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Cao K, Yuan W, Hou C, Wang Z, Yu J, Wang T. Hypoxic Signaling Pathways in Carotid Body Tumors. Cancers (Basel) 2024; 16:584. [PMID: 38339335 PMCID: PMC10854715 DOI: 10.3390/cancers16030584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/06/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Carotid body tumors (CBTs) are rare tumors with a 1-2 incidence per 100,000 individuals. CBTs may initially present without apparent symptoms, and symptoms begin to arise since tumors grow bigger to compress surrounding tissue, such as recurrent laryngeal nerve and esophagus. Also, the etiology of CBTs remains unclear since it is more likely to occur in those who live in high-altitude areas or suffer from chronic hypoxic diseases such as COPD. SDH mutations and familial inheritance have been reported to be related to CBTs. SDH complexes play crucial roles in aerobic respiration, and SDH mutations in CBTs have been reported to be associated with hypoxia. Hypoxic signaling pathways, specifically hypoxic markers, have attracted more research attention in tumor exploration. However, the existing literature on these signaling and markers lacks a systematic review. Also, therapeutic approaches in CBTs based on hypoxic signaling are rarely used in clinics. In this review, we concluded the role of hypoxic signaling and markers and their potential implications in the initiation and progression of CBTs. Our findings underscore the involvement of the SDH family, the HIF family, VEGFs, and inflammatory cytokines (ICs) in tumorigenesis and treatment. Of particular interest is the role played by SDHx, which has recently been linked to oxygen sensing through mutations leading to hereditary CBTs. Among the SDH family, SDHB and SDHD exhibit remarkable characteristics associated with metastasis and multiple tumors. Besides SDH mutations in CBTs, the HIF family also plays crucial roles in CBTs via hypoxic signaling pathways. The HIF family regulates angiogenesis during mammalian development and tumor growth by gene expression in CBTs. HIF1α could induce the transcription of pyruvate dehydrogenase kinase 1 (PDK1) to inhibit pyruvate dehydrogenase kinase (PDH) by inhibiting the TCA cycle. Then, carotid body cells begin to hyperplasia and hypertrophy. At the same time, EPAS1 mutation, an activating mutation, could decrease the degradation of HIF2α and result in Pacak-Zhuang syndrome, which could result in paraganglioma. HIFs can also activate VEGF expression, and VEGFs act on Flk-1 to control the hyperplasia of type I cells and promote neovascularization. ICs also play a pivotal signaling role within the CB, as their expression is induced under hypoxic conditions to stimulate CB hyperplasia, ultimately leading to CBTs detecting hypoxic areas in tumors, and improving the hypoxic condition could enhance photon radiotherapy efficacy. Moreover, this review offers valuable insights for future research directions on understanding the relationship between hypoxic signaling pathways and CBTs.
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Affiliation(s)
| | | | | | | | | | - Tao Wang
- Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China; (K.C.); (W.Y.); (C.H.); (Z.W.); (J.Y.)
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Lu X, Wang X, Gao S, Chen Z, Bai R, Wang Y. Bioparameter-directed nanoformulations as MRI CAs enable the specific visualization of hypoxic tumour. Analyst 2023; 148:4967-4981. [PMID: 37724375 DOI: 10.1039/d3an00972f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
A malignant tumour has hypoxic cells of varying degrees. The more severe the hypoxic degree, the more difficult the prognosis of the tumour and the higher the recurrence rate. Therefore, tumour hypoxia imaging is crucial. Magnetic resonance imaging (MRI) shows its strength in high resolution, depth of penetration and noninvasiveness. However, it needs more excellent contrast agents (CAs) to combat the complex tumour microenvironment (TME) and increased targeting of tumours to enhance clinical safety. Many research studies have focused on developing hypoxia-responsive MRI CAs that take advantage of the unique characteristics of hypoxic tumours. The low oxygen pressure, acidic TME, and up-regulated redox molecule levels found in hypoxic tumours serve as biological stimuli for nanoformulations that can accurately image the hypoxic region. This review highlights the importance of developing bioparameter-directed nanoformulations as MRI CAs for accurate tumour diagnosis. The design strategies and mechanisms of tumour-hypoxia imaging with nanoformulations are exemplified, with a focus on pH-responsiveness, redox-responsiveness, and p(O2)-responsiveness. The promising future of bioparameter-responsive nanoformulations for accurate tumour diagnosis and personalised cancer treatment is discussed.
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Affiliation(s)
- Xinyi Lu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
| | - Xin Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
| | - Susu Gao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
| | - Ziwei Chen
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
| | - Ru Bai
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
| | - Yaling Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, P. R. China.
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3
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Moroney J, Trivella J, George B, White SB. A Paradigm Shift in Primary Liver Cancer Therapy Utilizing Genomics, Molecular Biomarkers, and Artificial Intelligence. Cancers (Basel) 2023; 15:2791. [PMID: 37345129 DOI: 10.3390/cancers15102791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
Primary liver cancer is the sixth most common cancer worldwide and the third leading cause of cancer-related death. Conventional therapies offer limited survival benefit despite improvements in locoregional liver-directed therapies, which highlights the underlying complexity of liver cancers. This review explores the latest research in primary liver cancer therapies, focusing on developments in genomics, molecular biomarkers, and artificial intelligence. Attention is also given to ongoing research and future directions of immunotherapy and locoregional therapies of primary liver cancers.
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Affiliation(s)
- James Moroney
- Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Juan Trivella
- Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Ben George
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Sarah B White
- Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Abstract
Malignant tumors rank as a leading cause of death worldwide. Accurate diagnosis and advanced treatment options are crucial to win battle against tumors. In recent years, Cherenkov luminescence (CL) has shown its technical advantages and clinical transformation potential in many important fields, particularly in tumor diagnosis and treatment, such as tumor detection in vivo, surgical navigation, radiotherapy, photodynamic therapy, and the evaluation of therapeutic effect. In this review, we summarize the advances in CL for tumor diagnosis and treatment. We first describe the physical principles of CL and discuss the imaging techniques used in tumor diagnosis, including CL imaging, CL endoscope, and CL tomography. Then we present a broad overview of the current status of surgical resection, radiotherapy, photodynamic therapy, and tumor microenvironment monitoring using CL. Finally, we shed light on the challenges and possible solutions for tumor diagnosis and therapy using CL.
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Ni J, Xu H, Zhong Y, Zhou Y, Hu S. Activatable UCL/CT/MR-enhanced in vivo imaging-guided radiotherapy and photothermal therapy. J Mater Chem B 2022; 10:549-561. [PMID: 34985095 DOI: 10.1039/d1tb02006d] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although sophisticated radiotherapy (RT) technology has been widely applied in clinical oncotherapy, unsatisfactory therapeutic effects due to hypoxic tumor microenvironments and complications are still prevalent. Herein, copper sulphide nanoparticles (CuS NPs) wrapped on the surface of upconversion nanoparticles (UCNPs) via manganese dioxide (MnO2) coatings were synthesized for O2 self-supplementing and enhanced combinational RT/photothermal therapy (PTT). In our design, the nanoplatforms can be rapidly enriched at tumor sites by the enhanced permeability and retention (EPR) effect and respond to the tumor microenvironment. The surface MnO2 coatings can interact with over-expressed H2O2 in tumors and cause an abundant generation of oxygen for hypoxic improvement, leading to an enhanced RT. More importantly, by irradiation with near-infrared light, the scattered CuS NPs can convert light energy into heat to destroy tumor cells and reinforce the therapeutic effects of RT. Furthermore, these NPs also displayed excellent performances in upconversion fluorescence imaging (UCL), computerized tomographic (CT) scanning and magnetic resonance imaging (MRI), demonstrating a potential imaging-guided cancer therapy system.
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Affiliation(s)
- Jianming Ni
- Radiology Department, Affiliated Wuxi No. 2 People's Hospital, Nanjing Medical University, Wuxi, 214002, China
| | - Huiting Xu
- Radiology Department, Affiliated Wuxi No. 2 People's Hospital, Nanjing Medical University, Wuxi, 214002, China
| | - Yanqi Zhong
- Radiology Department, Affiliated Hospital, Jiangnan University, Wuxi, 214122, China.
| | - Yongping Zhou
- Hepatobiliary surgery Department, Affiliated Wuxi No. 2 People's Hospital, Nanjing Medical University, Wuxi, 214002, China.
| | - Shudong Hu
- Radiology Department, Affiliated Hospital, Jiangnan University, Wuxi, 214122, China.
