VEGFR-2 expression in HCC, dysplastic and regenerative liver nodules, and correlation with pre-biopsy Dynamic Contrast Enhanced CT. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Thaiss, W.M.; Kaufmann, S.; Kloth, C.; Nikolaou, K.; Bösmüller, H.; Horger, M.
• Is Part Of: European journal of radiology. Volume 85:Issue 11(2016)
• Page Start: 2036
• Page End: 2041
• Publication Date: 2016-11
• Subjects: ALP arterial liver perfusion -- BF blood flow -- BV blood volume -- DLN Dysplastic Liver Nodule -- HCC Hepatocellular Carcinoma -- HPI Hepatic Perfusion Index -- PVP portal venous perfusion -- RLN Regenerative Liver Nodule -- VEGFR-2 Vascular Endothelial Growth Factor Receptor 2 -- VPCT Volume Perfusion CT; HCC -- VEGFR-2 -- Perfusion imaging -- DCE-CT; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.09.012
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: VEGFR-2-expression levels vary between HCC, dysplastic and regenerative liver nodules. Perfusion parameters vary between these groups in blood flow, blood volume and HPI. Strong correlations were observed between perfusion parameters and VEGFR-2-expression. The results might influence diagnosis and therapy of anti-vascular therapeutic regimes. Abstract: Purpose: To evaluate whether VEGFR-2-expression in hepatocellular carcinoma (HCC), dysplastic (DLN) and regenerative liver nodules (RLN) correlates with pre-histology, in vivo Dynamic Contrast Enhanced-Computed Tomography (DCE-CT) data as VEGFR-2-expression affects prognosis and therapeutic options. Materials and methods: 34 patients (63.6 ± 8.9 years, 7 females) underwent liver biopsy or surgery due to suspected HCC or dysplastic nodules after DCE-CT between 2009 and 2015 with no previous chemo- or interventional therapy. Immunohistochemistry staining for VEGFR-2 was performed using Immunoreactive-Remmele-Stegner-Score (IRS) for quantification. A 128-row CT-scanner was used for DCE-CT with assessment of perfusion parameters blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI). Results: Histology confirmed HCC (n = 10), DLN (n = 7) and RLN (n = 34). Mean IRS for VEGFR-2 in HCCs was 9.1 ± 3.0, 7.3 ± 1.6 for DLN and 5.2 ± 2.8 for RLN (p = 0.0004 for HCC vs. RLN). Perfusion values varied significantly between all three groups for BF and HPI (p < 0.001 and p < 0.0001) and for BV in HCC vs. RLN (p < 0.0001) and DLN vs. RLN (p = 0.0019). Strong correlations between VEGFR-2-IRS and perfusion parameters were observed for BF in HCC (r = 0.88, p < 0.01) and HPI in HCC and DLN (r = 0.85, p < 0.04; r = 0.9, p < 0.01). Conclusion: Immunostaining revealed different VEGFR-2-expression levels in HCC, dysplastic and regenerative liver nodules. Perfusion markers blood flow, blood volume and hepatic perfusion index correlated well with VEGFR-2-immunostaining. This non-invasive discrimination between regenerative and dysplastic/HCC nodules might open new perspectives for diagnosis, therapy planning, and anti-VEGFR therapy monitoring.