Measurement of blood-brain barrier permeability in a tumor model using magnetic resonance imaging with gadolinium-DTPA

Gadolinium Neutron Capture Therapy for Cats and Dogs with Spontaneous Tumors Using Gd-DTPA

We conducted a clinical veterinary study on neutron capture therapy (NCT) at a neutron-producing accelerator with seven incurable pets with spontaneous tumors and gadolinium as a neutron capture agent (gadolinium neutron capture therapy, or GdNCT). Gadolinium-containing dimeglumine gadopentetate, or Gd-DTPA (Magnevist®, 0.6 mL/kg b.w.), was used. We observed mild and reversible toxicity related to the treatment. However, no significant tumor regression in response to the treatment was observed. In most cases, there was continued tumor growth. Overall clinical improvement after treatment was only temporary. The use of Gd-DTPA for NCT had no significant effects on the life expectancy and quality of life of animals with spontaneous tumors. Further experiments using more advanced gadolinium compounds are needed to improve the effect of GdNCT so that it can become an alternative to boron neutron capture therapy. Such studies are also necessary for further NCT implementation in clinical practice as well as in veterinary medicine.

A continuous-infusion dynamic MRI model at 3.0 Tesla for the serial quantitative evaluation of microvascular proliferation in an animal model of glioblastoma multiforme

PURPOSE

To develop a continuous-infusion dynamic MRI technique to characterize tumor-associated microvascular proliferation (MVP) in a rat brain model of glioblastoma multiforme.

METHODS

The proposed model assumes effects due to tumor-associated MVP (eg, vascular permeability, K^trans ; intravascular plasma fraction, v_p ) cannot be individually separated and solves for a single parameter (k^vasc ) that quantifies the T₁ -weighted contrast enhancement from dynamic images acquired during continuous contrast agent (CA) infusion. Untreated C6 tumor-bearing animals (N = 6) were serially imaged on postoperative days (PODs) 14 and 18 with a 3 Tesla clinical scanner utilizing a dynamic spatial and temporal resolution of 0.38 × 0.38 × 1.5 mm³ and 3.47 s, respectively.

RESULTS

An association was present between PODs 14 and 18 for median tumor k^vasc (Pearson's r = 0.94, P = 0.0052) and CA concentration ([CA], derived from pre- and postcontrast R₁ maps; r = 0.94, P = 0.0054). On POD 18, there was a voxel-based association between k^vasc and [CA] within each tumor (0.45 < r < 0.82, P < 0.001). However, voxel-based subregions demonstrated a reduced association between k^vasc and [CA] (N = 5; -0.08 < r < 0.22, P > 0.05) or an inverse association (N = 1; r = -0.28, P = 0.001), indicating differences between locations of vascular permeability and subsequent CA pooling in tumors.

CONCLUSION

The continuous-infusion method may provide a quantitative measure for characterizing and monitoring tumor-associated MVP. Magn Reson Med 78:1824-1838, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

MR-Pathological Comparison in F98-Fischer Glioma Model Using a Human Gantry

OBJECT

This study reports our findings in assessing in vivo tumour growth with magnetic resonance imaging using a commercial magnet and antenna in F98 implanted Fischer rats. A comparison of T1 gadolinium-enhanced coronal MR scans and pathology specimens in corresponding animals was accomplished.

METHODS

One rat was used in serial experiments to establish adequate imaging parameters. Afterward, 12 animals implanted with F98 cells underwent a MR study following intervals spanning five, ten, 15 and 20 days on a 1.5T human Siemens. Using a small loop antenna, a coronal T1 weighted MRI scan with Gadolinium was performed. Images were analyzed and volumes of enhancing tumour were calculated. The animals were sacrificed after the imaging procedure and brain were harvested and processed in pathology. Pathology specimens and MR images were analyzed using image processing software. One hematoxylin + eosin (H&E) slide per specimen was compared to the corresponding MR slice depicting the largest area of enhancement.

RESULTS

The MR enhancement areas obtained were 2.18 mm2, 8.25 mm2, 21.6 mm2 and 23.17 mm2 at five, ten, 15 and 20 days. Tumour margin measurements on pathologic samples produced areas of 0.29 mm2, 4.43 mm2, 8.3 mm2, and 12.9 mm2 at five, ten, 15 and 20 days respectively.

CONCLUSION

The T1-enhancing images constantly overestimated the tumour bulk on H&E. This phenomenon is explained by enhancement of the brain around tumour, the extra-axial tumour growth, and a shrinking factor of 17% related to the fixation process. Nonetheless, the radiological tumour growth paralleled the histological samples. This technology is thus suitable to follow tumour growth in F98 implanted rats.

MRI and quantitative autoradiographic studies following bolus injections of unlabeled and (14)C-labeled gadolinium-diethylenetriaminepentaacetic acid in a rat model of stroke yield similar distribution volumes and blood-to-brain influx rate constants

In previous studies on a rat model of transient cerebral ischemia, the blood and brain concentrations of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) following intravenous bolus injection were repeatedly assessed by dynamic contrast-enhanced (DCE)-MRI, and blood-to-brain influx rate constants (K(i)) were calculated from Patlak plots of the data in areas with blood-brain barrier (BBB) opening. For concurrent validation of these findings, after completing the DCE-MRI study, radiolabeled sucrose or α-aminoisobutyric acid was injected intravenously, and the brain disposition and K(i) values were calculated by quantitative autoradiography (QAR) assay employing the single-time equation. To overcome two of the shortcomings of this comparison, the present experiments were carried out with a radiotracer virtually identical to Gd-DTPA, Gd-[(14)C]DTPA, and K(i) was calculated from both sets of data by the single-time equation. The protocol included 3 h of middle cerebral artery occlusion and 2.5 h of reperfusion in male Wistar rats (n = 15) preceding the DCE-MRI Gd-DTPA and QAR Gd-[(14)C]DTPA measurements. In addition to K(i) , the tissue-to-blood concentration ratios, or volumes of distribution (V(R) ), were calculated. The regions of BBB opening were similar on the MRI maps and autoradiograms. Within them, V(R) was nearly identical for Gd-DTPA and Gd-[(14)C]DTPA, and K(i) was slightly, but not significantly, higher for Gd-DTPA than for Gd-[(14)C]DTPA. The K(i) values were well correlated (r = 0.67; p = 0.001). When the arterial concentration-time curve of Gd-DTPA was adjusted to match that of Gd-[(14)C]DTPA, the two sets of K(i) values were equal and statistically comparable with those obtained previously by Patlak plots (the preferred, less model-dependent, approach) of the same data (p = 0.2-0.5). These findings demonstrate that this DCE-MRI technique accurately measures the Gd-DTPA concentration in blood and brain, and that K(i) estimates based on such data are good quantitative indicators of BBB injury.

