Imaging vascular physiology to monitor cancer treatment

• Published in: Critical reviews in oncology/hematology Vol. 58; no. 2; pp. 95 - 113
• Main Authors: Laking, George R., West, Catharine, Buckley, David L., Matthews, Julian, Price, Patricia M.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.05.2006; Elsevier Science
• Subjects: Angiogenesis; Angiogenesis Inhibitors - therapeutic use; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Blood Flow Velocity; Clinical Trials as Topic; DCE-MRI; Diagnostic Imaging; Drug Monitoring; Functional imaging; Hematologic and hematopoietic diseases; Humans; Magnetic Resonance Imaging; Medical sciences; Monitoring, Physiologic - methods; Neoplasms - blood supply; Neoplasms - pathology; Neoplasms - therapy; Neovascularization, Pathologic - diagnosis; Neovascularization, Pathologic - therapy; Perfusion; PET; Positron emission tomography; Reproducibility of Results; Surrogate endpoints; Ultrasonography, Doppler; X-ray computed tomography; Angiogenesis; DCE-MRI; Magnetic resonance imaging; X-ray computed tomography; Perfusion; Surrogate endpoints; Positron emission tomography; PET; Functional imaging; Radionuclide study; Radiodiagnosis; X ray; Malignant tumor; Nuclear magnetic resonance imaging; Radiography; Cancerology; Treatment; Blood vessel; Medical imagery; Physiology; Computerized axial tomography; Circulatory system; Neovascularization; Emission tomography
• ISSN: 1040-8428; 1879-0461
• DOI: 10.1016/j.critrevonc.2005.10.006

The primary physiological function of the vasculature is to support perfusion, the nutritive flow of blood through the tissues. Vascular physiology can be studied non-invasively in human subjects using imaging methods such as positron emission tomography (PET), magnetic resonance imaging (MRI), X-ray computed tomography (CT), and Doppler ultrasound (DU). We describe the physiological rationale for imaging vascular physiology with these methods. We review the published data on repeatability. We review the literature on ‘before-and-after’ studies using these methods to monitor response to treatment in human subjects, in five broad clinical settings: (1) antiangiogenic agents, (2) vascular disruptive agents, (3) conventional cytotoxic drugs, (4) radiation treatment, and (5) agents affecting drug delivery. We argue that imaging of vascular physiology offers an attractive ‘functional endpoint’ for clinical trials of anticancer treatment. More conventional measures of tumour response, such as size criteria and the uptake of fluorodeoxyglucose, may be insensitive to therapeutically important changes in vascular function.