Contrast-enhanced ultrasonography of cervical carcinoma: perfusion pattern and relationship with tumour angiogenesis

Br J Radiol. 2016 Sep;89(1065):20150887. doi: 10.1259/bjr.20150887. Epub 2016 Jun 24.

Abstract

Objective: This study aimed to investigate the use of contrast-enhanced ultrasonography (CEUS) and time-intensity curves to assess angiogenesis in cervical cancer.

Methods: 60 patients who were scheduled to undergo radical surgery for biopsy-proven cervical cancers underwent CEUS. Surgical tissue sections from 32 patients who did not receive neoadjuvant chemotherapy were analyzed with CD34 staining to estimate intratumoral microvessel density (MVD). CEUS images were analyzed for maximum intensity (IMAX), rise time (RT), time to peak (TTP) and mean transit time.

Results: Cervical lesions had a higher IMAX and shorter RT and TTP (p < 0.001) than reference regions. There was a linear association between the IMAX of the cervical lesion and the mean intratumoral MVD (r = 0.624, p < 0.001). There were no significant differences in CEUS variables according to histological type, grade and stage.

Conclusion: Quantitative CEUS variables have potential use for monitoring perfusion changes in tumours after non-surgical therapy for advanced cervical cancer.

Advances in knowledge: The article demonstrates the capability and value of quantitative CEUS as a non-invasive strategy for detecting the perfusion and angiogenic status of cervical cancer. Quantitative CEUS variables have potential use for monitoring tumour response to non-surgical therapy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Contrast Media
  • Female
  • Humans
  • Image Enhancement / methods
  • Microbubbles
  • Microvessels / diagnostic imaging
  • Microvessels / pathology
  • Middle Aged
  • Neovascularization, Pathologic / diagnostic imaging*
  • Phospholipids
  • Sulfur Hexafluoride
  • Ultrasonography / methods
  • Uterine Cervical Neoplasms / blood supply*
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / pathology

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride