Elsevier

Current Problems in Diagnostic Radiology

Volume 44, Issue 5, September–October 2015, Pages 407-424
Current Problems in Diagnostic Radiology

Imaging of Tumor Angiogenesis for Radiologists—Part 1: Biological and Technical Basis

https://doi.org/10.1067/j.cpradiol.2015.02.010Get rights and content

Angiogenesis is a key cancer hallmark involved in tumor growth and metastasis development. Tumor angiogenesis is the process whereby new blood vessels are formed to supply nutrients and oxygen to support the growth of tumors. This article reviews the biological basis behind imaging features and the different imaging modalities used to assess the status of tumor neovasculature in vivo at different scales: structural, functional, and molecular.

Introduction

Tumor angiogenesis is a fundamental biological feature whereby new blood vessels are formed to supply nutrients and oxygen for tumor growth. This complex multistep process constitutes a crucial prerequisite for tumor growth, invasion, and metastasis. Angiogenesis also plays a key role in forming and regulating the tumor microenvironment and greatly influences the response to antitumoral therapies.1 This article reviews the characteristics of tumor neovasculature and various imaging modalities that can be used in an attempt to assess its status in vivo.

Section snippets

Biological Basis of Tumor Angiogenesis

Tumor formation involves the coevolution of neoplastic cells together with extracellular matrix (ECM), immune cells, and tumor vasculature. Tumor vasculature development is a dynamic process that can limit tumor growth. Vascular networks occur through the formation of new vessels, a process named angiogenesis. Angiogenesis is regarded as one of the main hallmarks of cancer involved in tumorigenesis.1, 2 The angiogenic process begins with a prevascular phase where a few tumor cells exist without

Imaging Modalities in the Assessment of Angiogenesis

Noninvasive imaging plays a key role in cancer evaluation. Anatomical imaging remains the mainstay for tumor evaluation. Imaging assessment of tumors continues to be based primarily on size measurement and structural evaluation (eg, degree of enhancement). However, functional and molecular imaging techniques may provide additional insights into the tumor microenvironment. Until now, the standard paradigm for studying angiogenesis has been histopathologic techniques such as MVD counts or

Conclusion

In conclusion, our understanding of the complexity of the angiogenic process in tumors and its evaluation using imaging is incomplete. DCE imaging techniques (DCE-US, PCT, and DCE-MRI techniques) are basic tools in our daily practice, mainly based in their qualitative analysis. A quantitative imaging approach is only at the beginning of its possible incorporation into clinical imaging protocols. Many different functional and molecular imaging techniques have emerged and may ultimately improve

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