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Gordon AC, White SB, Gates VL, Procissi D, Harris KR, Yang Y, Zhang Z, Li W, Lyu T, Huang X, Omary RA, Salem R, Lewandowski RJ, Larson AC. Yttrium-90 Radioembolization and Tumor Hypoxia: Gas-challenge BOLD Imaging in the VX2 Rabbit Model of Hepatocellular Carcinoma. Acad Radiol 2021; 28:849-858. [PMID: 32522403 PMCID: PMC7719607 DOI: 10.1016/j.acra.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 01/05/2023]
Abstract
RATIONALE AND OBJECTIVES To use a rapid gas-challenge blood oxygen-level dependent magnetic resonance imaging exam to evaluate changes in tumor hypoxia after 90Y radioembolization (Y90) in the VX2 rabbit model. MATERIALS AND METHODS White New Zealand rabbits (n = 11) provided a Y90 group (n = 6 rabbits) and untreated control group (n = 5 rabbits). R2* maps were generated with gas-challenges (O2/room air) at baseline, 1 week, and 2 weeks post-Y90. Laboratory toxicity was evaluated at baseline, 24 hours, 72 hours, 1 hours, and 2 weeks. Histology was used to evaluate tumor necrosis on hematoxylin and eosin and immunofluorescence imaging was used to assess microvessel density (CD31) and proliferative index (Ki67). RESULTS At baseline, median tumor volumes and time to imaging were similar between groups (p = 1.000 and p = 0.4512, respectively). The median administered dose was 50.4 Gy (95% confidence interval:44.8-55.9). At week 2, mean tumor volumes were 5769.8 versus 643.7 mm3 for control versus Y90 rabbits, respectively (p = 0.0246). At two weeks, ΔR2* increased for control tumors to 12.37 ± 12.36sec-1 and decreased to 4.48 ± 9.00sec-1 after Y90. The Pearson correlation coefficient for ΔR2* at baseline and percent increase in tumor size by two weeks was 0.798 for the Y90 group (p = 0.002). There was no difference in mean microvessel density for control versus Y90 treated tumors (p = 0.6682). The mean proliferative index was reduced in Y90 treated tumors at 30.5% versus 47.5% for controls (p = 0.0071). CONCLUSION The baseline ΔR2* of tumors prior to Y90 may be a predictive imaging biomarker of tumor response and treatment of these tumors with Y90 may influence tumor oxygenation over time.
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Affiliation(s)
- Andrew C Gordon
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Biomedical Engineering, Northwestern University, Evanston, Illinois.
| | - Sarah B White
- Department of Radiology, Division of Vascular & Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Vanessa L Gates
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Procissi
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kathleen R Harris
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Yihe Yang
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Zhuoli Zhang
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Weiguo Li
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tianchu Lyu
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Xiaoke Huang
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Reed A Omary
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Riad Salem
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medicine-Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery-Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Robert J Lewandowski
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Andrew C Larson
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
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Cao X, Gunn JR, Allu SR, Bruza P, Jiang S, Vinogradov SA, Pogue BW. Implantable sensor for local Cherenkov-excited luminescence imaging of tumor pO2 during radiotherapy. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200229SSR. [PMID: 33236619 PMCID: PMC7685386 DOI: 10.1117/1.jbo.25.11.112704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/04/2020] [Indexed: 05/16/2023]
Abstract
SIGNIFICANCE The necessity to use exogenous probes for optical oxygen measurements in radiotherapy poses challenges for clinical applications. Options for implantable probe biotechnology need to be improved to alleviate toxicity concerns in human use and facilitate translation to clinical trial use. AIM To develop an implantable oxygen sensor containing a phosphorescent oxygen probe such that the overall administered dose of the probe would be below the Federal Drug Administration (FDA)-prescribed microdose level, and the sensor would provide local high-intensity signal for longitudinal measurements of tissue pO2. APPROACH PtG4, an oxygen quenched dendritic molecule, was mixed into an agarose matrix at 100 μM concentration, allowing for local injection into tumors at the total dose of 10 nmol per animal, forming a gel at the site of injection. Cherenkov-excited luminescence imaging (CELI) was used to acquire the phosphorescence and provide intratumoral pO2. RESULTS Although PtG4 does not form covalent bonds with agarose and gradually leaches out into the surrounding tissue, its retention time within the gel was sufficiently long to demonstrate the capability to measure intratumoral pO2 with the implantable gel sensors. The sensor's performance was first evaluated in vitro in tissue simulation phantoms, and then the sensor was used to measure changes in oxygen in MDA-MB-231 tumors during hypofractionated radiotherapy. CONCLUSIONS Our study demonstrates that implantable oxygen sensors in combination with CELI present a promising approach for quantifying oxygen changes during the course of radiation therapy and thus for evaluating the tumor response to radiation. By improving the design of the gel-probe composition in order to prevent leaching of the probe into the tissue, biosensors can be created that should allow longitudinal oxygen measurements in tumors by means of CELI while using FDA-compliant microdose levels of the probe and thus lowering toxicity concerns.
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Affiliation(s)
- Xu Cao
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Ministry of Education, Xidian University, Engineering Research Center of Molecular and Neuroimaging, School of Life Science and Technology, Xi’an, Shaanxi, China
- Address all correspondence to Xu Cao, ; Brian W. Pogue,
| | - Jason R. Gunn
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Srinivasa Rao Allu
- University of Pennsylvania, Perelman School of Medicine, Department of Biochemistry and Biophysics, Philadelphia, Pennsylvania, United States
- University of Pennsylvania, School or Arts and Sciences, Department of Chemistry, Philadelphia, Pennsylvania, United States
| | - Petr Bruza
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Shudong Jiang
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
| | - Sergei A. Vinogradov
- University of Pennsylvania, Perelman School of Medicine, Department of Biochemistry and Biophysics, Philadelphia, Pennsylvania, United States
- University of Pennsylvania, School or Arts and Sciences, Department of Chemistry, Philadelphia, Pennsylvania, United States
| | - Brian W. Pogue
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
- Address all correspondence to Xu Cao, ; Brian W. Pogue,
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8
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Cao X, Allu SR, Jiang S, Gunn Bs JR, Yao PhD C, Xin PhD J, Bruza PhD P, Gladstone ScD DJ, Jarvis Md PhD LA, Tian PhD J, Swartz Md Msph PhD HM, Vinogradov PhD SA, Pogue PhD BW. High-Resolution pO 2 Imaging Improves Quantification of the Hypoxic Fraction in Tumors During Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 109:603-613. [PMID: 33002542 DOI: 10.1016/j.ijrobp.2020.09.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE The extreme microscopic heterogeneity of tumors makes it difficult to characterize tumor hypoxia. We evaluated how changes in the spatial resolution of oxygen imaging could alter measures of tumor hypoxia and their correlation to radiation therapy response. METHODS AND MATERIALS Cherenkov-Excited Luminescence Imaging in combination with an oxygen probe, Oxyphor PtG4 was used to directly image tumor pO2 distributions with 0.2 mm spatial resolution at the time of radiation delivery. These pO2 images were analyzed with variations of reduced spatial resolution from 0.2 mm to 5 mm, to investigate the influence of how reduced imaging spatial resolution would affect the observed tumor hypoxia. As an in vivo validation test, mice bearing tumor xenografts were imaged for hypoxic fraction and median pO2 to examine the predictive link with tumor response to radiation therapy, while accounting for spatial resolution. RESULTS In transitioning from voxel sizes of 200 μm to 3 mm, the median pO2 values increased by a few mm Hg, and the hypoxic fraction decreased by more than 50%. When looking at radiation-responsive tumors, the median pO2 values changed just a few mm Hg as a result of treatment, and the hypoxic fractions changed by as much as 50%. This latter change, however, could only be seen when sampling was performed with high spatial resolution. Median pO2 or similar quantities obtained from low resolution measurements are commonly used in clinical practice, however these parameters are much less sensitive to changes in the tumor microenvironment than the tumor hypoxic fraction obtained from high-resolution oxygen images. CONCLUSIONS This study supports the hypothesis that for adequate measurements of the tumor response to radiation therapy, oxygen imaging with high spatial resolution is required to accurately characterize the hypoxic fraction.
