Dynamic contrast-enhanced MRI of gastric cancer: Correlations of the pharmacokinetic parameters with histological type, Lauren classification, and angiogenesis

Magn Reson Imaging. 2017 Apr:37:27-32. doi: 10.1016/j.mri.2016.11.004. Epub 2016 Nov 11.

Abstract

Purpose: To compare the pharmacokinetic parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in gastric cancers of different histological type and Lauren classification, and to investigate whether DCE-MRI parameters correlate with vascular endothelial growth factor (VEGF) expression levels in gastric cancer.

Methods: Included were 32 patients with gastric cancer who underwent DCE-MRI of the upper abdomen before tumor resection. DCE-MRI parameters including the volume transfer coefficient (Ktrans), reverse reflux rate constant (Kep), and extracellular extravascular volume fraction (Ve) were calculated from the tumor region. Post-operative specimens were used for determination of histological differentiation (i.e., non-mucinous, mucinous, or signet-ring-cell adenocarcinoma) as well as Lauren classification (intestinal type or diffuse type). VEGF expression was examined for assessing angiogenesis. DCE-MRI parameters with different histological type and Lauren classification were compared using independent samples t-test and analysis of variance, respectively. Correlations between DCE-MRI parameters and VEGF expression grades were tested using Spearman correlation analysis.

Results: Among gastric adenocarcinomas of three different histological types, mucinous adenocarcinomas showed a higher Ve and lower Ktrans than the others (P<0.01). Between the two Lauren classifications, the diffuse type showed a higher Ve than the intestinal type (P<0.001). The mean Ktrans showed a significantly positive correlation with VEGF (r=0.762, P<0.001).

Conclusion: DCE-MRI permits noninvasive prediction of tumor histological type and Lauren classification and estimation of tumor angiogenesis in gastric cancer. DCE-MRI parameters can be used as imaging biomarkers to predict the biologic aggressiveness of a tumor as well as patient prognosis.

Keywords: Dynamic contrast-enhanced magnetic resonance imaging; Gastric cancer; Vascular endothelial growth factor.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Biomarkers
  • Contrast Media*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / pathology
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Biomarkers
  • Contrast Media
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A