Characterization of a human tumorsphere glioma orthotopic model using magnetic resonance imaging

Magnetic resonance imaging (MRI) is the imaging modality of choice by which to monitor patient gliomas and treatment effects, and has been applied to murine models of glioma. However, a major obstacle to the development of effective glioma therapeutics has been that widely used animal models of glioma have not accurately recapitulated the morphological heterogeneity and invasive nature of this very lethal human cancer. This deficiency is being alleviated somewhat as more representative models are being developed, but there is still a clear need for relevant yet practical models that are well-characterized in terms of their MRI features. Hence we sought to chronicle the MRI profile of a recently developed, comparatively straightforward human tumor stem cell (hTSC) derived glioma model in mice using conventional MRI methods. This model reproduces the salient features of gliomas in humans, including florid neoangiogenesis and aggressive invasion of normal brain. Accordingly, the variable, invasive morphology of hTSC gliomas visualized on MRI duplicated that seen in patients, and it differed considerably from the widely used U87 glioma model that does not invade normal brain. After several weeks of tumor growth the hTSC model exhibited an MRI contrast enhancing phenotype having variable intensity and an irregular shape, which mimicked the heterogeneous appearance observed with human glioma patients. The MRI findings reported here support the use of the hTSC glioma xenograft model combined with MRI, as a test platform for assessing candidate therapeutics for glioma, and for developing novel MR methods.

Estimating blood and brain concentrations and blood-to-brain influx by magnetic resonance imaging with step-down infusion of Gd-DTPA in focal transient cerebral ischemia and confirmation by quantitative autoradiography with Gd-[(14)C]DTPA

An intravenous step-down infusion procedure that maintained a constant gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) blood concentration and magnetic resonance imaging (MRI) were used to localize and quantify the blood-brain barrier (BBB) opening in a rat model of transient cerebral ischemia (n=7). Blood-to-brain influx rate constant (K(i)) values of Gd-DTPA from such regions were estimated using MRI-Patlak plots and compared with the K(i) values of Gd-[(14)C]DTPA, determined minutes later in the same rats with an identical step-down infusion, quantitative autoradiography (QAR), and single-time equation. The normalized plasma concentration-time integrals were identical for Gd-DTPA and Gd-[(14)C]DTPA, indicating that the MRI protocol yielded reliable estimates of plasma Gd-DTPA levels. In six rats with a BBB opening, 14 spatially similar regions of extravascular Gd-DTPA enhancement and Gd-[(14)C]DTPA leakage, including one very small area, were observed. The terminal tissue-plasma ratios of Gd-[(14)C]DTPA tended to be slightly higher than those of Gd-DTPA in these regions, but the differences were not significant. The MRI-derived K(i) values for Gd-DTPA closely agreed and correlated well with those obtained for Gd-[(14)C]DTPA. In summary, MRI estimates of Gd-DTPA concentration in the plasma and brain and the influx rate are quantitatively and spatially accurate with step-down infusions.

Targeting malignant glioma survival signalling to improve clinical outcomes

Malignant gliomas are common and aggressive brain tumours in adults. Current treatments for glioblastoma multiforme result in a poor median survival of less than 12 months. The blood-brain barrier restricts the delivery of many chemotherapies to the central nervous system, contributing to the failure of treatment. PI3K/Akt and Ras/MAPK pathways have been identified as important oncogenic pathways in these tumours. The PI3K/Akt pathway mediates cell survival and growth, whereas the Ras/MAPK pathway signals cell differentiation, proliferation and anti-apoptosis. Modern targeted therapies include antibodies to circulating growth factors and cell surface receptors, as well as inhibitors of receptor tyrosine kinases and specific intracellular signalling proteins. Monotherapy with most targeted therapies produces only modest efficacy. Better results are achieved in combination with cytotoxic chemotherapies. Future therapeutics should focus on combination therapy with small lipophilic molecules.

Kinetic modeling of contrast-enhanced MRI: an automated technique for assessing inflammation in the rheumatoid arthritis wrist

In recent years, development of rheumatoid arthritis (RA) drug therapy has been more directly targeted to counteract specific mechanisms of inflammation, and it is now believed that early aggressive treatment with disease modifying drugs is important to inhibit future structural joint damage. The development of these new treatments has increased the need for methodologies to assess disease activity in RA and monitor the effectiveness of drug therapy. Unlike X-ray, which shows only structural bone damage, magnetic resonance imaging (MRI) can depict soft tissue damage and synovitis, the primary pathology of RA. Recent studies have also indicated that MRI is sensitive to pathophysiologic changes that may predate radiographic erosions and may predict future joint damage. In this study, we have developed a computer automated analysis technique for MR wrist images that provides an objective measure of RA synovitis. This method applies a two-compartment pharmacokinetic model to every voxel of a dynamic contrast-enhanced MRI (DCE-MRI) dataset and outputs resulting parametric images. The aim of this technique is to not only objectively quantify the severity of rheumatoid synovitis, but to also locally determine where areas of serious disease activity are situated through kinetic modeling of blood-tissue exchange. Preliminary results show good correlation to early enhancement rate, which has previously been shown to be a useful clinical marker of RA activity. However, the use of tracer kinetic modeling methods potentially provides more specific information regarding underlying RA physiology. This approach could provide a useful new tool in RA patient management and could substantially improve RA therapeutic studies by calculating objective biomarkers of the disease state.

Targeting SPARC expression decreases glioma cellular survival and invasion associated with reduced activities of FAK and ILK kinases

Secreted protein acidic and rich in cysteine (SPARC) is an extracellular glycoprotein expressed in several solid cancers, including malignant gliomas, upon adoption of metastatic or invasive behaviors. SPARC expression in glioma cells promotes invasion and survival under stress, the latter process dependent on SPARC activation of AKT. Here we demonstrate that downregulation of SPARC expression with short interfering RNA (siRNA) in glioma cells decreased tumor cell survival and invasion. SPARC siRNA reduced the activating phosphorylation of AKT and two cytoplasmic kinases, focal adhesion kinase (FAK) and integrin-linked kinase (ILK). We determined the contributions of FAK and ILK to SPARC effects using SPARC protein and cell lines engineered to overexpress SPARC. SPARC activated FAK and ILK in glioma cells previously characterized as responsive to SPARC. Downregulation of either FAK or ILK expression inhibited SPARC-mediated AKT phosphorylation, and targeting both FAK and ILK attenuated AKT activation more potently than targeting either FAK or ILK alone. Decreased SPARC-mediated AKT activation correlated with a reduction in SPARC-dependent invasion and survival upon the downregulation of FAK and/or ILK expression. These data further demonstrate the role of SPARC in glioma tumor progression through the activation of intracellular kinases that may provide novel therapeutic targets for advanced cancers.

High-resolution blood-brain barrier permeability and blood volume imaging using quantitative synchrotron radiation computed tomography: study on an F98 rat brain glioma

The authors previously provided evidence of synchrotron radiation computed tomography (SRCT) efficacy for quantitative in vivo brain perfusion measurements using monochromatic X-ray beams. However, this technique was limited for small-animal studies by partial volume effects. In this paper, high-resolution absolute cerebral blood volume and blood-brain barrier permeability coefficient measurements were obtained on a rat glioma model using SRCT and a CCD camera (47x47 microm2 pixel size). This is the first report of in vivo high-resolution brain vasculature parameter assessment. The work gives interesting perspectives to quantify brain hemodynamic changes accurately in healthy and pathological small animals.

Silent radiological imaging time in patients with brain metastasis

Cerebral metastasis is a common finding in patients with systemic carcinoma and is an indication for progress of the disease. When brain metastases occur, they lead to a considerable decrease in both survival and the quality of life, in patients who otherwise might be functional. Furthermore, the location, size and number of such lesions, play a decisive role in management and prognosis. Even though early diagnosis and treatment is curative in rare cases, it may lead to a useful remission of the central nervous system (CNS) symptoms, enhance the patient's quality of life and prolong survival. The radiological exams established in the diagnosis of this condition, include computed tomography (CT) scan or magnetic resonance imaging (MRI). In cases of "micrometastatic" disease though, these exams may be pronounced as normal. This retrospective study was performed in patients with advanced systemic disease, who presented with neurological findings of intracranial mass lesion, in the absence of radiological evidence. Early-occurring symptoms were evaluated in accordance to location of the primary disease and follow-up with repetitive MRI scans was performed, in an attempt to confirm the diagnosis and facilitate prompt and appropriate treatment.

