Angiogenesis of renal cell carcinoma: perfusion CT findings

Objective To observe the perfusion CT findings of renal cell carcinoma (RCC) and prospectively correlate perfusion CT parameters with tumor MVD and VEGF expression. Methods Dynamic contrast-enhanced multislice spiral CT was performed prospectively in 73 cases with histologically proven RCC (65 clear cell, 3 papillary, and 5 chromophobe). Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface-area product (PS) of RCC and normal renal cortex were measured, respectively. The tumor MVD count and VEGF expression level were determined by immunohistochemistry with specific monoclonal antibodies. Results There was significant difference between BF, BV, MTT, and PS of normal renal cortex (454.32 ± 110.90 mL/min/100 g, 23.53 ± 5.71 mL/100 g, 3.62 ± 1.38 s, 63.95 ± 18.85 mL/min/100 g) and RCC (261.96 ± 175.86 mL/min/100 g, 17.17 ± 8.34 mL/100 g, 7.08 ± 3.42 s, 25.07 ± 13.20 mL/min/100 g) ( P < 0.01). BF and BV among RCC histologic subtypes were significantly different ( P < 0.05), MTT and PS were not ( P > 0.05). MVD (42.29 ± 21.00) of RCC is positively correlated with BF, BV, and PS ( P < 0.01), not with MTT ( P > 0.05). No relationship was found between the expression levels of VEGF and any perfusion CT parameter. Conclusions Perfusion CT is a feasible technique to assess tissue perfusion in patients with RCC. BV, BF, and PS correlate positively with MVD and may reflect angiogenesis of RCC.