Single-level dynamic spiral CT of hepatocellular carcinoma: Correlation between imaging features and density of tumor microvessels

Abstract

AIM:To investigate the correlation of enhancement features of hepatocellular carcinoma (HCC) revealed by single-level dynamic spiral CT scanning (DSCT) with tumor microvessel density (MVD), and to determine the validity of DSCT in assessing in vivo tumor angiogenic activity of HCC. METHODS:Twenty six HCC patients were diagnosed histopathologically. DSCT was performed for all patients according to standard scanning protocol. Time-density curves were generated, relevant curve parameters were measured, and gross enhancement morphology was analyzed. Operation was performed to remove HCC lesions 1 to 2 weeks following CT scan. Histopathological slides were carefully prepared for the standard F 8 RA immunohistochemical staining and tumor microvessel counting. Enhancement imaging features of HCC lesions were correlatively studied with tumor MVD and its intra-tumor distribution characteristics. RESULTS:On DSCT images of HCC lesions, three patterns of time-density curve and three types of gross enhancement morphology were recognized. Histomorphologically, the distribution of positively stained tumor endothelial cells within tumor was categorized into 3 types. Curve parameters such as peak enhancement value and contrast enhancement ratio were significantly correlated with tumor tissue MVD (r=0.508 and r=0.423, P<0.01 and P<0.05 respectively). Both the pattern of time-density curve and the gross enhancement morphology of HCC lesions were also correlated with tumor MVD, and reflected the distributive features of tumor microvessels within HCC lesions. Correlation between the likelihood of intrahepatic metastasis of HCC lesions with densely enhanced pseudocapsules and rich pseudocapsular tumor MVD was found.CONCLUSION: Enhancement imaging features of HCC lesions on DSCT scanning are correlated with tumor MVD, and reflect the intra-tumor distribution characteristics of tumor microvessels. DSCT is valuable in assessing the angiogenic activity and tumor neovascularity of HCC patients in vivo.Chen WX, Min PQ, Song B, Xiao BL, Liu Y, Ge YH. Single-level dynamic spiral CT of hepatocellular carcinoma: Correlation between imaging features and density of tumor microvessels.

CT Perfusion of the Liver: Principles and Applications in Oncology

“…CT perfusion may reflect tumor aggressiveness and therefore may allow for the prediction of prognosis based on tumor vascularity because it can provide indirect information regarding tumor neoangiogenesis. Indeed, reports relating pathologic assessments of tumor angiogenesis to CT perfusion parameters have supported the hypothesis that peak tumor enhancement and blood volume correlate most closely with the expression of vascular endothelial growth factor and microvessel density in various tumors (18,(74)(75)(76)(77).…”

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“…Small and well-differentiated HCC lesions, which are often iso-or hypovascular, do not enhance and are therefore difficult to detect [85]. Enhancement on dynamic spiral CT imaging correlates with microvessel density in HCC [87]. Increase in vascularization during HCC progression results in changes in CT appearance [88].…”

Role of transforming growth factor-beta1-smad signal transduction pathway in patients with hepatocellular carcinoma

“…MVD of tumor is a valid marker to reflect tumor angiogenesis. Chen et al [2] reported that HCC MVD can be reflected by dynamic enhancement of spiral CT scanning. MVD of tumor has been detected by marking vessel endothelium.…”