Imaging of murine brain tumors using a 1.5 Tesla clinical MRI system

BACKGROUND

In this study, we investigated the feasibility of using a 1.5 Tesla (T) clinical magnetic resonance imaging (MRI) system for in vivo assessment of three histopathologically different brain tumor models in mice.

METHODS

We selected mouse models in which tumor growth was observed in different intracranial compartments: Patched+/- heterozygous knock-out mice for tumor growth in the cerebellum (n = 5); U87 MG human astrocytoma cells xenografted to the frontal lobe of athymic mice (n = 15); and F5 (n = 15) or IOMM Lee (n = 15) human malignant meningioma cells xenotransplanted to the athymic mouse skull base or convexity. Mice were imaged using a small receiver surface coil and a clinical 1.5 T MRI system. T1- and fast spin echo T2-weighted image sequences were obtained in all animals. Gadolinium was injected via tail vein to better delineate the intracranial tumors. Twenty mice were followed by serial MRI to study tumor growth over time. In these mice, images were typically performed after tumor implantation, and at two week intervals. Mice were euthanized following their last imaging procedure, and their tumors were examined by histopathology. The histopathological preparations were then compared to the last MR images to correlate the imaging features with the pathology.

RESULTS

Magnetic resonance imaging delineated th tumors in the cerebellum, frontal lobes and skull base in all mouse models. The detection of intracranial tumors was enhanced with prio administration of gadolinium, and the limit of resolution of brain tumors in the mice was 1-2 mm3. Sequential images performed at different time intervals showed progressive tumor growth in all animals. The MR images of tumor size and location correlated accurately with th results of the histopathological analysis.

CONCLUSION

Magnetic resonance imaging of murine brain tumors in different intracrania compartments is feasible with a 1.5 T clinical MR system and a specially designed surface coil. Tumors as small as 1-2 mm3 can be detecte with good image resolution. Mice harbouring nascent brain tumors can be followed sequentially by serial MR imaging. This may allow for a noninvasive means by which tumor growth can be measured, and novel therapies tested without resorting to sacrifice of the mice.

Patlak plots of Gd-DTPA MRI data yield blood-brain transfer constants concordant with those of 14C-sucrose in areas of blood-brain opening

The blood-to-brain transfer rate constant (K(i)) of Gd-DTPA was determined in MRI studies of a rat model of transient cerebral ischemia. The longitudinal relaxation rate, R(1), was estimated using repeated Look-Locker measurements. A model-independent analysis of deltaR(1), the Patlak plot, produced maps of K(i) for Gd-DTPA and the distribution volume of the mobile protons (V(p)) with intravascular-Gd changed R(1)'s. The K(i)'s of Gd-DTPA were estimated in regions of interest with blood-brain barrier (BBB) opening (regions of interest, ROIs) and compared to those of (14)C-sucrose determined shortly thereafter by quantitative autoradiography. The K(i)'s for both Gd-DTPA and sucrose were much higher than normal within the ROIs (n = 7); linear regression of K(i) for Gd-DTPA vs. K(i) for sucrose yielded a slope of 0.43 +/- 0.11 and r(2) = 0.72 (P = 0.01). Thus, K(i) for Gd-DTPA varied in parallel with, but was less than, K(i) for sucrose. In the ROIs, mean V(p) was 0.071 ml g(-1) and much higher than mean vascular volume estimated by dynamic-contrast-enhancement (0.013 ml g(-1)) or mean V(p) in contralateral brain (0.015 ml g(-1)). This elevated V(p) may reflect increased capillary permeability to water. In conclusion, K(i) can be reliably calculated from Gd-DTPA-MRI data by Patlak plots.

Measurements of extracellular volume fraction and capillary permeability in tissues using dynamic spin-lattice relaxometry: studies in rabbit muscles

Dynamic MR longitudinal R(1) relaxometry after administration of a gadolinium contrast bolus (Gd-DTPA) has been used for in vivo measurements of the extracellular volume fraction (v) and the capillary permeability (k min(-1)) in rabbit muscles to distinguish between red slow- and white fast-twitch muscle fiber types. For this purpose a protocol imaging sequence has been used which allows fast R(1) measurements during the contrast agent uptake. Physiological tissue parameters, k and v, were obtained by computing procedures assuming a simplified monoexponential plasma model. These were shown to be about twice as large in the slow-twitch semimembranosous proprius muscle (SP), containing 100% oxidative type-I fiber, that in the fast-twitch rectus femorus muscle (RF), containing only 6% type-I fiber type. The capillary permeability has been found to be 0.25 +/- 0.02 min(-1) for the (SP) and 0.10 +/- 0.01 min(-1) for the (RF). Similarly, the extracellular volume fractions were 0.189 +/- 0.015 and 0.082 +/- 0.006 respectively, in close agreement with literature data and experimental results obtained by invasive radionuclide measurements. For the pool of the 10 studied animals, no significant variation among animals was observed in the extracellular volume fraction and the capillary permeability for the different muscle fiber types. The dynamic relaxometry method used is easy to implement on conventional MR imagers and has potential applications in muscle diseases. The method has also potential applications for tissue characterization based on extracellular volume and capillary permeability quantification. In particular, the method can be used for the evaluation of tumors and their responses to therapies.

Applications of dynamic contrast enhanced MRI in oncology: measurement of tumor oxygen tension

A new model based on an extension of the Krog's cylindrical model was developed to calculate tumor oxygen tension (pO(2)) from the H-1 dynamic contrast enhanced MRI (DCE-MRI) measurements. The model enables one to calculate the tumor pO(2) using the vascular volume fraction (f(b)) obtained by the DCE-MRI. The proposed model has three parameters. For small values of f(b) one assumes that there exists a linear relationship between and f(b). The constant of proportionality in this case is given by C(1) - the oxygen tension per vascular volume fraction. For larger values of f(b) a modified version of Krogh model using two parameters is developed and here C(2) - is the integrated blood oxygen tension, and C(3) - given by the combination of the oxygen diffusion coefficient, solubility of oxygen in the tissue, capillary radius, and tissue metabolic consumption rate. The parameters of the model can be determined by performing simultaneous in-vivo F-19 MRI oxygen tension measurement and dynamic Gd-DTPA enhanced MRI on the same tumor. Dynamic MRI data can be used with a compartmental model to calculate tumor vascular volume fraction on a pixel by pixel basis. Then tumor oxygen tension map can be calculated from the vascular volume fraction by the extended Krogh model as described above. In the present work, the model parameters were determined using three rats bearing Walker-256 tumors and performing simultaneous F-19 and DCE MRI on the same tumor. The parameters obtained by fitting the model equation to the experimental data were: C(1) = 983.2 +/- 133.2torr, C(2) = 58.20 +/- 2.4 torr, and C(3) = 1.7 +/- 0.1 torr. The performance of the extended Krogh model was then tested on two additional rats by performing both F-19 and DCE-MRI studies and calculating the pO(2) (H-1) using the model and comparing it with the pO(2) (F-19) obtained from the F-19 MRI. It was found that the measurements obtained by both techniques had a high degree of correlation [pO(2) (H-1) = (1.01 +/- 0.07) pO(2) (F-19) + (0.91 +/- 0.05) and r=0.96], indicating the applicability of the proposed model in determining pO(2) from the DCE-MRI.

