Dynamic CT evaluation of tumor vascularity in renal cell carcinoma

OBJECTIVE. The purpose of our study was to evaluate the correlation between the enhancement parameters of dynamic CT; the carcinoma tissue microvessel density (MVD, a hot- spot method to provide a histologic assessment of tumor vascularity); and turno in renal cell carcinomas. SUBJECTS AND METHODS. Twenty-four patients with histologically diagnosed renal cell carcinoma underwent dynamic enhanced CT. Enhancement parameters, slope of the time-density curve, the density difference before and after tissue enhancement (Delta H), tissue b ratio (TBR), and area under the time-density curve (AR), were calculated for all lesions. Pathology slides corresponding to the CT plane were stained using mouse antihuman CD34 monoclonal antibody and H and E. Fuhnnan nuclear grade was used. Vascular hot spots of crovessels were recorded. Speannan's rank correlation was performed to determine the strength of the relationship between enhancement parameters, MVD determinations, and tumor nuclear grade. RESULTS. MVD with CD34 staining revealed uneven distribution of positively stained vascular endothelial cells in renal cell carcinoma lesions. Heterogeneous distribution of contrast enhancement was seen among and within individual tumors. The tumors appeared as uneven patterns on time-density curves of renal cell carcinoma lesions. Enhancement parameters of H (median, 2 1.0 H; range, 2.2-105.8 H), TBR (median, 39%; range, 10.7-154.7%), AR (median, 1.58 H x sec; range, 0.23-3.67 H x sec), and slope (median, 2.76; range, 0.53-6.76) varied greatly. Renal cell carcinoma tissue MVD significantly correlated with all enhancement parameters of dynamic CT. The correlation coefficients (r) were 0.62, 0.54, 0.55, and 0.44, respectively, for A H, slope, TBR, and AR (p < 0.0 5). All enhancement parameters did not significantly correlate with tumor nuclear grade. They were not predictive of nuclear grade. CONCLUSION. Enhancement parameters of dynamic CT may be suited to evaluate tumor vascularity in vivo. Dynamic enhanced CT images may reflect the heterogeneity of tumor angiogenesis on the basis of the correlation between enhancement parameters and MVD of renal cell carcinoma.