Читать книгу Anti-Aging Therapeutics Volume XIII - A4M American Academy - Страница 9

•Imaging aggressiveness: The blood flow patterns depicted by Doppler sonography provide a way to quantitatively measure and serially monitor the severity of malignancy, as well as the response to therapy throughout the treatment course. Blood flow analysis can show which cancers are aggressive, since these have many vessels and which are responding to treatment, or nutritional intervention, or both, since the number of tumor vessels decreases with successful therapies.³

•Monitoring intervals: Because it is a non-invasive procedure, the 3-D Doppler exam can be performed as often as necessary. Our experience has shown that cancers are more variable in their response to intervention than generally believed. During early stages of diagnosis and intervention for PCa, a 3-month follow-up exam is warranted. Once the cancer shows signs of regressing, based primarily on measures of vascularity and density, a 6 to 9-month follow-up schedule is more appropriate. MRIs should be repeated when the tumor has not responded to treatment by 6-months. Routine ultrasound follow up should be on a 6-month basis and MRI yearly for 3-years.

•Tumor size alone can be misleading: The routine use of tumor size decrease has been shown to be less reliable than blood flow analysis, since the edema of cell death may cause dying cancers to enlarge. Although this concept was described in the early 1990’s in Europe, it was first mentioned in the American literature in 1996 at the American Roentgen Ray Society Annual Meeting. Dr. E. Louvar from the Henry Ford Hospital combined radiology and pathology studies to determine that the power Doppler flows in malignancies was related to the vessels that fed aggressive tumors.

•Highly correlated to Gleason scores: Significantly higher Gleason scores were seen in cancer biopsies of high Doppler flow areas compared to cancers with no Doppler flows. Dr. D. Downey at John Robarts Research Institute of the University Hospital in Ontario, Canada has looked at vascular imaging techniques and 3-D imaging of blood vessels. Blood vessels can be rendered in 3-D with angiography (high intensity dye injected into arteries), CT scanning (medium intensity dye), MR angiography (low intensity dye), 3-D color Doppler imaging, and 3-D power Doppler imaging. In this article, published from the American Journal of Radiology in 1995, he noted that in PCa power Doppler was better able to delineate the abnormal vessel architecture than color Doppler techniques. Indeed, computer analysis of malignant vessel density is now being used as a substitute for Gleason grading, which is solely based on randomly obtained histologic microscopic findings.