Transvascular and interstitial transport of a 19 kDa linear molecule in human melanoma xenografts measured by contrast-enhanced magnetic resonance imaging

Cancer therapy involving blood-borne macromolecular therapeutic agents often fails, owing to inadequate macromolecule uptake in malignant tissue. The transvascular and interstitial transport of a 19 kDa linear molecule (NC22181 or poly-[Gd-DTPA]-co-[1,6-diaminohexane]) was studied in the present work in an attempt to identify transport barriers limiting the delivery of macromolecules to tumors. Tumors of four human melanoma xenograft lines were included in the study. The uptake of NC22181 was measured by spoiled gradient recalled magnetic resonance imaging (MRI). The effective microvascular permeability constant and the interstitial influx constant of NC22181 were calculated from NC22181 uptake curves by using a three-compartment tissue model. The uptake of NC22181 was limited by the interstitial transport and not by the transvascular transport in all xenograft lines. If the melanoma xenografts used in this study are representative models of human cancer, our results suggest that strategies for increasing the delivery of macromolecular therapeutic agents to tumors should focus on improving the transport conditions in the interstitium, rather than enhancing the permeability of the microvascular wall.

Dynamic contrast-enhanced MRI using Gd-DTPA: interindividual variability of the arterial input function and consequences for the assessment of kinetics in tumors

Gd-DTPA kinetics in arterial blood was investigated by dynamic MRI in 47 patients with malignant and benign mammary tumors. Signal enhancement was monitored for 10 min after the beginning of a 1-min infusion of 0.1 mmol/kg Gd-DTPA. Kinetics in blood was biexponential with median half-lives of 21 sec and 11.1 min, respectively. Peak signal enhancement and the area under the signal enhancement-time curve varied 2.5- and 3.7-fold between patients. The shortest mean residence time in one of up to three tumor compartments, MRT*, was estimated using either the individual (reference) or a mean population (surrogate) arterial input function (AIF). MRT* (reference estimate) was 1.0 (0-1.5), 1.9 (1.5-2.3), and 2.5 (2.3-2.8) min in carcinomas, fibroadenomas, and mastopathies, respectively (median and interquartile distance). Surrogate estimates were unbiased but differed from the reference estimates 1.5-fold or more in 23% of cases. AIFs should be monitored individually if accurate estimates of individual MRT* are desired.

Microvascular permeability to macromolecules in human melanoma xenografts assessed by contrast-enhanced MRI--intertumor and intratumor heterogeneity

Several novel macromolecular anticancer agents have fallen short of expectations owing to inadequate and heterogeneous uptake in tumor tissue. In the present work, contrast-enhanced magnetic resonance imaging was used to measure the intertumor and intratumor heterogeneity in the effective microvascular permeability constant, P(eff), of an 82 kDa macromolecule in an attempt to identify possible causes of the inadequate and heterogeneous uptake. Tumors of two human melanoma xenograft lines (A-07 and R-18) were included in the study. Human serum albumin with 30 gadopentetate dimeglumine units per molecule was used as a model molecule of macromolecular therapeutic agents. P(eff) was measured in manually defined regions of interest, corresponding to a whole tumor (ROI(WHOLE)) or to subregions of a tumor (ROIs(SUB)). The P(eff) of the ROI(WHOLE) of individual tumors ranged from 1.4 x 10(-7) cm/s to 2.8 x 10(-7) cm/s (A-07) and from 7.7 x 10(-8) cm/s to 3.2 x 10(-7) cm/s (R-18). P(eff) decreased with increasing tumor volume in R-18, but was independent of tumor volume in A-07. The intratumor heterogeneity in P(eff) exceeded the intertumor heterogeneity in both tumor lines. Some ROIs(SUB) showed P(eff) values that were similar to or slightly higher than the P(eff) values of albumin in normal tissues. Our observations suggest that inadequate and heterogeneous uptake of macromolecular therapeutic agents in tumor tissue is partly a result of low and heterogeneous microvascular permeability. However, the microvascular wall is probably not the major transport barrier to macromolecules in A-07 and R-18 tumors, as most individual tumors and individual tumor subregions showed high P(eff) values, i.e. values that are up to 10-fold higher than those of normal tissues.

Imaging blood flow in brain tumors using arterial spin labeling

Measurements of tumor blood flow (TBF) are important for understanding tumor physiology and can be valuable in selecting and evaluating therapies. Brain tumors typically present reduced blood flows compared to normal brain tissue. This study shows that the arterial spin labeling (ASL) technique can be used to measure TBF non-invasively in a rat glioma model. Results show that TBF in the core (36.3 +/- 18.9 ml/100g/min, n=4) and peripheral regions (85.3 +/- 26.9 ml/100g/min, n=4) of the tumor are significantly reduced and show considerable heterogeneity compared to cerebral blood flow (CBF) of normal brain tissue (147.7 +/- 31.1 ml/100g/min, n=4), while T(1) in the tumor (2.6 +/- 0.1 sec) is significantly elevated compared to normal tissue T(1) (2.0 +/- 0.0 sec). These results strongly support the feasibility of using the ASL technique to evaluate different cancer treatment strategies, to monitor the effects of agents designed to modulate TBF and oxygenation (e.g., carbogen gas), and to assess and guide the use of anti-angiogenic agents. Magn Reson Med 44:169-173, 2000.

Noninvasive assessment of the functional neovasculature in 9L-glioma growing in rat brain by dynamic 1H magnetic resonance imaging of gadolinium uptake

Pathophysiologic parameters of the functional neovasculature and the blood-brain barrier of 9L-glioma in rat brain were measured noninvasively by dynamic 1H magnetic resonance imaging studies of gadolinium (Gd)-DTPA uptake. Changes of apparent [Gd-DTPA] uptake in time (CT[t]) were analyzed in a slice through the center of 10 9L-gliomas using fast T1 measurements. The distribution of the contrast agent was spatially correlated with the distribution of perfused microvessels as determined by immunohistochemical analysis. This method permits a distinction between perfused and nonperfused microvessels with a disrupted blood-brain barrier. In transverse slices of the whole tumor, a spatial correlation was observed between CT maps and the two-dimensional distribution of perfused microvessels. In the next step, Gd-DTPA uptake rates were spatially related to the perfused microvessel density (Np) or vascular surface area (Sp). In tumor voxels with perfused microvessels, a linear correlation was found between Gd-DTPA uptake rate constants (k values) and Np or Sp. No correlation was observed between k values and the total microvessel density. These are the first data that show a relation between Gd-DTPA uptake rates and parameters of the functional neovasculature in 9L-glioma growing in rat brain. Now that Gd-DTPA uptake studies can be related to parameters of the functional neovasculature, they may be used more efficiently as a prognostic tool before or during therapy.

