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Measuring perfusion and permeability in renal cell carcinoma with dynamic contrast-enhanced MRI: A pilot study

✍ Scribed by Mike Notohamiprodjo; Steven Sourbron; Michael Staehler; Henrik J. Michaely; Ulrike I. Attenberger; Gerwin P. Schmidt; Holger Boehm; Annie Horng; Christian Glaser; Christian Stief; Maximilian F. Reiser; Karin A. Herrmann

Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
540 KB
Volume
31
Category
Article
ISSN
1053-1807

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✦ Synopsis

Purpose:

To retrospectively assess an improved quantitative methodology with separate assessment of perfusion and permeability for characterization of primary renal cell carcinoma (rcc) and monitoring antiangiogenic treatment.

Materials and methods:

Fifteen rcc patients before surgery, 6 rcc patients before and after neoadjuvant antiangiogenic therapy, and 15 patients without renal disease underwent dynamic contrast-enhanced (dce)-mri of the kidney with integrated retrospective respiratory triggering and an individual arterial input function. tracer kinetic analysis was performed with a two-compartment-filtration-model for the kidney data and a two-compartment-exchange-model for the tumor data, providing four independent parameters: the perfusion-parameters plasma flow (f(p)) and plasma volume (v(p)), and the permeability-parameters extraction flow (f(e)) and extravascular-extracellular volume (v(e)).

Results:

In tumors f(p) and f(e) were significantly lower than in normal kidneys. tracer kinetic analysis displayed hemodynamic alteration caused by vessel infiltration or necrosis. papillary rcc could be differentiated from clear-cell variants by a distinct perfusion pattern. in antiangiogenically treated rcc v(e) was not significantly decreased, while the perfusion parameters v(p) and f(p) were significantly diminished.

Conclusion:

Dce-mri with integrated motion compensation enables evaluation of primary rcc and detects distinct perfusion patterns. quantification with a two-compartment-exchange-model produces a separate perfusion- and permeability characterization and may become a diagnostic tool to monitor antiangiogenic treatment.

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