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Affiliation(s)
- Xu Cao
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Xidian University, Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xi'an, Shaanxi, China
| | - Srinivasa Rao Allu
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Chemistry, School or Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shudong Jiang
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Jason R Gunn Bs
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire
| | - Cuiping Yao PhD
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Xi'an Jiaotong University, Institute of Biomedical Analytical Technology and Instrumentation, School of Life Science and Technology, Key Laboratory of Biomedical Information Engineering of Ministry of Education, Xi'an, Shaanxi, China
| | - Jing Xin PhD
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Xi'an Jiaotong University, Institute of Biomedical Analytical Technology and Instrumentation, School of Life Science and Technology, Key Laboratory of Biomedical Information Engineering of Ministry of Education, Xi'an, Shaanxi, China
| | - Petr Bruza PhD
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire
| | - David J Gladstone ScD
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Lesley A Jarvis Md PhD
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Jie Tian PhD
- Xidian University, Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xi'an, Shaanxi, China; CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | | | - Sergei A Vinogradov PhD
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Chemistry, School or Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian W Pogue PhD
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire; Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
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Broglie MA, Dulguerov P, Henke G, Siano M, Putora PM, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Elicin O. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 4 (Biomarkers). Front Oncol 2019; 9:1128. [PMID: 31709188 PMCID: PMC6822019 DOI: 10.3389/fonc.2019.01128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51-74%), moderate (75-84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate, and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
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Affiliation(s)
- Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland.,Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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10
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Pinto SM, Tomé V, Calvete MJ, Castro MMC, Tóth É, Geraldes CF. Metal-based redox-responsive MRI contrast agents. Coord Chem Rev 2019. [DOI: 10.1016/j.ccr.2019.03.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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11
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Chauhan DS, Reddy BPK, Mishra SK, Prasad R, Dhanka M, Vats M, Ravichandran G, Poojari D, Mhatre O, De A, Srivastava R. Comprehensive Evaluation of Degradable and Cost-Effective Plasmonic Nanoshells for Localized Photothermolysis of Cancer Cells. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2019; 35:7805-7815. [PMID: 31090425 DOI: 10.1021/acs.langmuir.8b03460] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Integrating the concept of biodegradation and light-triggered localized therapy in a functional nanoformulation is the current approach in onco-nanomedicine. Morphology control with an enhanced photothermal response, minimal toxicity, and X-ray attenuation of polymer-based nanoparticles is a critical concern for image-guided photothermal therapy. Herein, we describe the simple design of cost-effective and degradable polycaprolactone-based plasmonic nanoshells for the integrated photothermolysis as well as localized imaging of cancer cells. The gold-deposited polycaprolactone-based plasmonic nanoshells (AuPCL NS) are synthesized in a scalable and facile way under ambient conditions. The synthesized nanoshells are monodisperse, fairly stable, and highly inert even at five times (250 μg/mL) the therapeutic concentration in a week-long test. AuPCL NS are capable of delivering standalone photothermal therapy for the complete ablation of cancer cells without using any anticancerous drugs and causing toxicity. It delivers the same therapeutic efficacy to different cancer cell lines, irrespective of their chemorefractory status and also works as a potential computed tomography contrast agent for the integrated imaging-directed photothermal cancer therapy. High biocompatibility, degradability, and promising photothermal efficacy of AuPCL NS are attractive aspects of this report that could open new horizons of localized plasmonic photothermal therapy for healthcare applications.
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Affiliation(s)
- Deepak S Chauhan
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - B Pradeep K Reddy
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Sumit K Mishra
- Molecular Functional Imaging Lab , Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre , Kharghar, Navi Mumbai 410210 , India
| | - Rajendra Prasad
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Mukesh Dhanka
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Mukti Vats
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Gayathri Ravichandran
- Molecular Functional Imaging Lab , Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre , Kharghar, Navi Mumbai 410210 , India
| | - Deeksha Poojari
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Omkar Mhatre
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
| | - Abhijit De
- Molecular Functional Imaging Lab , Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre , Kharghar, Navi Mumbai 410210 , India
| | - Rohit Srivastava
- Department of Biosciences and Bioengineering (BSBE) , Indian Institute of Technology Bombay , Powai, Mumbai 400076 , India
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12
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Brender JR, Kishimoto S, Merkle H, Reed G, Hurd RE, Chen AP, Ardenkjaer-Larsen JH, Munasinghe J, Saito K, Seki T, Oshima N, Yamamoto K, Choyke PL, Mitchell J, Krishna MC. Dynamic Imaging of Glucose and Lactate Metabolism by 13C-MRS without Hyperpolarization. Sci Rep 2019; 9:3410. [PMID: 30833588 PMCID: PMC6399318 DOI: 10.1038/s41598-019-38981-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/11/2018] [Indexed: 02/01/2023] Open
Abstract
Metabolic reprogramming is one of the defining features of cancer and abnormal metabolism is associated with many other pathologies. Molecular imaging techniques capable of detecting such changes have become essential for cancer diagnosis, treatment planning, and surveillance. In particular, 18F-FDG (fluorodeoxyglucose) PET has emerged as an essential imaging modality for cancer because of its unique ability to detect a disturbed molecular pathway through measurements of glucose uptake. However, FDG-PET has limitations that restrict its usefulness in certain situations and the information gained is limited to glucose uptake only.13C magnetic resonance spectroscopy theoretically has certain advantages over FDG-PET, but its inherent low sensitivity has restricted its use mostly to single voxel measurements unless dissolution dynamic nuclear polarization (dDNP) is used to increase the signal, which brings additional complications for clinical use. We show here a new method of imaging glucose metabolism in vivo by MRI chemical shift imaging (CSI) experiments that relies on a simple, but robust and efficient, post-processing procedure by the higher dimensional analog of singular value decomposition, tensor decomposition. Using this procedure, we achieve an order of magnitude increase in signal to noise in both dDNP and non-hyperpolarized non-localized experiments without sacrificing accuracy. In CSI experiments an approximately 30-fold increase was observed, enough that the glucose to lactate conversion indicative of the Warburg effect can be imaged without hyper-polarization with a time resolution of 12s and an overall spatial resolution that compares favorably to 18F-FDG PET.
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Affiliation(s)
- Jeffrey R Brender
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shun Kishimoto
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Hellmut Merkle
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Galen Reed
- General Electric Healthcare, Toronto, Canada
| | | | | | - Jan Henrik Ardenkjaer-Larsen
- General Electric Healthcare, Toronto, Canada.,Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Jeeva Munasinghe
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Keita Saito
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Tomohiro Seki
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nobu Oshima
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kazutoshi Yamamoto
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter L Choyke
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James Mitchell
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Murali C Krishna
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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13
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Kroenke M, Hirata K, Gafita A, Watanabe S, Okamoto S, Magota K, Shiga T, Kuge Y, Tamaki N. Voxel based comparison and texture analysis of 18F-FDG and 18F-FMISO PET of patients with head-and-neck cancer. PLoS One 2019; 14:e0213111. [PMID: 30818360 PMCID: PMC6394953 DOI: 10.1371/journal.pone.0213111] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/14/2019] [Indexed: 12/22/2022] Open
Abstract
Background Hypoxia can induce radiation resistance and is an independent prognostic marker for outcome in head and neck cancer. As 18F-FMISO (FMISO), a hypoxia tracer for PET, is far less common than 18F-FDG (FDG) and two separate PET scans result in doubled cost and radiation exposure to the patient, we aimed to predict hypoxia from FDG PET with new techniques of voxel based analysis and texture analysis. Methods Thirty-eight patients with head-and-neck cancer underwent consecutive FDG and FMISO PET scans before any treatment. ROIs enclosing the primary cancer were compared in a voxel-by-voxel manner between FDG and FMISO PET. Tumour hypoxia was defined as the volume with a tumour-to-muscle ratio (TMR) > 1.25 in the FMISO PET and hypermetabolic volume was defined as >50% SUVmax in the FDG PET. The concordance rate was defined as percentage of voxels within the tumour which were both hypermetabolic and hypoxic. 38 different texture analysis (TA) parameters were computed based on the ROIs and correlated with presence of hypoxia. Results Within the hypoxic tumour regions, the FDG uptake was twice as high as in the non-hypoxic tumour regions (SUVmean 10.9 vs. 5.4; p<0.001). A moderate correlation between FDG and FMISO uptake was found by a voxel-by-voxel comparison (r = 0.664 p<0.001). The average concordance rate was 25% (± 22%). Entropy was the TA parameter showing the highest correlation with hypoxia (r = 0.524 p<0.001). Conclusion FDG uptake was higher in hypoxic tumour regions than in non-hypoxic regions as expected by tumour biology. A moderate correlation between FDG and FMISO PET was found by voxel-based analysis. TA yielded similar results in FDG and FMISO PET. However, it may not be possible to predict tumour hypoxia even with the help of texture analysis.
