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- Title
Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum.
- Authors
Kluza, Ewelina; Kleijnen, Jean-Paul; Martens, Milou; Rennspiess, Dorit; Maas, Monique; Jeukens, Cécile; Riedl, Robert; Hausen, Axel; Beets, Geerard; Beets-Tan, Regina; Kleijnen, Jean-Paul J E; Martens, Milou H; Jeukens, Cécile R L P N; Riedl, Robert G; Zur Hausen, Axel; Beets, Geerard L; Beets-Tan, Regina G H
- Abstract
<bold>Objectives: </bold>To evaluate the MRI macroscopic and microscopic parameters of mesorectal vasculature in rectal cancer patients.<bold>Methods: </bold>Thirteen patients with rectal adenocarcinoma underwent a dynamic contrast-enhanced MRI at 1.5 T using a blood pool agent at the primary staging. Mesorectal macrovascular features, i.e., the number of vascular branches, average diameter and length, were assessed from baseline-subtracted post-contrast images by two independent readers. Mesorectal microvascular function was investigated by means of area under the enhancement-time curve (AUC). Histopathology served as reference standard of the tumour response to CRT.<bold>Results: </bold>The average vessel branching in the mesorectum around the tumour and normal rectal wall was 8.2 ± 3.8 and 1.7 ± 1.3, respectively (reader1: p = 0.001, reader2: p = 0.002). Similarly, the tumour-surrounding mesorectum displayed circa tenfold elevated AUC (p = 0.01). Interestingly, patients with primary node involvement had a twofold higher number of macrovascular branches compared to those with healthy nodes (reader1: p = 0.005 and reader2: p = 0.03). A similar difference was observed between good and poor responders to CRT, whose tumour-surrounding mesorectum displayed 10.7 ± 3.4 and 5.6 ± 1.5 vessels, respectively (reader1/reader2: p = 0.02).<bold>Conclusions: </bold>We showed at baseline MRI of rectal tumours a significantly enhanced macrovascular structure and microvascular function in rectal tumour-surrounding mesorectum, and the association of primary mesorectal macrovascular parameters with node involvement and therapy response.<bold>Key Points: </bold>• Vascular MRI reveals macrovascular and microvascular abnormalities in the rectal tumour-surrounding mesorectum. • Formation of highly vascular stroma precedes the actual tumour invasion. • High macrovascular parameters are associated with node involvement. • Mesorectal vascular network differs for good and poor responders.
- Subjects
RECTAL cancer patients; MAGNETIC resonance imaging; ADENOCARCINOMA; CHEMORADIOTHERAPY; BLOOD vessels; BLOOD-vessel abnormalities; DIAGNOSTIC imaging; LONGITUDINAL method; RECTUM; RECTUM tumors; CONTRAST media
- Publication
European Radiology, 2016, Vol 26, Issue 5, p1311
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3955-1