Original Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2009; 15(25): 3114-3121
Published online Jul 7, 2009. doi: 10.3748/wjg.15.3114
Enhancement patterns of pancreatic adenocarcinoma on conventional dynamic multi-detector row CT: Correlation with angiogenesis and fibrosis
Yuki Hattori, Toshifumi Gabata, Osamu Matsui, Kentaro Mochizuki, Hirohisa Kitagawa, Masato Kayahara, Tetsuo Ohta, Yasuni Nakanuma
Yuki Hattori, Toshifumi Gabata, Osamu Matsui, Kentaro Mochizuki, Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
Hirohisa Kitagawa, Masato Kayahara, Tetsuo Ohta, Department of Gastroenterologic Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
Yasuni Nakanuma, Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
Author contributions: Hattori Y and Gabata T performed the majority of experiments; Hattori Y, Gabata T, Matsui O, Mochizuki K and Nakanuma Y designed the research; Hattori Y, Gabata T and Nakanuma Y performed the research; Kitagawa H, Kayahara M and Ohta T provided specimens; Hattori Y, Gabata T, Matsui O and Nakanuma Y analyzed the data; Hattori Y, Gabata T and Matsui O wrote the paper.
Correspondence to: Yuki Hattori, MD, Department of Radiology, Kanazawa University Graduate School of Medical Science,13-1 Takara-machi, Kanazawa 920-8641, Japan. hattori-ht2ryk@nifty.com
Telephone: +81-76-2652323
Fax: +81-76-2344256
Received: April 4, 2009
Revised: May 25, 2009
Accepted: June 1, 2009
Published online: July 7, 2009
Abstract

AIM: To evaluate retrospectively the correlation between enhancement patterns on dynamic computed tomography (CT) and angiogenesis and fibrosis in pancreatic adenocarcinoma.

METHODS: Twenty-three patients with pancreatic adenocarcinoma underwent dynamic CT and tumor resection. In addition to the absolute and relative enhanced value that was calculated by subtracting the attenuation value on pre-contrast from those on contrast-enhanced CT in each phase, we defined one parameter, “tumor-aorta enhancement ratio”, which was calculated by dividing enhancement of pancreatic cancer by enhancement of abdominal aorta in each phase. These enhancement patterns were correlated with the level of vascular endothelial growth factor (VEGF), microvessel density (MVD), and extent of fibrosis.

RESULTS: The absolute enhanced value in the arterial phase correlated with the level of VEGF and MVD (P = 0.047, P = 0.001). The relative enhanced value in arterial phase and tumor-aorta enhancement ratio (arterial) correlated with MVD (P = 0.003, P = 0.022). Tumor-aorta enhancement ratio (arterial) correlated negatively with the extent of fibrosis (P = 0.004). The tumors with greater MVD and higher expression of VEGF tended to show high enhancement in the arterial dominant phase. On the other hand, the tumors with a larger amount of fibrosis showed a negative correlation with the grade of enhancement during the arterial phase.

CONCLUSION: Enhancement patterns on dynamic CT correlated with angiogenesis and may be modified by the extent of fibrosis.

Keywords: Computed tomography, Contrast media, Pancreatic cancer, Angiogenesis