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Affiliation(s)
- Markus Kroenke
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.,Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Andrei Gafita
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Shiro Watanabe
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Shozo Okamoto
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Keiichi Magota
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Tohru Shiga
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
| | - Yuji Kuge
- Central Institute of Isotope Science, of Hokkaido University, Sapporo, Japan
| | - Nagara Tamaki
- Department of Nuclear Medicine, Graduate School of Medicine of Hokkaido University, Sapporo, Japan
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14
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Geng W, Jia S, Zheng Z, Li Z, Ding D, Guo D. A Noncovalent Fluorescence Turn‐on Strategy for Hypoxia Imaging. Angew Chem Int Ed Engl 2019; 58:2377-2381. [DOI: 10.1002/anie.201813397] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/08/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Wen‐Chao Geng
- College of ChemistryKey Laboratory of Functional Polymer Materials (Ministry of Education)State Key Laboratory of Elemento-Organic ChemistryNankai University Tianjin 300071 China
| | - Shaorui Jia
- Key Laboratory of Bioactive MaterialsMinistry of EducationCollege of Life SciencesNankai University Tianjin 300071 China
| | - Zhe Zheng
- College of ChemistryKey Laboratory of Functional Polymer Materials (Ministry of Education)State Key Laboratory of Elemento-Organic ChemistryNankai University Tianjin 300071 China
| | - Zhihao Li
- College of ChemistryKey Laboratory of Functional Polymer Materials (Ministry of Education)State Key Laboratory of Elemento-Organic ChemistryNankai University Tianjin 300071 China
| | - Dan Ding
- Key Laboratory of Bioactive MaterialsMinistry of EducationCollege of Life SciencesNankai University Tianjin 300071 China
| | - Dong‐Sheng Guo
- College of ChemistryKey Laboratory of Functional Polymer Materials (Ministry of Education)State Key Laboratory of Elemento-Organic ChemistryNankai University Tianjin 300071 China
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15
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Geng WC, Jia S, Zheng Z, Li Z, Ding D, Guo DS. A Noncovalent Fluorescence Turn-on Strategy for Hypoxia Imaging. Angew Chem Int Ed Engl 2019. [DOI: 10.1002/ange.201813397] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Wen-Chao Geng
- College of Chemistry; Key Laboratory of Functional Polymer Materials (Ministry of Education); State Key Laboratory of Elemento-Organic Chemistry; Nankai University; Tianjin 300071 China
| | - Shaorui Jia
- Key Laboratory of Bioactive Materials; Ministry of Education; College of Life Sciences; Nankai University; Tianjin 300071 China
| | - Zhe Zheng
- College of Chemistry; Key Laboratory of Functional Polymer Materials (Ministry of Education); State Key Laboratory of Elemento-Organic Chemistry; Nankai University; Tianjin 300071 China
| | - Zhihao Li
- College of Chemistry; Key Laboratory of Functional Polymer Materials (Ministry of Education); State Key Laboratory of Elemento-Organic Chemistry; Nankai University; Tianjin 300071 China
| | - Dan Ding
- Key Laboratory of Bioactive Materials; Ministry of Education; College of Life Sciences; Nankai University; Tianjin 300071 China
| | - Dong-Sheng Guo
- College of Chemistry; Key Laboratory of Functional Polymer Materials (Ministry of Education); State Key Laboratory of Elemento-Organic Chemistry; Nankai University; Tianjin 300071 China
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16
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Challapalli A, Carroll L, Aboagye EO. Molecular mechanisms of hypoxia in cancer. Clin Transl Imaging 2017; 5:225-253. [PMID: 28596947 PMCID: PMC5437135 DOI: 10.1007/s40336-017-0231-1] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/21/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE Hypoxia is a condition of insufficient oxygen to support metabolism which occurs when the vascular supply is interrupted, or when a tumour outgrows its vascular supply. It is a negative prognostic factor due to its association with an aggressive tumour phenotype and therapeutic resistance. This review provides an overview of hypoxia imaging with Positron emission tomography (PET), with an emphasis on the biological relevance, mechanism of action, highlighting advantages, and limitations of the currently available hypoxia radiotracers. METHODS A comprehensive PubMed literature search was performed, identifying articles relating to biological significance and measurement of hypoxia, MRI methods, and PET imaging of hypoxia in preclinical and clinical settings, up to December 2016. RESULTS A variety of approaches have been explored over the years for detecting and monitoring changes in tumour hypoxia, including regional measurements with oxygen electrodes placed under CT guidance, MRI methods that measure either oxygenation or lactate production consequent to hypoxia, different nuclear medicine approaches that utilise imaging agents the accumulation of which is inversely related to oxygen tension, and optical methods. The advantages and disadvantages of these approaches are reviewed, along with individual strategies for validating different imaging methods. PET is the preferred method for imaging tumour hypoxia due to its high specificity and sensitivity to probe physiological processes in vivo, as well as the ability to provide information about intracellular oxygenation levels. CONCLUSION Even though hypoxia could have significant prognostic and predictive value in the clinic, the best method for hypoxia assessment has in our opinion not been realised.
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Affiliation(s)
- Amarnath Challapalli
- Department of Clinical Oncology, Bristol Cancer Institute, Horfield Road, Bristol, United Kingdom
| | - Laurence Carroll
- Department of Surgery and Cancer, Imperial College, GN1, Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W120NN United Kingdom
| | - Eric O. Aboagye
- Department of Surgery and Cancer, Imperial College, GN1, Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W120NN United Kingdom
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17
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Liu JN, Bu W, Shi J. Chemical Design and Synthesis of Functionalized Probes for Imaging and Treating Tumor Hypoxia. Chem Rev 2017; 117:6160-6224. [DOI: 10.1021/acs.chemrev.6b00525] [Citation(s) in RCA: 556] [Impact Index Per Article: 79.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Jia-nan Liu
- State
Key Laboratory of High Performance Ceramics and Superfine Microstructures, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, P.R. China
| | - Wenbo Bu
- State
Key Laboratory of High Performance Ceramics and Superfine Microstructures, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, P.R. China
- Shanghai
Key Laboratory of Green Chemistry and Chemical Processes, School of
Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, P.R. China
| | - Jianlin Shi
- State
Key Laboratory of High Performance Ceramics and Superfine Microstructures, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, P.R. China
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18
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Abouzied MM, Fathala A, Alsugair A, Muhaideb AIA, Qahtani MHA. Role of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in the Evaluation of Head and Neck Carcinoma. World J Nucl Med 2017; 16:257-265. [PMID: 29033672 PMCID: PMC5639440 DOI: 10.4103/wjnm.wjnm_40_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET-CT) has been playing a pivotal role in tumor imaging for the past 20 years. Head and neck (HN) cancers are a good example that can illustrate such unique role of FDG imaging contributing to the patient's management. In this review article, we will describe the normal physiological distribution of FDG within HN structures focusing on its limitations and pitfalls. In addition, we will be also describing its role in the initial staging and restaging of the disease, particularly with regard to therapy response assessment. Furthermore, its role in the evaluation of patients with malignant cervical adenopathy from an unknown primary will be described. In 2016, the Royal College of Radiologists in its third edition published evidence-based guidelines for PET-CT use in HN cancer emphasizing its rule in all these clinical scenarios that are being described in this review. Finally, we will be highlighting future directions in the field of molecular imaging of HN tumors with a special emphasis on the new PET tracers.
