1. ¹Department of Medical Oncology, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex HA6 2RN, UK
2. ²Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex HA6 2RN, UK
3. ³Cancer Research UK Clinical MR Research Group, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Cotswold Rd, Sutton SM2 5NG, UK

Correspondence: Professor GJS Rustin, E-mail: Gordon.Rustin@whht.nhs.uk

Received 7 April 2005; Revised 15 September 2005; Accepted 16 September 2005; Published online 18 October 2005.

Abstract

Dynamic contrast enhanced MRI (DCE-MRI) is being used increasingly in clinical trials to demonstrate that vascular disruptive and antiangiogenic agents target tumour microcirculation. Significant reductions in DCE-MRI kinetic parameters are seen within 4–24 and 48 h of treatment with vascular disruptive and antiangiogenic agents, respectively. It is important to know whether cytotoxic agents also cause significant acute reductions in these parameters, for reliable interpretation of results. This study investigated changes in transfer constant (K^trans) and the initial area under the gadolinium curve (IAUGC) following the first dose of chemotherapy in patients with mostly gynaecological tumours. A reproducibility analysis on 20 patients (using two scans performed on consecutive days) was used to determine the significance of DCE-MRI parameter changes 24 h after chemotherapy in 18 patients. In 11 patients who received platinum alone or with a taxane, there were no significant changes in K^trans or IAUGC in either group or individual patient analyses. When the remaining seven patients (treated with a variety of agents including platinum and taxanes) were included (n=18), there were also no significant changes in K^trans. Therefore, if combination therapy does show changes in DCE-MRI parameters then the effects can be attributed to antivascular therapy rather than chemotherapy.