MULTIMODALITY IMAGING OF BLADDER TUMOR VASCULARITY

MULTIMODALITY IMAGING
OF BLADDER TUMOR
VASCULARITY
ROBERT L. BARD, M.D. ROBERT L. BARD, M.D.
ROBERT L. BARD, M.D. ROBERT L. BARD, M.D.
DIRECTORDIRECTOR
BIOFOUNDATION FOR ANGIOGENESIS RESEARCH & DEVELOPMENTBIOFOUNDATION FOR ANGIOGENESIS RESEARCH & DEVELOPMENT
NEW YORK CITYNEW YORK CITY
VITO CANTISANI, M.D. VITO CANTISANI, M.D. ––ROMEROME
JELLE BARENTSZ, M.D. JELLE BARENTSZ, M.D. --NIJMEGENNIJMEGEN

OBJECTIVE
•DEMONSTRATE THE VALUE OF
DOPPLER SONOGRAPHY WITH
DCE
-
MRI IN EVALUATION OF
DCE
-
MRI IN EVALUATION OF
BLADDER CANCERS

DISCLOSURE
ROBERT L BARD-NOTHING TO DECLARE
VITO CANTISANI-NOTHING TO DECLARE
JELLE BARENTSZ
-
NOTHING TO DECLARE
JELLE BARENTSZ
-
NOTHING TO DECLARE

2010 DIAGNOSTIC IMAGING
BLADDER CANCER DETECTION:
GOLD STANDARD = CYSTOSCOPY
NON SPECIFIC: CT, PET, SPECT
NON SPECIFIC: CT, PET, SPECT
2010 MULTIDISCIPLINARY NYU
PROSTATE CANCER SYMPOSIUM
97% ACCURACY DOPPLER US/DCE-MRI
INT SOC ENDOVASCULAR THERAPY 2009

NEOVASCULAR PATTERNS
DCE-MRI SHOWS CAPILLARY NEOVASCULARITY
DOPPLER IDENTIFIES VESSELS 0.5-1.5 MM
WITH:
ABNORMAL DISTRIBUTION
LOSS OF NORMAL ARBORIZATION
LOSS OF VASOMOTOR TONE &
PRESENCE OF ARTERIOVENOUS SHUNTS
PRODUCE LOW RESISTANCE FLOWS
CONTRAST ENHANCED US (CEUS) SHOWS
CAPILLARY NEOVASCULARITY