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Affiliation(s)
- Moheieldin M Abouzied
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ahmed Fathala
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Abdulaziz Alsugair
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ahmad I Al Muhaideb
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Mohammed H Al Qahtani
- Department of Cyclotron and Radiopharmaceuticals, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
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19
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Schweifer A, Maier F, Ehrlichmann W, Lamparter D, Kneilling M, Pichler BJ, Hammerschmidt F, Reischl G. [ 18F]Fluoro-azomycin-2´-deoxy-β-d-ribofuranoside - A new imaging agent for tumor hypoxia in comparison with [ 18F]FAZA. Nucl Med Biol 2016; 43:759-769. [PMID: 27693670 DOI: 10.1016/j.nucmedbio.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/25/2016] [Accepted: 08/07/2016] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Radiolabeled 2-nitroimidazoles (azomycins) are a prominent class of biomarkers for PET imaging of hypoxia. [18F]Fluoro-azomycin-α-arabinoside ([18F]FAZA) - already in clinical use - may be seen as α-configuration nucleoside, but enters cells only via diffusion and is not transported by cellular nucleoside transporters. To enhance image contrast in comparison to [18F]FAZA our objective was to 18F-radiolabel an azomycin-2´-deoxyriboside with β-configuration ([18F]FAZDR, [18F]-β-8) to mimic nucleosides more closely and comparatively evaluate it versus [18F]FAZA. METHODS Precursor and cold standards for [18F]FAZDR were synthesized from methyl 2-deoxy-d-ribofuranosides α- and β-1 in 6 steps yielding precursors α- and β-5. β-5 was radiolabeled in a GE TRACERlab FXF-N synthesizer in DMSO and deprotected with NH4OH to give [18F]FAZDR ([18F]-β-8). [18F]FAZA or [18F]FAZDR was injected in BALB/c mice bearing CT26 colon carcinoma xenografts, PET scans (10min) were performed after 1, 2 and 3h post injection (p.i.). On a subset of mice injected with [18F]FAZDR, we analyzed biodistribution. RESULTS [18F]FAZDR was obtained in non-corrected yields of 10.9±2.4% (9.1±2.2GBq, n=4) 60min EOB, with radiochemical purity >98% and specific activity >50GBq/μmol. Small animal PET imaging showed a decrease in uptake over time for both [18F]FAZDR (1h p.i.: 0.56±0.22% ID/cc, 3h: 0.17±0.08% ID/cc, n=9) and [18F]FAZA (1h: 1.95±0.59% ID/cc, 3h: 0.87±0.55% ID/cc), whereas T/M ratios were significantly higher for [18F]FAZDR at 1h (2.76) compared to [18F]FAZA (1.69, P<0.001), 3h p.i. ratios showed no significant difference. Moreover, [18F]FAZDR showed an inverse correlation between tracer uptake in carcinomas and oxygen breathing, while muscle tissue uptake was not affected by switching from air to oxygen. CONCLUSIONS First PET imaging results with [18F]FAZDR showed advantages over [18F]FAZA regarding higher tumor contrast at earlier time points p.i. Availability of precursor and cold fluoro standard together with high output radiosynthesis will allow for a more detailed quantitative evaluation of [18F]FAZDR, especially with regard to mechanistic studies whether active transport processes are involved, compared to passive diffusion as observed for [18F]FAZA.
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Affiliation(s)
- Anna Schweifer
- Institute of Organic Chemistry, University of Vienna, Vienna, Austria
| | - Florian Maier
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | - Walter Ehrlichmann
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | - Denis Lamparter
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | - Manfred Kneilling
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany; Department of Dermatology, University of Tübingen, Tübingen, Germany
| | - Bernd J Pichler
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | | | - Gerald Reischl
- Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany.
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20
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Laurens E, Yeoh SD, Rigopoulos A, O'Keefe GJ, Tochon-Danguy HJ, Chong LW, White JM, Scott AM, Ackermann U. Fluorine-18 radiolabeling of a nitrophenyl sulfoxide and its evaluation in an SK-RC-52 model of tumor hypoxia. J Labelled Comp Radiopharm 2016; 59:416-23. [PMID: 27435268 DOI: 10.1002/jlcr.3426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 11/10/2022]
Abstract
The significance of imaging hypoxia with the positron emission tomography ligand [(18) F]FMISO has been demonstrated in a variety of cancers. However, the slow kinetics of [(18) F]FMISO require a 2-h delay between tracer administration and patient scanning. Labeled chloroethyl sulfoxides have shown faster kinetics and higher contrast than [(18) F]FMISO in a rat model of ischemic stroke. However, these nitrogen mustard analogues are unsuitable for routine production and use in humans. Here, we report on the synthesis and in vitro and in vivo evaluation of a novel sulfoxide, which contains an ester moiety for hydrolysis and subsequent trapping in hypoxic cells. Non-decay corrected yields of radioactivity were 1.18 ± 0.24% (n = 27, 2.5 ± 0.5% decay corrected radiochemical yield) based on K[(18) F]F. The radiotracer did not show any defluorination and did not undergo metabolism in an in vitro assay using S9 liver fractions. Imaging studies using an SK-RC-52 tumor model in BALB/c nude mice have revealed that [(18) F]1 is retained in hypoxic tumors and has similar hypoxia selectivity to [(18) F]FMISO. Because of a three times faster clearance rate than [(18) F]FMISO from normoxic tissue, [(18) F]1 has emerged as a promising new radiotracer for hypoxia imaging.
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Affiliation(s)
- Evelyn Laurens
- School of Chemistry, The University of Melbourne, Melbourne, Australia.,Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Shinn Dee Yeoh
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | | | - Graeme J O'Keefe
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - Henri J Tochon-Danguy
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Lee Wenn Chong
- School of Chemistry, The University of Melbourne, Melbourne, Australia.,Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Jonathan M White
- School of Chemistry, The University of Melbourne, Melbourne, Australia.,Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Uwe Ackermann
- Bio21 Institute, The University of Melbourne, Melbourne, Australia.,Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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21
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Okamoto S, Shiga T, Yasuda K, Watanabe S, Hirata K, Nishijima KI, Magota K, Kasai K, Onimaru R, Tuchiya K, Kuge Y, Shirato H, Tamaki N. The reoxygenation of hypoxia and the reduction of glucose metabolism in head and neck cancer by fractionated radiotherapy with intensity-modulated radiation therapy. Eur J Nucl Med Mol Imaging 2016; 43:2147-2154. [DOI: 10.1007/s00259-016-3431-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/23/2016] [Indexed: 12/19/2022]
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22
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Hawkins-Daarud A, Rockne R, Corwin D, Anderson ARA, Kinahan P, Swanson KR. In silico analysis suggests differential response to bevacizumab and radiation combination therapy in newly diagnosed glioblastoma. J R Soc Interface 2016. [PMID: 26202682 PMCID: PMC4535409 DOI: 10.1098/rsif.2015.0388] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recently, two phase III studies of bevacizumab, an anti-angiogenic, for newly diagnosed glioblastoma (GBM) patients were released. While they were unable to statistically significantly demonstrate that bevacizumab in combination with other therapies increases the overall survival of GBM patients, there remains a question of potential benefits for subpopulations of patients. We use a mathematical model of GBM growth to investigate differential benefits of combining surgical resection, radiation and bevacizumab across observed tumour growth kinetics. The differential hypoxic burden after gross total resection (GTR) was assessed along with the change in radiation cell kill from bevacizumab-induced tissue re-normalization when starting therapy for tumours at different diagnostic sizes. Depending on the tumour size at the time of treatment, our model predicted that GTR would remove a variable portion of the hypoxic burden ranging from 11% to 99.99%. Further, our model predicted that the combination of bevacizumab with radiation resulted in an additional cell kill ranging from 2.6×107 to 1.1×1010 cells. By considering the outcomes given individual tumour kinetics, our results indicate that the subpopulation of patients who would receive the greatest benefit from bevacizumab and radiation combination therapy are those with large, aggressive tumours and who are not eligible for GTR.
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Affiliation(s)
| | - Russell Rockne
- Department of Neurological Surgery, Northwestern University, Chicago, IL 60611, USA
| | - David Corwin
- Department of Neurological Surgery, Northwestern University, Chicago, IL 60611, USA
| | | | - Paul Kinahan
- Department of Radiology, University of Washington, Seattle, WA 98195-7987, USA
| | - Kristin R Swanson
- Department of Neurological Surgery, Northwestern University, Chicago, IL 60611, USA
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23
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Abstract
SIGNIFICANCE Most solid tumors contain regions of low oxygenation or hypoxia. Tumor hypoxia has been associated with a poor clinical outcome and plays a critical role in tumor radioresistance. RECENT ADVANCES Two main types of hypoxia exist in the tumor microenvironment: chronic and cycling hypoxia. Chronic hypoxia results from the limited diffusion distance of oxygen, and cycling hypoxia primarily results from the variation in microvessel red blood cell flux and temporary disturbances in perfusion. Chronic hypoxia may cause either tumor progression or regressive effects depending on the tumor model. However, there is a general trend toward the development of a more aggressive phenotype after cycling hypoxia. With advanced hypoxia imaging techniques, spatiotemporal characteristics of tumor hypoxia and the changes to the tumor microenvironment can be analyzed. CRITICAL ISSUES In this review, we focus on the biological and clinical consequences of chronic and cycling hypoxia on radiation treatment. We also discuss the advanced non-invasive imaging techniques that have been developed to detect and monitor tumor hypoxia in preclinical and clinical studies. FUTURE DIRECTIONS A better understanding of the mechanisms of tumor hypoxia with non-invasive imaging will provide a basis for improved radiation therapeutic practices.
