Elsevier

Current Problems in Diagnostic Radiology

Volume 44, Issue 5, September–October 2015, Pages 425-436
Current Problems in Diagnostic Radiology

Imaging of Tumor Angiogenesis for Radiologists—Part 2: Clinical Utility

https://doi.org/10.1067/j.cpradiol.2015.02.009Get rights and content

Angiogenesis is a key cancer hallmark involved in tumor growth and metastasis development. Angiogenesis and tumor microenvironment significantly influence the response of tumors to therapies. Imaging techniques have changed our understanding of the process of angiogenesis, the resulting vascular performance, and the tumor microenvironment. This article reviews the status and potential clinical value of the imaging modalities used to assess the status of tumor vasculature in vivo, before, during, and after treatment.

Introduction

Tumor angiogenesis is a fundamental biological feature whereby new blood vessels are formed to supply nutrients and oxygen for growing tumors, which is a crucial prerequisite for tumor development and dissemination.1 This article reviews the role of imaging techniques in the assessment of angiogenesis in vivo in clinical practice and correlates imaging findings with the corresponding biological features before, during, and after treatment.

Section snippets

Imaging of Angiogenesis in Clinical Practice

Imaging techniques have a critical role in cancer management. These techniques are extremely useful tools in the management of oncologic patients, including diagnosis, prognosis, planning therapy, and assessment of response to treatment. In addition, the specific assessment of angiogenesis status may provide critical data for patients. Most published studies using imaging to probe the structure, characteristics, and function of tumor microvasculature have used dynamic contrast-enhanced (DCE)

Multiparametric Approach

Because cancers are characterized by profound spatial and temporal heterogeneity in a variety of biological characteristics that are exacerbated by therapy effects, a multiparametric imaging assessment that maps the tumor biology is desirable for enabling improved biological understanding. Combinations of multiple modalities can yield complementary information offering advantages that go beyond what can be achieved by any modality used alone (Fig 9).

Multiparametric functional-molecular imaging

Future Challenges for Imaging of Angiogenesis

There are several challenges that imaging of angiogenesis needs to address before its clinical application. First, there is often a lack of standard approaches to data collection and analysis. The range of reported methodologies and analyses between studies has made identification of best technique difficult. In general, specialist research groups are the main users of these imaging techniques. Second, measurements of reproducibility are needed. Biological parameters are subject to random and

Conclusion

Noninvasive imaging plays a key role in cancer evaluation. To date, anatomical imaging remains the mainstay for tumor evaluation. However, new functional and molecular imaging techniques offer insights into tumor hallmarks, including angiogenesis, beyond conventional imaging capabilities. Although a quantitative imaging approach is only at the beginning of its possible incorporation into clinical imaging protocols, these advanced imaging techniques may answer key questions relating to tumor

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