Can dynamic contrast-enhanced MRI evaluate VEGF expression in brain glioma? An MRI-guided stereotactic biopsy study

Purpose. - To investigate whether pharmacokinetic parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to evaluate vascular endothelial growth factor (VEGF) expression in brain glioma based on a point-to-point basis. Materials and methods. - Forty-seven patients with treatment-naive glioma received preoperative DCE-MRI before stereotactic biopsy. We histologically quantified VEGF from section of stereotactic biopsies, and co-registered biopsy locations with localized measurements of DCE-MRI parameters including volume transfer coefficient (K-trans), reverse reflux rate constant (Kep), extracellular extravascular volume fraction (ye) and blood plasma volume (Vp). The correlations between DCE-MRI parameters K-trans, Kep, Ve and Vp) and VEGF were determined using Spearman correlation coefficient. P <= .05 was considered statistically significant. Results. - Seventy-nine biopsy samples were obtained and graded into 45 high-grade gliomas (HGGs) and 34 low-grade gliomas (LGGs). K-trans showed a significant positive correlation with VEGF expression in HGGs group (rho = 0.505, P < 0.001) and in combined group (LGGs + HGGs) (rho = 0.549, P < 0.001), but not in LGGs group (P > 0.05). Kep, Ve or Vp was not correlated with VEGF even though a positive trend showed (P > 0.05). Conclusions. - DCE-MRI is a useful, non-invasive imaging technique for quantitative evaluation of VEGF, and its parameter Vans other than Kep, Ve or Vp may be used as a surrogate for VEGF expression in brain gliomas. (C) 2018 Elsevier Masson SAS. All rights reserved.