Tumor Angiogenesis Assessed by Dynamic Contrast Harmonic Imaging Endoscopic Ultrasound and Immunohistochemical Analysis in Gastric Cancer - A Feasibility Study

Aims Our aim was to assess the vascular perfusion pattern in gastric cancer (GC) using dynamic contrast harmonic imaging endoscopic ultrasound (CHI-EUS) and compare it to immunohistochemical markers of angiogenesis and clinico-pathological parameters.

Methods GC patient’s CHI-EUS examinations were assessed before treatment decision. We used a dedicated software (Vuebox, Bracco Imaging S.p.A., Milan, Italy) to quantitatively analyze the vascular pattern of specific regions of interest (ROI). Time-intensity curve (TIC) and the following parameters were automatically generated: peak enhancement (PE), wash-in area under the curve (WiAUC), rise time (RT), mean transit time (mTTI), time to peak (TTP), wash-in rate (WiR), wash-in perfusion index (WiPI), wash-out AUC (WoAUC), wash-in area under the curve (WiAUC), wash-in and wash-out AUC (WiWoAUC), fall time (FT), wash-out rate (WoR), quality of fit (QOF), and ROI area. After CD105 immunostaining, we calculated the vascular area and the microvascular density (MVD). The correlation between angiogenesis markers and tumor stage, grade and dimension were assessed.

Results Twenty-eight CHI-EUS video sequences were analyzed. Correlations with statistical significance (p<0.05) were observed between TIC analysis parameters (PE, WiPI, RT, TTP), MVD and pathological factors like tumor diameter, grade, as well as N and M staging. Positive correlations were observed between PE, WiPI, ROI area and tumor diameter (r = 0,8749, r = 0,8598, r = 0.7993 and P < 0.05), between RT, TTP and M staging (r = 0.7634, r = 0.9316 with P<0.05) and between TTP and N stage (r = - 0.6798, p=0.005). We also found statistical significance (p < 0.05) between tumor diameter, N staging and MVD (r = - 0.97, r = - 0.86).

Conclusions CHI-EUS may be a feasible tool to estimate real-time GC angiogenesis and disease prognosis. Further studies are needed to establish its role in GC management.

Citation Sacerdotianu V-M, Ungureanu BS, Iordache S et al. eP397 TUMOR ANGIOGENESIS ASSESSED BY DYNAMIC CONTRAST HARMONIC IMAGING ENDOSCOPIC ULTRASOUND AND IMMUNOHISTOCHEMICAL ANALYSIS IN GASTRIC CANCER - A FEASIBILITY STUDY. Endoscopy 2021; 53: S226.

Publication History

Article published online:
19 March 2021