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Affiliation(s)
- Chen-Ting Lee
- 1 Department of Radiation Oncology, Duke University Medical Center , Durham, North Carolina
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24
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Kelada OJ, Carlson DJ. Molecular imaging of tumor hypoxia with positron emission tomography. Radiat Res 2014; 181:335-49. [PMID: 24673257 DOI: 10.1667/rr13590.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The problem of tumor hypoxia has been recognized and studied by the oncology community for over 60 years. From radiation and chemotherapy resistance to the increased risk of metastasis, low oxygen concentrations in tumors have caused patients with many types of tumors to respond poorly to conventional cancer therapies. It is clear that patients with high levels of tumor hypoxia have a poorer overall treatment response and that the magnitude of hypoxia is an important prognostic factor. As a result, the development of methods to measure tumor hypoxia using invasive and noninvasive techniques has become desirable to the clinical oncology community. A variety of imaging modalities have been established to visualize hypoxia in vivo. Positron emission tomography (PET) imaging, in particular, has played a key role for imaging tumor hypoxia because of the development of hypoxia-specific radiolabelled agents. Consequently, this technique is increasingly used in the clinic for a wide variety of cancer types. Following a broad overview of the complexity of tumor hypoxia and measurement techniques to date, this article will focus specifically on the accuracy and reproducibility of PET imaging to quantify tumor hypoxia. Despite numerous advances in the field of PET imaging for hypoxia, we continue to search for the ideal hypoxia tracer to both qualitatively and quantitatively define the tumor hypoxic volume in a clinical setting to optimize treatments and predict response in cancer patients.
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Affiliation(s)
- Olivia J Kelada
- a Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut; and
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Laurens E, Yeoh SD, Rigopoulos A, Cao D, Cartwright GA, O'Keefe GJ, Tochon-Danguy HJ, White JM, Scott AM, Ackermann U. Radiolabelling and evaluation of a novel sulfoxide as a PET imaging agent for tumor hypoxia. Nucl Med Biol 2014; 41:419-25. [PMID: 24767600 DOI: 10.1016/j.nucmedbio.2014.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 02/26/2014] [Accepted: 03/01/2014] [Indexed: 12/20/2022]
Abstract
[¹⁸F]FMISO is the most widely validated PET radiotracer for imaging hypoxic tissue. However, as a result of the pharmacokinetics of [¹⁸F]FMISO a 2h wait between tracer administration and patient scanning is required for optimal image acquisition. In order to develop hypoxia imaging agents with faster kinetics, we have synthesised and evaluated several F-18 labelled anilino sulfoxides. In this manuscript we report on the synthesis, in vitro and in vivo evaluation of a novel fluoroethyltriazolyl propargyl anilino sulfoxide. The radiolabelling of the novel tracer was achieved via 2-[¹⁸F]fluoroethyl azide click chemistry. Radiochemical yields were 23 ± 4% based on 2-[¹⁸F]fluoroethyl azide and 7 ± 2% based on K[¹⁸F]F. The radiotracer did not undergo metabolism or defluorination in an in vitro assay using S9 liver fractions. Imaging studies using SK-RC-52 tumors in BALB/c nude mice have indicated that the tracer may have a higher pO₂ threshold than [¹⁸F]FMISO for uptake in hypoxic tumors. Although clearance from muscle was faster than [¹⁸F]FMISO, uptake in hypoxic tumors was slower. The average tumor to muscle ratio at 2h post injection in large, hypoxic tumors with a volume greater than 686 mm³ was 1.7, which was similar to the observed ratio of 1.75 for [¹⁸F]FMISO. Although the new tracer showed improved pharmacokinetics when compared with the previously synthesised sulfoxides, further modifications to the chemical structure need to be made in order to offer significant in vivo imaging advantages over [¹⁸F]FMISO.
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Affiliation(s)
- Evelyn Laurens
- School of Chemistry and Bio21 Institute, The University of Melbourne, Parkville VIC 3052, Australia
| | - Shinn Dee Yeoh
- Centre for PET, Austin Health, Level 1 HSB, 145 Studley Road, Heidelberg VIC 3084, Australia
| | - Angela Rigopoulos
- Ludwig Institute for Cancer Research, Melbourne - Austin Branch, Heidelberg VIC 3084, Australia
| | - Diana Cao
- Ludwig Institute for Cancer Research, Melbourne - Austin Branch, Heidelberg VIC 3084, Australia
| | - Glenn A Cartwright
- Ludwig Institute for Cancer Research, Melbourne - Austin Branch, Heidelberg VIC 3084, Australia
| | - Graeme J O'Keefe
- Centre for PET, Austin Health, Level 1 HSB, 145 Studley Road, Heidelberg VIC 3084, Australia
| | - Henri J Tochon-Danguy
- Centre for PET, Austin Health, Level 1 HSB, 145 Studley Road, Heidelberg VIC 3084, Australia; School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne VIC 3010, Australia
| | - Jonathan M White
- School of Chemistry and Bio21 Institute, The University of Melbourne, Parkville VIC 3052, Australia
| | - Andrew M Scott
- Centre for PET, Austin Health, Level 1 HSB, 145 Studley Road, Heidelberg VIC 3084, Australia; Ludwig Institute for Cancer Research, Melbourne - Austin Branch, Heidelberg VIC 3084, Australia; School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne VIC 3010, Australia
| | - Uwe Ackermann
- Centre for PET, Austin Health, Level 1 HSB, 145 Studley Road, Heidelberg VIC 3084, Australia; Ludwig Institute for Cancer Research, Melbourne - Austin Branch, Heidelberg VIC 3084, Australia; School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne VIC 3010, Australia.
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Servagi-Vernat S, Differding S, Hanin FX, Labar D, Bol A, Lee JA, Grégoire V. A prospective clinical study of ¹⁸F-FAZA PET-CT hypoxia imaging in head and neck squamous cell carcinoma before and during radiation therapy. Eur J Nucl Med Mol Imaging 2014; 41:1544-52. [PMID: 24570097 DOI: 10.1007/s00259-014-2730-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 02/07/2014] [Indexed: 01/05/2023]
Abstract
PURPOSE Hypoxia in head and neck squamous cell carcinoma (HNSCC) is associated with poor prognosis and outcome. (18) F-Fluoroazomycin arabinoside (FAZA) is a positron emission tomography (PET) tracer developed to enable identification of hypoxic regions within tumor. The aim of this study was to evaluate the use of (18) F-FAZA-PET for assessment of hypoxia before and during radiation therapy. METHODS Twelve patients with locally advanced HNSCC underwent (18) F-FAZA-PET scans before and at fraction 7 and 17 of concomitant chemo-radiotherapy. A hypoxic voxel was defined as a voxel expressing a standardized uptake value (SUV) equal or above the SUVmean of the posterior contralateral neck muscles plus three standard deviations. The fractional hypoxic volume fraction (FHV) and the spatial move of hypoxic volumes during treatment were analyzed. RESULTS A hypoxic volume could be identified in ten patients before treatment. FAZA-PET FHV varied from 0 to 54.3% and from 0 to 41.4% in the primary tumor and in the involved node, respectively. Six out of these ten patients completed all the FAZA-PET-computed tomography (CT) during the radiotherapy. In all patients, FHV and SUVmax values decreased. All patient presented a spatial move of hypoxic volume, but only three patients had newborn hypoxic voxels after 17 fractions. CONCLUSION This study indicated that (18) F-FAZA-PET could be used to identify and quantify tumor hypoxia before and during concomitant radio-chemotherapy in patients with locally advanced HNSCC. In addition to the information on prognostic value, the use of (18) F-FAZA-PET allowed the delineation of hypoxic volumes for dose escalation protocols. However, due to fluctuation of hypoxia during treatment, repeated scan will have to be performed (i.e. adaptive radiotherapy).
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Affiliation(s)
- Stéphanie Servagi-Vernat
- Department of Radiation Oncology and Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Institut de Recherche Clinique (IREC), Université catholique de Louvain, St-Luc University Hospital, Brussels, Belgium,
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El-Salam M, Reda S, Lotfi S, Refaat T, El-Abd E. Imaging Techniques in Cancer Diagnosis. Cancer Biomark 2014:19-38. [DOI: 10.1201/b16389-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Pérez Romasanta LA, García Velloso MJ, López Medina A. Functional imaging in radiation therapy planning for head and neck cancer. Rep Pract Oncol Radiother 2013; 18:376-82. [PMID: 24416582 PMCID: PMC3863200 DOI: 10.1016/j.rpor.2013.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 10/16/2013] [Accepted: 10/16/2013] [Indexed: 11/22/2022] Open
Abstract
Functional imaging and its application to radiotherapy (RT) is a rapidly expanding field with new modalities and techniques constantly developing and evolving. As technologies improve, it will be important to pay attention to their implementation. This review describes the main achievements in the field of head and neck cancer (HNC) with particular remarks on the unsolved problems.
