Computed tomography perfusion imaging evaluation of angiogenesis in patients with pancreatic adenocarcinoma

BACKGROUND: Pancreatic adenocarcinoma is one of the most common malignant tumors of the digestive system. More than 80% of patients with pancreatic adenocarcinoma are not diagnosed until late stage and have distant or local metastases. AIM: To investigate the value of computed tomography (CT) perfusion imaging in the evaluation of angiogenesis in pancreatic adenocarcinoma patients. METHODS: This is a retrospective cohort study. Patients with pancreatic adenocarcinoma and volunteers without pancreatic diseases underwent CT perfusion imaging from December 2014 to August 2017 in Huashan Hospital, Fudan University Shanghai, China. RESULTS: A total number of 35 pancreatic adenocarcinoma patients and 33 volunteers were enrolled. The relative blood flow (rBF), and relative blood volume (rBV) were significantly lower in patients with pancreatic adenocarcinoma than in the control group (P < 0.05). Conversely, the relative permeability in patients with pancreatic adenocarcinoma was significantly higher than that in controls (P < 0.05). In addition, rBF, rBV, and the vascular maturity index (VMI) were significantly lower in grade III-IV pancreatic adenocarcinoma than in grade I-II pancreatic adenocarcinoma (P < 0.05). Vascular endothelial growth factor (VEGF), CD105-MVD, CD34-MVD, and angiogenesis rate (AR) were significantly higher in grade III-IV pancreatic adenocarcinoma than in grade I-II pancreatic adenocarcinoma (P < 0.05). Significant correlations between rBF and VEGF, CD105-MVD, AR, and VMI (P < 0.01) were observed. Moreover, the levels of rBV were statistically significantly correlated with those of VEGF, CD105-MVD, CD34-MVD, and VMI (P < 0.01). CONCLUSION: Perfusion CT imaging may be an appropriate approach for quantitative assessment of tumor angiogenesis in pancreatic adenocarcinoma.