Correlation between angiographically assessed vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma.

Abstract

The correlation between vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma was studied in 22 metastatic liver tumors. Hepatic metastases were categorized into Grades A-C, in order of increasing vascularity, as determined by hepatic angiography. Of the 22 metastatic liver tumors from 15 patients that showed on angiography, 5 tumors had slightly increased tumor vascularization (Grade A), 10 tumors had vascularization similar to normal (Grade B), and 7 tumors showed decreased vascularization relative to liver parenchyma (Grade C). Blood flow in these metastatic liver tumors was calculated quantitatively by positron emission tomography (PET) scanning using the C(15)O(2) steady-state method and the H(2)(15)O dynamic method. Using the H(2)(15)O method, blood flow value in Grade A tumors was 52.9 +/- 17.0 mL per 100 g per minute (mean +/- standard error), that in Grade B tumors was 35.7 +/- 3.8 mL per 100 g per minute, and that in Grade C tumors was 31.7 +/- 6.6 mL per 100 g per minute. A significant difference was found between blood flows in Grade A metastatic liver tumors and Grade B or C tumors (P < 0.002). There was no significant difference between blood flows in Grade B and C tumors. PET scan quantification results were almost parallel with the angiographic results. Even Grade C tumors had sufficient blood flow, about 32 mL per 100 g per minute on dynamic PET scans. These findings suggest that blood flow in hepatic metastases from colorectal carcinoma is greater than generally is believed.