Tmem-mcd in the minimally invasive assessment of the activity status of tmem in its dissemination of tumor cells

A method of determining the entrance of tumor cells into a blood vessel through a Tumor Micro-Environment for Metastasis (TMEM) site in a tumor comprising:

• (a) measuring TMEM activity as a transient increase in permeability of the blood vessel at the TMEM site using Gd-DTPA and MRI by
• (i) imaging the tumor four times at a temporal resolution between 2.3 and 4.3 seconds starting from a time of infusion of Gd-DTPA,
• (ii) imaging at a flip angle greater than other flip angles to obtain a dynamic fourth image, and
• (iii) expressing the TMEM activity as one or more of a PermMEAN score and a Uth score;
• (b) measuring expression of MenaINV or MenaCalc in tumor cells by
• (i) obtaining a sample of cells from the tumor using fine needle aspiration (FNA), and
• (ii) obtaining MenaINV or MenaCalc transcript expression relative to the expression of protein variants that are not changed in expression in a metastatic tumor as measured by qRT-PCR;
• (c) determining the entrance of tumor cells into the blood vessel through the TMEM site using a combination of (a) and (b).