Imaging the rat brain on a 1.5 T clinical MR-scanner

Magnetic resonance imaging (MRI) offers a noninvasive technique for studying neurodegenerative events in the rat brain, however, most of the studies are performed on small bore purpose dedicated MR scanners of limited availability and at high cost. The present study explored the feasibility of using a clinical whole body MR-scanner to perform imaging in rat brain and specifically in models of Parkinson's (PD) and Huntington's disease (HD). For that purpose rats were placed into a specially designed PVC device equipped with a flexible surface coil-and T2-weighted spin echo sequences were acquired on a Siemens Magnetom Vision at 1.5 T. In the experimental protocols of PD and HD, animals underwent 6-hydroxydopamine (6-OHDA) and quinolinic acid (QA) injections, respectively and were subsequently grafted with fetal tissue. T2-weighted images showed a small hyperintense area at the 6-OHDA lesion site and a diffuse hyperintensity in the striata with QA lesions. Transplants were seen as a hypointense area surrounded by a hyperintense rim on T1-weighted images. Moreover, disturbances of the blood-brain-barrier and its time of restoration could be monitored. In conclusion, high-resolution in vivo imaging of small animals is feasible with clinical MR-scanners and hence allows the study of various experimental protocols.

Microvessel organization and structure in experimental brain tumors: microvessel populations with distinctive structural and functional properties

We studied microvessel organization in five brain tumor models (ENU, MSV, RG-2, S635cl15, and D-54MG) and normal brain, including microvessel diameter (LMVD), intermicrovessel distance (IMVD), microvessel density (MVD), surface area (S(v)), and orientation. LMVD and IMVD were larger and MVD was lower in tumors than normal brain. S(v) in tumors overlapped normal brain values and orientation was random in both tumors and brain. ENU and RG-2 tumors and brain were studied by electron microscopy. Tumor microvessel wall was thicker than that of brain. ENU and normal brain microvessels were continuous and nonfenestrated. RG-2 microvessels contained fenestrations and endothelial gaps; the latter had a maximum major axis of 3.0 microm. Based on anatomic measurements, the pore area of RG-2 tumors was estimated at 7.4 x 10(-6) cm(2) g(-1) from fenestrations and 3.5 x 10(-5) cm(2) g(-1) from endothelial gaps. Increased permeability of RG-2 microvessels to macromolecules is most likely attributable to endothelial gaps. Three microvessel populations may occur in brain tumors: (1) continuous nonfenestrated, (2) continuous fenestrated, and (3) discontinuous (with or without fenestrations). The first group may be unique to brain tumors; the latter two are similar to microvessels found in systemic tumors. Since structure-function properties of brain tumor microvessels will affect drug delivery, studies of microvessel function should be incorporated into clinical trials of brain tumor therapy, especially those using macromolecules.

Use of T(2)-weighted susceptibility contrast MRI for mapping the blood volume in the glioma-bearing rat brain

The aim of this work was to evaluate the potential of T(2)-weighted, steady-state susceptibility-enhanced contrast magnetic resonance imaging (MRI), to characterize brain tumor heterogeneity and tumor vascularization. In vivo T(2)-weighted MRI experiments were carried out on normal rats (n = 11) and rats bearing C6 glioma (n = 17), before and after the injection of a remanent superparamagnetic contrast agent. The DeltaR(2) variations of the transverse relaxation rate due to the injection of the contrast agent were used to generate relative cerebral blood volume (CBV) maps. Contrast enhancement of the tumor was shown to reflect tissue vascularization rather than leakage of the blood-brain barrier. The quantitative results clearly show the heterogeneity of tumor vascularization and reveal a high vessel density in the peripheral area (CBV(per) approximately 17.2 +/- 2.3 sec(-1)) and a low vessel density in the central area of the tumor (CBV(cen) approximately 2.5 +/- 0.5 sec(-1)). Magn Reson Med 42:754-761, 1999.

A model of the dual effect of gadopentetate dimeglumine on dynamic brain MR images

An optimized dynamic gradient echo sequence with two echoes is used to obtain data that can be analyzed with indicator dilution theory as well as with pharmacokinetic theory. Taking advantage of the simultaneity of T(*)(2) and T(1) information, both theories can be employed and merged to interpret consistently the observed effects of the redistribution of a contrast agent (gadopentetate dimeglumine) into the tissue from first pass onward. The regional cerebral blood volume (rCBV) and the exchange rate of the contrast agent between the vascular and the interstitial space through the blood-brain barrier are analyzed for each pixel in a two-step algorithm. Two values for rCBV are obtained with different weighting for the microvascular fraction of the blood volume. Because the analysis, called PELEAKAN, is capable of separating effects related to perfusion (through intravascular blood volume) and to leakage in places where the blood-brain barrier is damaged, it is an appropriate tool for evaluating these parameters in brain tumors, and we show clinical examples of this analysis in brain tumor patients.

Sequential imaging and volumetric analysis of an intracerebral C6 glioma by means of a clinical MRI system

In this study, using high resolution coils; implanted growing rat brain tumors were imaged sequentially with 3-D volume measurements generated by means of a clinical magnetic resonance imaging system (CMRI) and commercially available wrist coil. Ten female Sprague-Dawley rats were used, eight were implanted with C6 rat glioma cells and two served as controls. The images that were used for the three-dimensional (3-D) measurements were obtained from T1 weighted post contrast sequences. A commercially available computer work station with 3-D image analysis software was used to generate the tumor volumes. In addition to the rat studies a mouse was included to see if the resolution would be adequate for imaging very small brains. Six rats had brain tumor growth after transplantation and two rats did not have any tumor growth, however, their images were similar to the controls animals. Tumor volumes varied widely among the implanted rats. The number of implanted tumor cells had no direct relationship to developing tumor volumes. This study demonstrates that high resolution images of a rat brain tumor can be obtained from a CMRI system using a commercially available wrist coil which is capable of imaging two rats at the same time or even a mouse brain. A commercially available computer work station was able to generate the tumor volumes. The ability to image brain tumor and generate volume measurements over time has potential for animal research.

Striatal grafts in a rat model of Huntington's disease: time course comparison of MRI and histology

Survival and integration into the host brain of grafted tissue are crucial factors in neurotransplantation approaches. The present study explored the feasibility of using a clinical MR scanner to study striatal graft development in a rat model of Huntington's disease. Rat fetal lateral ganglionic eminences grown as free-floating roller-tube cultures were grafted into the quinolinic acid-lesioned striatum, and T1- and T2-weighted sequences were acquired at 2, 7, 21, and 99 days posttransplantation. MR images were then compared with images of corresponding histological sections. The lesion-induced striatal degeneration caused a progressive ventricle enlargement, which was significantly different from controls at 21 days posttransplantation. Seven days posttransplantation, T1-weighted images revealed a defined liquid-isointense signal surrounded by a hyperintense rim at the site of graft placement, which was found unaltered for the first 21 days posttransplantation, whereas a hypointense graft signal was detected at 99 days posttransplantation. At 2 days posttransplantation, T2-weighted images showed the graft region as a hyperintense area surrounded by a rim of low signal intensity but at later time-points graft location could not be further verified. Measures for graft size and ventricle size obtained from MR images highly correlated with measures obtained from histologically processed sections (R = 0.8, P < 0.001). In conclusion, the present study shows that fetal rat lateral ganglionic eminences grown as free-floating roller-tube cultures can be successfully grafted in a rat Huntington model and that a clinical MR scanner offers a useful noninvasive tool for studying striatal graft development.