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Affiliation(s)
- Luis A. Pérez Romasanta
- Radiation Oncology, Hospital Universitario de Salamanca, Ps. San Vicente 58, 37007 Salamanca, Spain
| | | | - Antonio López Medina
- Medical Physics Department and Radiological Protection, Galaria – Hospital do Meixoeiro – Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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Bhatnagar P, Subesinghe M, Patel C, Prestwich R, Scarsbrook AF. Functional Imaging for Radiation Treatment Planning, Response Assessment, and Adaptive Therapy in Head and Neck Cancer. Radiographics 2013; 33:1909-29. [DOI: 10.1148/rg.337125163] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Hoeben BAW, Bussink J, Troost EGC, Oyen WJG, Kaanders JHAM. Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer. Acta Oncol 2013; 52:1257-71. [PMID: 24003853 DOI: 10.3109/0284186x.2013.812799] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer (18)F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.
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Affiliation(s)
- Bianca A W Hoeben
- Department of Radiation Oncology, Radboud University Nijmegen Medical Centre , Nijmegen , The Netherlands
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Constantinidou A, Pollack S, Loggers E, Rodler E, Jones RL. The evolution of systemic therapy in sarcoma. Expert Rev Anticancer Ther 2013; 13:211-23. [PMID: 23406562 DOI: 10.1586/era.12.161] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Approximately 50% of patients with localized soft tissue sarcomas will develop recurrent disease after complete surgical resection, requiring alternative means of treatment. Conventional chemotherapy comprising of doxorubicin and ifosfamide has shown benefit in advanced disease, however, there remains a clear need for more effective, less toxic, therapies for the treatment of this heterogeneous group of mesenchymal malignancies. Recently, greater emphasis has been placed on the underlying biology of individual sarcoma subtypes, with the development and evaluation of novel therapies both in common and in rare subtypes. In addition, there is a greater specificity in the selection of chemotherapy agents based on activity in individual histological subtypes. Despite these advances the management of sarcoma, and in particular of rare subtypes, remains a major challenge. Some histological subtypes are resistant to conventional chemotherapy and patients with these diseases should be offered participation in early phase clinical trials of novel drugs.
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Chino J, Das S, Wong T. Positron Emission Tomography in Radiation Treatment Planning. Radiol Clin North Am 2013; 51:913-25. [DOI: 10.1016/j.rcl.2013.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Feliciano J, Feigenberg S, Mehta M. Chemoradiation for definitive, preoperative, or postoperative therapy of locally advanced non-small cell lung cancer. Cancer J 2013; 19:222-30. [PMID: 23708069 PMCID: PMC3703658 DOI: 10.1097/ppo.0b013e318293238d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Over the last few decades, the integration of chemotherapy and radiation has played a crucial role in the management of locally advanced non-small cell lung cancer (NSCLC). Locally advanced NSCLC is a very heterogeneous disease. Because of this heterogeneity, advanced NSCLC can be managed in various ways depending on the bulk of disease, the comorbidities of the patient, and the expertise and resources of the treating physicians and facilities. This review describes the evolution of current treatment strategies and predicted future changes for the management of locally advanced NSCLC.
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Affiliation(s)
- Josephine Feliciano
- Assistant Professor, University of Maryland Greenebaum Cancer Center, 22 South Greene Street, Suite SD9, Baltimore, MD 21201, Office - (410) 328 – 7225, Fax - (410) 328 – 2578,
| | - Steven Feigenberg
- Associate Professor/Director of Clinical Research, University of Maryland School of Medicine, Department of Radiation Oncology, 22 South Greene St., Baltimore, MD 21201, Office – (410) 328 - 2328, Fax – (410) 328 - 6911,
| | - Minesh Mehta
- Professor / Medical Directory, Maryland Proton Treatment Center, University of Maryland School of Medicine, Department of Radiation Oncology, 22 South Greene St., Baltimore, MD 21201, Office – (410) 328 – 2328, Fax – (410) 328 – 6911,
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Newbold K, Powell C. PET/CT in Radiotherapy Planning for Head and Neck Cancer. Front Oncol 2012; 2:189. [PMID: 23233906 PMCID: PMC3518254 DOI: 10.3389/fonc.2012.00189] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 11/20/2012] [Indexed: 11/25/2022] Open
Abstract
The use of PET/CT as an adjunct in radiotherapy planning is an attractive option in head and neck cancer (HNC) for several reasons. First, with potentially better identification of the disease extent, i.e., staging, the risk of geographical miss of radiation delivery to the gross tumor volume is reduced. Second, in characterizing the biological behavior of the disease for example, areas of hypoxia, rich or poor vascularity, or high cell proliferation, PET/CT can identify biological target volumes either for escalation of radiation dose or to predict the requirement for the addition of a radiosensitizer or alternative treatment strategies. 18F-FDG is the most common tracer used in oncology studies, but many other tracers have been investigated with several entering clinical practice, although these remain predominantly in the research domain in HNC.
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Affiliation(s)
- Katie Newbold
- The Royal Marsden National Health Service Trust London, UK
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Garg MK, Glanzman J, Kalnicki S. The Evolving Role of Positron Emission Tomography-Computed Tomography in Organ-Preserving Treatment of Head and Neck Cancer. Semin Nucl Med 2012; 42:320-7. [DOI: 10.1053/j.semnuclmed.2012.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lin A, Hahn SM. Hypoxia Imaging Markers and Applications for Radiation Treatment Planning. Semin Nucl Med 2012; 42:343-52. [DOI: 10.1053/j.semnuclmed.2012.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Laurens E, Yeoh SD, Rigopoulos A, Cao D, Cartwright GA, O'Keefe GJ, Tochon-Danguy HJ, White JM, Scott AM, Ackermann U. Radiolabelling and evaluation of novel haloethylsulfoxides as PET imaging agents for tumor hypoxia. Nucl Med Biol 2012; 39:871-82. [DOI: 10.1016/j.nucmedbio.2012.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 11/04/2011] [Accepted: 01/10/2012] [Indexed: 10/14/2022]
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Tran LBA, Bol A, Labar D, Jordan B, Magat J, Mignion L, Grégoire V, Gallez B. Hypoxia imaging with the nitroimidazole 18F-FAZA PET tracer: a comparison with OxyLite, EPR oximetry and 19F-MRI relaxometry. Radiother Oncol 2012; 105:29-35. [PMID: 22677038 DOI: 10.1016/j.radonc.2012.04.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 04/02/2012] [Accepted: 04/16/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE (18)F-FAZA is a nitroimidazole PET tracer that can provide images of tumor hypoxia. However, it cannot provide absolute pO(2) values. To qualify (18)F-FAZA PET, we compared PET images to pO(2) measured by OxyLite, EPR oximetry and (19)F-MRI. MATERIALS AND METHODS Male WAG/Rij rats grafted with rhabdomyosarcoma were used. Tumor oxygenation was modified by gas breathing (air or carbogen). The same day of PET acquisition, the pO(2) was measured in the same tumor either by OxyLite probes (measurement at 10 different sites), EPR oximetry using low frequency EPR or (19)F-relaxometry using 15C5 on an 11.7T MR system. RESULTS There was a good correlation between the results obtained by PET and EPR (R = 0.93). In the case of OxyLite, although a weaker correlation was observed (R = 0.55), the trend for two values to agree was still related to the inverse function theoretically predicted. For the comparison of (18)F-FAZA PET and (19)F-MRI, no change in T(1) was observed. CONCLUSIONS A clear correlation between (18)F-FAZA PET image intensities and tumor oxygenation was demonstrated, suggesting that (18)F-FAZA PET is a promising imaging technique to guide cancer therapy.
