Clinical Applications of DSC-MRI Parameters Assess Angiogenesis and Differentiate Malignant From Benign Soft Tissue Tumors in Limbs

Yitong Bian; Ping Jin; Yanliang Wang; Xiaocheng Wei; Yongqian Qiang; Gang Niu; Guohong Jin; Jian Yang

doi:10.1016/j.acra.2019.04.023

Clinical Applications of DSC-MRI Parameters Assess Angiogenesis and Differentiate Malignant From Benign Soft Tissue Tumors in Limbs

Acad Radiol. 2020 Mar;27(3):354-360. doi: 10.1016/j.acra.2019.04.023.

Authors

Yitong Bian¹, Ping Jin², Yanliang Wang³, Xiaocheng Wei⁴, Yongqian Qiang¹, Gang Niu¹, Guohong Jin⁵, Jian Yang⁶

Affiliations

¹ Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi 710061, P.R. China.
² Department of Geriatric cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China.
³ Department of Intervention, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471000, P.R. China.
⁴ GE Healthcare, Shanghai 210000, P.R. China.
⁵ Department of Radiology, General Hospital of Ningxia Medical University, No. 804 Shengli South Road, Yinchuan, Ningxia 750004, P.R. China. Electronic address: jgh0951@163.com.
⁶ Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi 710061, P.R. China. Electronic address: yangjian@vip.163.com.

PMID: 31151900
DOI: 10.1016/j.acra.2019.04.023

Abstract

Objective: To investigate the correlation between dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) parameters and angiogenesis and to explore prospectively the feasibility of using DSC-MRI to differentiate malignant from benign soft tissue tumors (STTs) in limbs.

Methods: This prospective study included 33 patients with STTs in limbs who underwent DSC-MRI after bolus Gd-DTPA infusion. All STTs were confirmed by pathological examination after surgery and microvessel density (MVD), vascular endothelial growth factor (VEGF) expression, were evaluated by immune-histochemical analysis. Semiquantitative DSC-MRI parameters, including negative enhancement integral (NEI), maximum slopes of decrease (MSD) and increase (MSI), and mean time to enhancement were calculated by postprocessing in workstation. The correlation was analyzed between DSC-MRI parameters and angiogenesis factors. Then, the DSC-MRI parameters were compared between benign and malignant STTs and evaluated for diagnostic efficiency by receiver operating characteristic.

Results: The 33 evaluated tumors were consisted of 13 benign and 20 malignant STTs in limbs. Significant positive correlations were observed between NEI, MSD, MSI and MVD, VEGF (p < 0.05). However, mean time to enhancement had no correlation with MVD and VEGF. The benign and malignant STTs differed significantly in terms of NEI, MSD, and MSI (p < 0.05). The areas under the curve (AUC) of NEI, MSD, and MSI were 0.915, 0.862, and 0.815 for discriminating between benign and malignant STTs, respectively.

Conclusion: DSC-MRI parameters are positively correlated with MVD and VEGF, which can evaluate angiogenesis indirectly. Furthermore, DSC-MRI can be considered as one of assistant noninvasive MR imaging technique in differentiation between benign and malignant STTs in limbs.

Keywords: Angiogenesis; Dynamic susceptibility contrast; Magnetic resonance imaging; Soft tissue tumors.

MeSH terms

Contrast Media
Humans
Magnetic Resonance Imaging
Prospective Studies
Soft Tissue Neoplasms* / diagnostic imaging
Vascular Endothelial Growth Factor A*

Substances

Contrast Media
Vascular Endothelial Growth Factor A