Simultaneous assessment of cerebral hemodynamics and contrast agent uptake in lesions with disrupted blood-brain-barrier

The purpose of this study was to develop a method that eliminates the influence of the T1 relaxation time upon the signal-time course in perfusion-weighted imaging of cerebral lesions with blood-brain-barrier (BBB) disruption. On a 1.5 T whole body clinical magnetic resonance (MR) imager, we implemented a dual-echo RF-spoiled FLASH sequence (TE=6/23.6 ms). We developed a postprocessing routine that allowed to calculate a signal-time course representing only the change in T2* and another one representing only the change in T1. Using this method, we examined 7 patients with various brain lesions showing evidence of BBB disruption. In the signal-time-curves obtained from the early echo we found a distinct signal drop due to the T2* effect. These effects could be eliminated by the correction algorithm yielding a 67% higher signal increase. Correction of the signal-time curve of the late echo yielded a more pronounced maximum signal drop and a decrease in postcontrast signal intensity. We found that without this correction the relative regional cerebral blood volume and the first moment of the concentration-time curve were underestimated by 72% and 22%, respectively. The dual echo-sequence combined with the postprocessing algorithm separates T1 and T2* effects and thus allows to assess cerebral hemodynamics and contrast agent kinetics simultaneously. This method may be a useful tool for characterizing, staging, and therapy monitoring of brain tumors.

Temporal sampling requirements for the tracer kinetics modeling of breast disease

The physiological parameters measured in the tracer kinetics modeling of data from a dynamic contrast-enhanced magnetic resonance (MR) breast exam (blood flow-extraction fraction product [FE], volume of the extracellular extravascular space [Ve], and blood volume [Vb]) may enable non-invasive diagnosis of breast cancer. One of the factors that compromises the accuracy and precision of the parameter estimates, and therefore their diagnostic potential, is the temporal resolution of the MR scans used to measure contrast agent (gadolinium-diethylenetriamine pentaacetic acid [Gd-DTPA]) concentration in an artery (arterial input function [AIF]) and in the tissue (tissue residue function [TRF]). Using computer simulations, we have examined, for several AIF widths, the errors introduced into estimates of tracer kinetic parameters in breast tissue due to insufficient temporal sampling. Temporal sampling errors can be viewed as uncertainties and biases in the parameter estimates introduced by the uncertainty in the relative alignments of the AIF, TRF, and sampling grid. These effects arise from the model's inherent sensitivity to error in either the AIF or TRF, which is dependent on the values of the tracer kinetic parameters and increases with AIF width. Based on the results of the simulations, to ensure that the error in FE and Ve will be under 10% of their true values, we recommend a rapid bolus injection of contrast agent (approximately 10 s), that the AIF be sampled every second, and that the TRF be sampled every 16 s or less. An accurate measurement of Vb requires that the TRF be sampled at least every 4 s. The results of these investigations can be used to set minimum dynamic imaging rates for tracer kinetics modeling of the breast.

Measurement of tumor vascular volume and mean microvascular random flow velocity magnitude by dynamic Gd-DTPA-albumin enhanced and diffusion-weighted MRI

Tumor vascular volume fraction and the magnitude of the mean microvascular random flow velocity were measured in an animal tumor model by combining dynamic Gd-DTPA-albumin enhanced MRI and diffusion-weighted MRI in conjunction with a compartmental modeling analysis. The vascular volume fraction maps were obtained from the dynamic Gd-DTPA-albumin enhanced MRI measurement. It was found that the vascular volume fraction for Walker 256 tumor was higher within the outgrowing rim and decreased towards the central region. The average value obtained from five animals was 0.062 +/- 0.009 ml/g. By using the vascular volume fraction from the Gd-DTPA-albumin enhanced MRI measurement, maps of the magnitude of the mean microvascular random flow velocity were obtained from the diffusion-weighted MRI measurements with the compartmental modeling analysis. The relative extravascular and intravascular contributions to the diffusion-weighted MRI signal were determined for three tissue groups with different Gd-DTPA-albumin enhancement characteristics, and the flow and molecular diffusion-induced attenuation factors for the intravascular compartment were also compared. The mean microvascular random flow velocity magnitude maps were obtained with an average value of 0.67 +/- 0.06 mm/s.

Dynamic contrast-enhanced imaging and analysis at high spatial resolution of MCF7 human breast tumors

High resolution, dynamic GdDTPA-enhanced images of MCF7 human breast tumors in immunodeficient mice were analyzed at pixel resolution. The analysis, based on a physiological model, was performed by applying a nonlinear least-square algorithm using a color coded scale. The final output mapped at pixel resolution capillary permeability times surface area and fraction of extracellular volume, for each tumor slice. In addition, the output included assessment of the fit to the model by determining the proportion of variability (R2) for each pixel. The spatial variation in the R2 values served to identify regions where the predominant mechanism of enhancement was leakage from the intravascular volume to the extracellular volume (R2 close to 1). In regions with low R2 other mechanisms of enhancement appear to be dominating presumably diffusion within the extracellular space. As expected, in necrotic regions lacking microcapillaries and identified by analyzing T2-weighted images of the same tumors, the model failed to fit the dynamic contrast enhanced data. The heterogeneous distribution of the determined pathophysiological features demonstrates the importance of recording and analyzing breast tumor images at high spatial resolution.

Magnetic resonance imaging observations of blood-brain-barrier permeability in an animal model of brain injury

RATIONALE AND OBJECTIVES

Knowledge of the in vivo relaxivity of paramagnetic contrast agents is important in the accurate measurement of the permeability of the blood-brain barrier (BBB). This study was aimed at developing an animal model for the magnetic resonance (MR) imaging investigation of injuries to the BBB.

METHODS

MR imaging (1.9 T) was performed in 18 rats with acute, stable injuries to the brain caused by freezing. After injection of gadodiamide (0.05-0.20 mmol/kg), estimates were made of BBB permeability, leakage space, and relaxivity (also measured in saline).

RESULTS

The BBB was always disrupted at the injured site (permeability = 0.038 min-1 +/- 0.0006). The central area of necrosis and the periphery of edema showed substantial differences in leakage space and relaxivity. The relaxivity of gadodiamide was much greater at the injured site than in saline.

CONCLUSION

The in vivo relaxivity at a site of pathologic change in the brain may be substantially greater than that measured in aquo.

Modeling tracer kinetics in dynamic Gd-DTPA MR imaging

Three major models (from Tofts, Larsson, and Brix) for collecting and analyzing dynamic MRI gadolinium-diethylene-triamine penta-acetic acid (Gd-DTPA) data are examined. All models use compartments representing the blood plasma and the abnormal extravascular extracellular space (EES), and they are intercompatible. All measure combinations of three parameters; (1) kPSp is the influx volume transfer constant (min-1), or permeability surface area product per unit volume of tissue, between plasma and EES; (2) ve is the volume of EES space per unit volume of tissue (0 < ve < 1); and (3) K(ep), the efflux rate constant (min-1), is the ratio of the first two parameters (k(ep) = kPSp/ve). The ratio K(ep) is the simplest to measure, requiring only signal linearity with Gd tracer concentration or, alternatively, a measurement of T1 before injection of Gd (T10). To measure the physiologic parameters kPSp and ve separately requires knowledge of T10 and of the tissue relaxivity R1 (approximately in vitro value).

