclusion: Baseline BF and MTT can discriminate patients with a favorable response from those that fail to respond to CRT, potentially selecting high-risk patients with resistant tumors that may benefit from an aggressive preoperative treatment approach.

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CT Measurement of Perfusion and Permeability Within Lymphoma Masses and Its Ability to Assess Grade, Activity, and Chemotherapeutic Response

Abstract: Only CT perfusion measurements of nodes have potential for assessing lymphoma grade, activity, and treatment response.

Cited by 97 publications

References 14 publications

Role of Perfusion CT in Assessing Tumor Blood Flow and Malignancy Level of Gastric Cancer

Role of Perfusion CT in Assessing Tumor Blood Flow and Malignancy Level of Gastric Cancer

Imaging Characteristics of Primary Laryngeal Lymphoma

Usefulness of Perfusion CT to Assess Response to Neoadjuvant Combined Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer

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