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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:747-753 • 0278-4297

Echo Contrast-Enhanced Power Doppler Ultrasonography for Assessment of Angiogenesis in Renal Cell Carcinoma

Neslihan Kabakci, MD, Enis Igci, MD, Mustafa Secil, MD, Kutsal Yorukoglu, MD, Ugur Mungan, MD, Ilhan Celebi, MD and Ziya Kirkali, MD

Departments of Radiology (N.K., E.I., M.S.), Pathology (K.Y.), and Urology (U.M., I.C., Z.K.), Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Address correspondence to Neslihan Kabakci, MD, Department of Radiology, Faculty of Medicine, Dokuz Eylul University, 35340 Inciralti, Izmir, Turkey. E-mail: neslihan.kabakci{at}deu.edu.tr

Objective. Tumoral growth is an angiogenesis-dependent event. Although there are studies about the importance of histopathologic angiogenesis in various malignancies, the assessment of the angiogenesis by radiologic techniques is not well established. The aim of this study was to investigate the efficacy of echo contrast-enhanced power Doppler ultrasonography (PDUS) in determining the angiogenic status of renal cell carcinoma (RCC). Methods. Power Doppler ultrasonography was performed before and after intravenous administration of an echo contrast agent in 42 patients with renal masses. Twenty-one of these renal masses were diagnosed as RCC histopathologically, and these 21 patients were reevaluated retrospectively. The color pixel ratios of selected images were calculated as the ratio of the number of pixels showing power Doppler signals to the total number of pixels within the lesion. The results were compared with the histopathologic microvessel density (MVD). Results. A significant correlation was found between color pixel ratio and MVD values in both PDUS techniques. The use of the echo contrast agent improved this correlation and P values (Spearman {rho} from 0.436 to 0.551; P from .048 to .01). Conclusions. Color pixel ratio values reflect the MVD in RCC. Therefore, these results suggest that preoperative quantification of angiogenesis can be possible with the help of PDUS in RCC.

Key Words: angiogenesis • echo contrast agent • power Doppler ultrasonography • renal cell carcinoma

Abbreviations: CPR, color pixel ratio • MVD, microvessel density • PDUS, power Doppler ultrasonography • RCC, renal cell carcinoma




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Copyright © 2005 by the American Institute of Ultrasound in Medicine.