Gd-enhanced MR imaging of brain metastases: contrast as a function of dose and lesion size

MR imaging contrast of brain metastases after cumulative doses of gadolinium chelate is quantitated and compared in order to assess the clinical utility of high dosage. T1-weighted spin-echo MR images of 39 patients with metastatic brain tumors were made before and after each of three equal doses cumulating to 0.1, 0.2 and 0.3 mmol Gd-complex per kg body weight. Quantitation of MRI contrast was limited to homogeneous brain metastases larger than 3 mm (n = 246). Post-Gd MRI contrast doubled with dose escalation from 0.1 to 0.3 mmol/kg and also increased with lesion size, by a factor of 2.5 between metastases of 3 and 16 mm diameter, that is after correcting for partial volume effect. At 0.2 and 0.3 mmol/kg the respective numbers of visible metastases increased by 15% and 43% compared with 0.1 mmol/kg (p < 0.0001, both). Image contrast figures differed significantly between doses (p = 0.018). Both the number of metastases and the image contrast is significantly higher when dose escalation is performed. It is indicated that the number of detected metastases will increase further at Gd doses beyond 0.3 mmol/kg. Post-Gd MRI contrast increases with lesion size, to an extent that can not be attributed to partial volume attenuation.

Regional comparison of tumor vascularity and permeability parameters measured by albumin-Gd-DTPA and Gd-DTPA

Sequential albumin-Gd-DTPA and Gd-DTPA dynamic enhancement studies were performed in an animal tumor model for the comparison of regional vascularity and permeability parameters measured by these two different sizes of contrast agents. The early albumin-Gd-DTPA enhancement arises from the vascular compartment, and the averaged signal enhancement derived from the first 3 to first 6 images postinjection can be reliably used to assess vascularity. The signal intensity in the images during the period of 5-10 min post-albumin-Gd-DTPA injection shows a steady linear variation. The intercept of the linear relationship is another indicator of the vascularity and the slope represents the tumor permeability to albumin-Gd-DTPA. The Gd-DTPA enhancement study was analyzed by a two-compartmental pharmacokinetic model to calculate the regional vascularity and permeability. The permeability parameters measured from albumin-Gd-DTPA and Gd-DTPA show an excellent correlation. The vascularity parameters measured from albumin-Gd-DTPA show good linear correlation with the low vascularity groups measured by Gd-DTPA, but show saturation for the high vascularity groups. The enhancement mechanisms for both contrast agents are discussed to relate the imaging parameters to the physiological variables.

Effect of rapid correction of hyponatremia on the blood-brain barrier of rats

Brain demyelination sometimes follows rapid correction of hyponatremia, especially if the hyponatremia is chronic. During correction brain water decreases and the brain shrinks. The present study examined whether such shrinkage might be sufficient to disrupt the tight junctions of the blood-brain barrier. Barrier intactness was evaluated using magnetic resonance imaging and intravenous gadolinium contrast administration. Hypertonic saline infusion rapidly increased the plasma sodium concentration and caused barrier disruption more frequently in chronic than in acute hyponatremic rats. Similar increases in plasma sodium concentration did not disrupt the barrier in normonatremic rats. The disruption appeared to be due to altered plasma osmolality since infusion of hypertonic mannitol, which raised plasma osmolality without changing the plasma sodium concentration, disrupted the barrier in hyponatremic but not normonatremic rats. Moreover, the osmotic threshold for barrier disruption was lowest in chronic hyponatremia, intermediate in acute hyponatremia, and highest in normonatremia. The greater susceptibility to osmotic disruption in chronic hyponatremia suggests that blood-brain barrier disruption may play a significant role in causing the demyelination sometimes found following too rapid correction of hyponatremia, possibly through exposure of oligodendrocytes to plasma macromolecules such as complement.

Assessment of myocardial perfusion using contrast-enhanced MR imaging: current status and future developments

Excellent inherent tissue contrast is one of the great promises of clinical magnetic resonance (MR) imaging, but functional information is relatively limited. However, MR imaging complemented by the administration of contrast agents can provide such functional assessment. The perfusion status of the myocardium is one of the most important functional information in cardiovascular imaging. Because the clinical acceptance of a contrast agent is measured by its ability to improve patient outcome and to guide therapy, it is unlikely that detection of myocardial infarction, the final stage of ischemic heart disease, should be the target for contrast media development. It would obviously be better if occult regional myocardial perfusion deficits could be reliably detected. The current article was prepared to help the clinical radiologist to keep pace with new strategies for myocardial enhancement and their potential clinical applicability for detection of early perfusion deficits. Several techniques for noninvasive measurement of myocardial perfusion are currently evolving which have the potential to be introduced into routine MR imaging. Most investigators favor a first-pass analysis of the contrast agent bolus through the myocardium using ultrafast sequences. However, such a technique may require clinical introduction of a blood pool agent. There are good reasons to favor T1-weighted sequences over susceptibility imaging in such first-pass studies. In the future, assessment of myocardial perfusion status using contrast-enhanced MR imaging may be done producing perfusion maps with high spatial resolution (e.g., 256 x 128), with sequences available on most scanners without special hardware requirements (e.g., IR-Turboflash, keyhole imaging), and requiring only a short period of time for examination (approximately 3 min).

Invited review: biophysical properties and clinical applications of magnetic resonance imaging contrast agents

Contrast enhanced magnetic resonance imaging (MRI) is a very versatile and effective technique for detecting and characterizing lesions, for identifying a variety of patho-physiological abnormalities, and for providing perfusion and functional information. The application of contrast enhanced MRI to many clinical and research indications has emerged because of the rapid evolution in imaging techniques, improved methodology, and the development of efficient and specific contrast agents. Problems related to optimizing parameters and dosage have been due to complex interplay of relaxation times, biophysical mechanisms and acquisition parameters. A knowledge of basic biophysical aspects is therefore essential for a full understanding of the results obtained for different organs under different conditions, and for optimizing the image parameters and dosage of contrast agents. This article underlines the biophysical basis of the effects of contrast agents in MRI, identifies the problems involved in optimizing the parameters for maximum efficiency, and presents a general overview of the clinical studies and research applications in the central nervous system, perfusion abnormalities, hepatobiliary system, musculoskeletal system and the gastrointestinal tract. The section on perfusion studies includes a discussion of quantitative analysis and kinetic models describing the effects of contrast agents. Finally, a critical evaluation of the scope and limitations of contrast enhanced MRI is presented.

Measurement of vascular volume fraction and blood-tissue permeability constants with a pharmacokinetic model: studies in rat muscle tumors with dynamic Gd-DTPA enhanced MRI

We propose a compartmental model to explain the signal enhancement curves following the bolus injection of Gd-DTPA. The model incorporates vascular volume fraction contribution, and the possibility of having different transport constants between the plasma and extravascular components. A Walker 256 carcinoma grown in rat muscle was used to demonstrate the capability of this model. Several different types of tissues were included in the measurements: normal, quickly enhanced, slowly enhanced, and necrotic tissues. Blood volume and blood-tissue permeability information can be derived from the dynamic contrast-enhanced MRI study employing the proposed model. In the tissue contrast enhancement curve, the initial rising slope after injection is related to the blood volume (or, vascular volume fraction), the maximum enhancement ratio is related to the uptake of tissue, and the decay rate is related to the clearance of tracer from tissue. The measured permeability constant is not the conventional permeability; instead they are contrast agents uptake and clearance rates, which are limited by the blood perfusion. These parameters can be used to characterize different enhancement patterns.

