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Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Oncology (Medical Radiology / Diagnostic Imaging)

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Radiologists have long been interested in imaging and measuring blood fl ow and in characterising the structure of blood vessels within pathological tissues. In 1927 Egas Moniz described the technique of cerebral angiography using injection of radio-opaque contrast agent combined with conventional radiology. His earlier published work had focused on the physiology of sex, so the fact that dynamic contrast imaging was able to divert him is a testament to the excitement intrinsic to the topic. Perhaps it is worrying that he later went on to invent the technique of prefrontal lobotomy – one can only hope that it was not his frustration with dynamic contrast imaging that drove him to it. More seriously, it soon became obvious that dynamic contrast imaging using conventional radiography (i.e. angiography) was an enormously powerful clinical tool for the identifi cation, localisation and characterisation of a wide range of pathological tissues.

This was especially true in the head, where alternative radiological tools were not available, and in vascular and malignant lesions. The angiographer became a mainstay in many areas of diagnosis, and numerous articles were subsequently published on the characterisation of tumours based on their angiographic appearances. Even in these early days before the Second World War it was clear that classifying tumours based on the number of blood vessels, the density of capillaries, the rate of blood fl ow and the extent of contrast leakage provided valuable, and at the time unique, information, although these classifi cation methods remained purely subjective.
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Industrial Organic Chemicals
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