Non-invasive methods of assessing angiogenesis and their value in predicting response to treatment in colorectal cancer

Abstract

Rectal tumours with higher permeability at presentation appear to respond better to chemoradiotherapy than those of lower permeability. This may allow preselection of appropriate tumours for these regimens, with patients with low-permeability tumours being considered for alternative therapies.

Dynamic Contrast Enhanced Magnetic Resonance Imaging in Rectal Cancer

“…Furthermore, they demonstrated that malignant lesions showed faster and greater enhancement compared with benign lesions and claimed that a more accurate differentiation with the usage of dynamic gadolinium-enhanced MRI could be obtained than with standard contrast-enhanced MRI. As regards the therapy response, George et al (2001) showed a correlation between K trans and VEGF tumour expression showing that tumours having higher permeability seemed to better respond to pre-CRT than tumours having lower permeability. de Lussanet et al (2005) evaluated radio-therapy related microvascular changes in locally advanced rectal cancer (LARC) by DCE-MRI quantitative approach and histology.…”

“…Another approach is to extract TIC features that are associated to tracer kinetics theory (see section 4.2). Within this framework de Lussanet et al (2005); de Vries et al (2000;2001;2003); Kremser et al (2007) used, as a first step in quantitative assessment of tumor perfusion, the steepest slope of the TIC during contrast medium uptake (WIS max ), and, on the base of the work by Miles (1991) they evaluated the Perfusion Index (PI) as:…”

“…More specifically, in the case of rectal cancer, previous trials have provided the proof of principle that inhibition of angiogenesis has the potential to enhance the effectiveness of the treatment for this disease. In vivo imaging techniques capable to assess tumour perfusion have the potential to improve the management of treatment for patients with rectal cancer (Chen et al, 2005;de Vries et al, 2000;2001;2003;Kremser et al, 2007). The aim of this chapter is to review the main issues concerning the assessment of the angiogenic status of rectal cancer by means of DCE-MRI.…”

Inhibitory effects of oxaliplatin in experimental radiation treatment of colorectal carcinoma: does oxaliplatin improve 5-fluorouracil-dependent radiosensitivity?

“…Pretreatment serum level of carcinoembryonic antigen (CEA) of >2.5 ng/ml has been associated with lower pCR rates, and in conjunction with high tumor circumferential extent (>60%) and tumor distance of >5 cm from the anal verge, response to CRT has been predicted using these factors (74 (85,86). In a single study, growth hormone receptor overexpression was significantly associated with poor tumor response (87).…”

Temporal Analysis of Tumor Heterogeneity and Volume for Cervical Cancer Treatment Outcome Prediction: Preliminary Evaluation

“…The use of DCE-MRI for quantification of tumor vascularity, tumor staging, or treatment efficacy has been explored for cancers of the prostate 5,6 , colon 7 , liver 8 , breast 9 , and cervix. For the case of cervical cancer, the change in volume over the first 2-4 weeks of therapy has been shown to be related to treatment outcome 10 .…”