Discrete signal processing of dynamic contrast-enhanced MR imaging: statistical validation and preliminary clinical application

A high-resolution image-based method was developed to analyze dynamic contrast agent-enhanced magnetic resonance images quantitatively. This method determines the initial rate of contrast agent accumulation, the delayed rate of accumulation, and the maximum enhancement in each pixel. These three parameters allow characterization of the dynamic signal features. Simulated noisy test sets of dynamic enhancement curves have shown this method to yield a fast and accurate characterization of the dynamic signal. Clinical examples of both qualitative image parameter maps and quantitative statistical analysis of the parameter distributions demonstrated the quality and potential of the technique. The technique is designed to yield imaging and quantitative information on contrast agent accumulation that can be useful in detecting residual tumor and evaluating response to therapy, while requiring less than 7 minutes of imaging time and 5 minutes of processing time per study.

Early identification of sites of embryo implantation in rats by means of gadolinium-enhanced MR imaging

To determine if magnetic resonance (MR) imaging techniques can be used to examine sites of embryo implantation in intact rats, pregnant animals were imaged with gadopentetate dimeglumine-enhanced MR imaging approximately 10 hours after initiation of implantation on day 5 of pregnancy. T1-weighted, three-dimensional SPGR (spoiled gradient-recalled acquisition in the steady state) sequences were used to image the volume of abdomen containing the uterine horns before and after injection of gadopentetate dimeglumine into a femoral venous catheter. While unenhanced images provided little detail in uterine tissue, analysis of the gadolinium-enhanced abdominal images with interactive vascular imaging allowed easy identification of sites of embryo implantation along both uterine horns in four of four pregnant rats. These punctate patterns of enhancement match those of macroscopic bluing after injection of Evans blue dye. Similar gadolinium-enhanced MR imaging of nonpregnant rats produced only a slight, generalized enhancement of entire uterine horns. The authors conclude that local increases in extracellular fluid volume, vascular permeability, and blood flow in the uterus may all contribute to the gadolinium enhancement of the implantation sites. They propose that this approach can be used in experimental settings to provide information regarding embryo implantation unaccessible with traditional approaches. In clinical settings, gadolinium-enhanced MR imaging may be used to examine potential causes of infertility, including luteal phase defects.

Measurement of capillary permeability from the Gd enhancement curve: a comparison of bolus and constant infusion injection methods

Dynamic imaging of Gd-DTPA uptake has been used by several groups to characterise the permeability of blood-brain barrier and blood-retina barrier lesions, using both bolus and constant infusion rate injections. However, no consensus on which injection protocol is most efficient has been reached. To address this problem, we extend our Simplified Early Enhancement (SEE) theory, applicable to retinal lesions, to cover infusion injections, and demonstrate its application to published data. The two injection methods are compared using computer simulation. We find that, first, an infusion cannot produce a constant plasma concentration in an acceptable time (although a hybrid injection, consisting of a combined bolus and infusion, is able to do this). Second, at any given time after the start of injection, a bolus achieves a higher tissue concentration, and hence enhancement, than does the same dose given as an infusion. Conversely, a bolus achieves any given tissue concentration in a shorter time than the same dose given as an infusion. Consequently, a bolus uses a smaller dose to achieve a given enhancement at a particular time. Third, if renal function is reduced, the error in calculating the permeability from a particular value of enhancement is lower for the bolus than for the infusion. And last, the SEE method is more accurate for a bolus than for an infusion. We conclude that a bolus is always more efficient than an infusion, as well as being easier to administer, and should always be used in preference to an infusion.

Technical improvements in the staging of cancer: the role of imaging and contrast agents

Despite advances in cancer diagnosis, there has been little impact upon outcome. This may be a consequence of the exceptional heterogeneity in cancers, especially their cell types, perfusion, oxygenation, and metabolic circumstances. Better therapeutic plans could require better characterization of individual tumors in individual patients. For some tumors, tissue characterization by sophisticated histologic analysis of biopsy samples may improve staging. However, noninvasive staging is more acceptable to patients and may be more comfortably repeated in the course of monitoring therapeutic regimens. Several imaging applications may serve these goals. First, new contrast agents may allow accurate cancer detection in regional lymph nodes. High resolution CT with perfluorocarbon lymphography is in the clinical trial stage. This could presage minimally invasive ablation of cancer in lymph nodes, as well. Second, new agents will better define local and metastatic cancers, also impacting standard and minimally invasive treatments. Finally, imaging methods may be able to measure perfusion and metabolism in small volumes in vivo, as well as estimate important local pharmacokinetics of therapeutics.

A rapid interleaved method for measuring signal intensity curves in both blood and tissue during contrast agent administration

A method has been developed that uses dynamic MR imaging to measure simultaneously the changes in signal intensity due to paramagnetic contrast agent in blood and tissue, using interleaved single-angle projection and imaging sequences. The basic projection/image sequence has a projection time resolution of 50 ms and can measure rapid changes in the blood signal intensity. Variants with a tissue suppression slab have time resolutions of 57 or 75 ms. Orientation of the projection and image planes can be defined independently. This technique will facilitate functional measurements using MR contrast agents, allowing the blood input function to be determined with excellent time resolution.

Diffusion into rat brain of contrast and shift reagents for magnetic resonance imaging and spectroscopy

A sensitive radiotracer technique was used to measure transfer constants (Kis) for blood to brain diffusion of the MR contrast reagent gadolinium diethylenetriaminepentaacetate (GdDTPA2-) and the MR shift reagent dysprosium triethylenetetraminehexaacetate (DyTTHA3-) across the normal and the ischemically injured blood-brain barrier (BBB) of rats. In rats with a normal BBB mean Kis (nL/g/s) for these reagents ranged from 0.3 to 1.4 across eight brain regions and were significantly lower in each region than Kis for sucrose (1.5-3.2), a substance known to be a poor permeant of the intact BBB. Kis measured 6 h after a 10 min period of normothermic forebrain ischemia were increased to 4.0-6.2 (reagents) and 6.6-7.5 (sucrose) in two brain regions, striatum and hippocampus, known to be especially vulnerable to ischemic injury. Measurements of BBB permeability to DyTTHA3- after osmotic opening of the barrier with hypertonic arabinose gave Kis of 25-30 in forebrain regions. Estimates of reagent concentrations in brain interstitial fluid 30 min after dosing the animals indicated that both an extremely high dose of DyTTHA3- and severe disruption of the BBB would be required to shift the resonance frequency of extracellular Na+ appreciably. With the moderate degrees of BBB injury produced by short-term ischemia, a dose of GdDTPA2- about 25 times the usual clinical dose of 0.1 mmol/kg would be required to quantify the injury by dynamic MRI.

Measurement of capillary permeability to macromolecules by dynamic magnetic resonance imaging: a quantitative noninvasive technique

A simple, linear kinetic model has been developed for the noninvasive assessment of capillary permeability to macromolecules in the rat by dynamic magnetic resonance imaging using albumin-Gd-DTPA. Data required by the model are signal intensity responses from a target tissue and a venous structure such as inferior vena cava before and after bolus intravenous injection of albumin-Gd-DTPA. Additional requirements include an early temporal resolution of approximately one image/min and a blood sample for hematocrit. The model does not require measurement of albumin-Gd-DTPA concentration in either arterial or venous blood. Pilot experiments suggest that this technique is adequate for estimation of the fractional leak rate of macromolecules from plasma to interstitial water as well as tissue plasma volume, the product of which yields a measure of the permeability surface area product of the tissue if the extraction fraction is modest (< 0.2). The technique may be generally applicable to the study of abnormal capillary permeability in humans as well as animals.