Korean J Radiol.  2008 Apr;9(2):119-127. 10.3348/kjr.2008.9.2.119.

Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

• Zhang H
• Pan Z
• Du L
• Yan C
• Ding B
• Song Q
• Ling H
• Chen K

• KMID: 1098190
• DOI: http://doi.org/10.3348/kjr.2008.9.2.119

Abstract

OBJECTIVE
To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.

Keyword

Gastric cancer; Multi-detector row CT; Prognosis

MeSH Terms

Adult
Aged
Female
Humans
Lymphatic Metastasis
Male
Microcirculation
Middle Aged
Prognosis
Prospective Studies
Regional Blood Flow
Stomach Neoplasms/*blood supply/pathology/*radiography
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Poorly differentiated gastric cancer. A. Cross section before contrast administration revealed protruding lesion classified as Borrmann I. Regions of interest have been placed between abdominal aorta and lesion. B. Corresponding time density curves show arterial and tumor attenuation change with time. C. Image calculating blood volume with mean value, 6.71 ml/100 g. D. Image calculating blood flow with mean value, 73.64 ml/100 g/min. E. Image calculating mean transit time with mean value, 10.45 sec. F. Those values of lesion were rather lower; permeability surface (mean, 18.49 ml/100 g/min) appeared to be rather high. G. This patient had low microvessel density (mean, 21/*400 field).

• 

  Fig. 2 Poorly differentiated gastric cancer. A. Cross section prior to contrast administration revealed ulcerative lesion at antrum classified as Borrmann II. B. Corresponding time density curves reveals arterial and tumor attenuation change with time. C. Image calculating blood volume with mean value, 4.59 ml/100 g. D. Image calculating blood flow with mean value, 100.45 ml/100 g/min. E. Image calculating mean transit time with mean value, 4.1 sec. F. Lesion values were lower; permeability surface (mean, 21.93 ml/100 g/min) was relatively high. G. Patient had high microvessel density (mean, 61/*400 field).

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