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Background: The histological count of microvascular density (MVD) is the current clinical standard for assessing tumor angiogenesis. Although it is hypothesized that perfusion MRI can be a noninvasive alternative to MVD, there have been few studies to validate their correlations, particularly in lung cancer.
Purpose: To investigate the correlation between MVD and perfusion parameters obtained from high-resolution GRASP (Golden-angle RAdial Sparse Parallel) dynamic contrast-enhanced (DCE)-MRI in a cohort of lung cancer patients, and to validate that GRASP MRI can serve as a free-breathing, noninvasive imaging approach for studying tumor angiogenesis.
Study Type: Prospective.
Population: Twenty-five lung cancer patients (16 male, 9 female, mean age = 57.3 ± 11.7 years).
Field Strength/sequence: 3T MRI; a prototype golden-angle stack-of-stars sequence.
Assessment: Contrast-enhanced MR data were acquired during free breathing and were reconstructed using GRASP with a temporal resolution of ∼3 sec/phase. For all data, perfusion analysis was performed using a standard Tofts model to generate the volume transfer coefficient (K ) and the interstitial volume (V ). The MVD of corresponding tumor specimens, obtained from Computed Tomography-guided biopsies, were counted with CD34 staining.
Statistical Tests: Pearson correlation analysis; one-way analysis of variance analysis; least significant difference-t method of multiple comparisons.
Results: The correlation coefficient was 0.983 and 0.972 for the measurement and remeasurement of K and V . The mean values of K , V , and MVD were 0.33 ± 0.22 min , 0.25 ± 0.12, and 49.68 ± 27.08 vessels/0.723 mm , respectively, in all patients (n = 25); 0.36 ± 0.26 min , 0.27 ± 0.13, and 49.09 ± 29.84 vessels/0.723 mm , respectively, in adenocarcinoma (n = 15); 0.34 ± 0.17 min , 0.26 ± 0.12, and 53.85 ± 23.53 vessels/0.723 mm , respectively, in squamous cell carcinoma (n = 8); and 0.13 ± 0.15 min , 0.14 ± 0.06, and 37.20 ± 28.28 vessels/0.723 mm , respectively, in small-cell carcinoma (n = 2). There was a positive relationship between the K and MVD in all patients (r = 0.738, P < 0.001).
Data Conclusion: High spatiotemporal resolution DCE-MRI using GRASP is a promising noninvasive alternative to the histological count of MVD for assessing tumor angiogenesis in lung cancer.
Level Of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1186-1194.
