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

J Neuroradiol. 2019 May;46(3):186-192. doi: 10.1016/j.neurad.2018.04.008. Epub 2018 May 9.

Abstract

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-naïve 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 (Ktrans), reverse reflux rate constant (Kep), extracellular extravascular volume fraction (Ve) and blood plasma volume (Vp). The correlations between DCE-MRI parameters (Ktrans, 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). Ktrans showed a significant positive correlation with VEGF expression in HGGs group (ρ=0.505, P<0.001) and in combined group (LGGs+HGGs) (ρ=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 Ktrans other than Kep, Ve or Vp may be used as a surrogate for VEGF expression in brain gliomas.

Keywords: Biopsy; Brain glioma; Dynamic contrast-enhanced MRI; VEGF.

MeSH terms

  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / metabolism*
  • Brain Neoplasms / pathology
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Glioma / diagnostic imaging*
  • Glioma / metabolism*
  • Glioma / pathology
  • Humans
  • Image Interpretation, Computer-Assisted
  • Image-Guided Biopsy*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Vascular Endothelial Growth Factor A / metabolism*

Substances

  • Contrast Media
  • Vascular Endothelial Growth Factor A
  • gadodiamide
  • Gadolinium DTPA