Angiogenesis of renal cell carcinoma: perfusion CT findings

Abstract

Objective: To observe the perfusion CT findings of renal cell carcinoma (RCC) and prospectively correlate perfusion CT parameters with tumor MVD and VEGF expression. Methods: Dynamic contrast-enhanced multislice spiral CT was performed prospectively in 73 cases with histologically proven RCC (65 clear cell, 3 papillary, and 5 chromophobe). Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface-area product (PS) of RCC and normal renal cortex were measured, respectively. The tumor MVD count and VEGF expression level were determined by immunohistochemistry with specific monoclonal antibodies. Results: There was significant difference between BF, BV, MTT, and PS of normal renal cortex (454.32 ± 110.90 mL/min/100 g, 23.53 ± 5.71 mL/100 g, 3.62 ± 1.38 s, 63.95 ± 18.85 mL/min/100 g) and RCC (261.96 ± 175.86 mL/min/100 g, 17.17 ± 8.34 mL/100 g, 7.08 ± 3.42 s, 25.07 ± 13.20 mL/min/100 g) (P < 0.01). BF and BV among RCC histologic subtypes were significantly different (P < 0.05), MTT and PS were not (P > 0.05). MVD (42.29 ± 21.00) of RCC is positively correlated with BF, BV, and PS (P < 0.01), not with MTT (P > 0.05). No relationship was found between the expression levels of VEGF and any perfusion CT parameter. Conclusions: Perfusion CT is a feasible technique to assess tissue perfusion in patients with RCC. BV, BF, and PS correlate positively with MVD and may reflect angiogenesis of RCC. © 2009 Springer Science+Business Media, LLC.