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Affiliation(s)
- Ly-Binh-An Tran
- Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
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Lucs A, Saltman B, Chung CH, Steinberg BM, Schwartz DL. Opportunities and challenges facing biomarker development for personalized head and neck cancer treatment. Head Neck 2012; 35:294-306. [PMID: 22287320 DOI: 10.1002/hed.21975] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 09/08/2011] [Indexed: 12/25/2022] Open
Abstract
Head and neck oncologists have traditionally relied on clinical tumor features and patient characteristics to guide care of individual patients. As surgical, radiotherapeutic, and systemic treatments have evolved to become more anatomically precise and mechanistically specific, the opportunity for improved cure and functional patient recovery has never been more promising for this historically debilitating cancer. However, personalized treatment must be accompanied by sophisticated patient selection to triage the application of advanced therapies toward ideal patient candidates. In this monograph, we review current progress, investigative themes, and key challenges facing head and neck cancer biomarker development intended to make personalized head and neck cancer treatment a clinical reality.
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Affiliation(s)
- Alexandra Lucs
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Benjamin Saltman
- Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - Christine H Chung
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bettie M Steinberg
- The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - David L Schwartz
- The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.,Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
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Narita T, Aoyama H, Hirata K, Onodera S, Shiga T, Kobayashi H, Murata J, Terasaka S, Tanaka S, Houkin K. Reoxygenation of glioblastoma multiforme treated with fractionated radiotherapy concomitant with temozolomide: changes defined by 18F-fluoromisonidazole positron emission tomography: two case reports. Jpn J Clin Oncol 2011; 42:120-3. [PMID: 22198964 DOI: 10.1093/jjco/hyr181] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Two glioblastoma multiforme patients underwent (18)F-FMISO (fluoromisonidazole) positron emission tomography study to access the tumor oxygenation status before and immediately after fractionated radiotherapy concomitant with temozolomide chemotherapy. In both cases, a prominent (18)F-FMISO tumor accumulation observed in the first study was notably decreased in the second study, which was supposed to be a reoxygenation of the tumor. As far as we investigated, this is the first report of the changes of oxygenation status in glioblastoma multiforme treated through radiation therapy with temozolomide.
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Affiliation(s)
- Takuhito Narita
- Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
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Ackermann U, Sigmund D, Yeoh SD, Rigopoulos A, O'Keefe G, Cartwright G, White J, Scott AM, Tochon-Danguy HJ. Synthesis of 2-[(4-[18F]Fluorobenzoyloxy)methyl]-1,4-naphthalenedione from 2-hydroxymethyl 1,4-naphthoquinone and 4-[18F]fluorobenzoic acid using dicyclohexyl carbodiimide. J Labelled Comp Radiopharm 2011. [DOI: 10.1002/jlcr.1932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - Angela Rigopoulos
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch; Melbourne; Australia
| | | | - Glenn Cartwright
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch; Melbourne; Australia
| | - Jonathan White
- The University of Melbourne; Bio21 Institute; Melbourne; Australia
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Yeom CJ, Zeng L, Zhu Y, Hiraoka M, Harada H. Strategies To Assess Hypoxic/HIF-1-Active Cancer Cells for the Development of Innovative Radiation Therapy. Cancers (Basel) 2011; 3:3610-31. [PMID: 24212970 PMCID: PMC3759213 DOI: 10.3390/cancers3033610] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 08/12/2011] [Accepted: 09/09/2011] [Indexed: 11/19/2022] Open
Abstract
Local tumor recurrence and distant tumor metastasis frequently occur after radiation therapy and result in the death of cancer patients. These problems are caused, at least in part, by a tumor-specific oxygen-poor microenvironment, hypoxia. Oxygen-deprivation is known to inhibit the chemical ionization of both intracellular macro-molecules and water, etc., and thus reduce the cytotoxic effects of radiation. Moreover, DNA damage produced by free radicals is known to be more repairable under hypoxia than normoxia. Hypoxia is also known to induce biological tumor radioresistance through the activation of a transcription factor, hypoxia-inducible factor 1 (HIF-1). Several potential strategies have been devised in radiation therapy to overcome these problems; however, they have not yet achieved a complete remission. It is essential to reveal the intratumoral localization and dynamics of hypoxic/HIF-1-active tumor cells during tumor growth and after radiation therapy, then exploit the information to develop innovative therapeutic strategies, and finally damage radioresistant cells. In this review, we overview problems caused by hypoxia/HIF-1-active cells in radiation therapy for cancer and introduce strategies to assess intratumoral hypoxia/HIF-1 activity.
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Affiliation(s)
- Chan Joo Yeom
- Group of Radiation and Tumor Biology, Career-Path Promotion Unit for Young Life Scientists, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; E-Mails: (C.J.Y.); (L.Z.); (Y.Z.)
| | - Lihua Zeng
- Group of Radiation and Tumor Biology, Career-Path Promotion Unit for Young Life Scientists, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; E-Mails: (C.J.Y.); (L.Z.); (Y.Z.)
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; E-Mail:
| | - Yuxi Zhu
- Group of Radiation and Tumor Biology, Career-Path Promotion Unit for Young Life Scientists, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; E-Mails: (C.J.Y.); (L.Z.); (Y.Z.)
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; E-Mail:
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; E-Mail:
| | - Hiroshi Harada
- Group of Radiation and Tumor Biology, Career-Path Promotion Unit for Young Life Scientists, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; E-Mails: (C.J.Y.); (L.Z.); (Y.Z.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-75-753-9301; Fax: +81-75-753-9281
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Hypoxia imaging with [F-18] FMISO-PET in head and neck cancer: potential for guiding intensity modulated radiation therapy in overcoming hypoxia-induced treatment resistance. Radiother Oncol 2011; 101:369-75. [PMID: 21872957 DOI: 10.1016/j.radonc.2011.07.029] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 07/27/2011] [Accepted: 07/29/2011] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Positron emission tomography (PET) imaging with [F-18] fluoromisonidazole (FMISO) has been validated as a hypoxic tracer. Head and neck cancer exhibits hypoxia, inducing aggressive biologic traits that impart resistance to treatment. Delivery of modestly higher radiation doses to tumors with stable areas of chronic hypoxia can improve tumor control. Advanced radiation treatment planning (RTP) and delivery techniques such as intensity modulated radiation therapy (IMRT) can deliver higher doses to a small volume without increasing morbidity. We investigated the utility of co-registered FMISO-PET and CT images to develop clinically feasible RTPs with higher tumor control probabilities (TCP). MATERIALS AND METHODS FMISO-PET images were used to determine hypoxic sub-volumes for boost planning. Example plans were generated for 10 of the patients in the study who exhibited significant hypoxia. We created an IMRT plan for each patient with a simultaneous integrated boost (SIB) to the hypoxic sub-volumes. We also varied the boost for two patients. RESULT A significant (mean 17%, median 15%) improvement in TCP is predicted when the modest additional boost dose to the hypoxic sub-volume is included. CONCLUSION Combined FMISO-PET imaging and IMRT planning permit delivery of higher doses to hypoxic regions, increasing the predicted TCP (mean 17%) without increasing expected complications.
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Wahl RL, Herman JM, Ford E. The promise and pitfalls of positron emission tomography and single-photon emission computed tomography molecular imaging-guided radiation therapy. Semin Radiat Oncol 2011; 21:88-100. [PMID: 21356477 PMCID: PMC4337868 DOI: 10.1016/j.semradonc.2010.11.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
External beam radiation therapy procedures have, until recently, been planned almost exclusively using anatomic imaging methods. Molecular imaging using hybrid positron emission tomography (PET)/computed tomography scanning or single-photon emission computed tomography (SPECT) imaging has provided new insights into the precise location of tumors (staging) and the extent and character of the biologically active tumor volume (BTV) and has provided differential response information during and after therapy. In addition to the commonly used radiotracer (18)F-fluoro- 2-deoxyD-glucose (FDG), additional radiopharmaceuticals are being explored to image major physiological processes as well as tumor biological properties, such as hypoxia, proliferation, amino acid accumulation, apoptosis, and receptor expression, providing the potential to target or boost the radiation dose to a biologically relevant region within a tumor, such as the most hypoxic or most proliferative area. Imaging using SPECT agents has furthered the possibility of limiting dose to functional normal tissues. PET can also portray the distribution of particle therapy by displaying activated species in situ. With both PET and SPECT imaging, fundamental physical issues of limited spatial resolution relative to the biological process, partial volume effects for quantification of small volumes, image misregistration, motion, and edge delineation must be carefully considered and can differ by agent or the method applied. Molecular imaging-guided radiation therapy (MIGRT) is a rapidly evolving and promising area of investigation and clinical translation. As MIGRT evolves, evidence must continue to be gathered to support improved clinical outcomes using MIGRT versus purely anatomic approaches.
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Affiliation(s)
- Richard L Wahl
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Biodistribution and radiation dosimetry of the hypoxia marker 18F-HX4 in monkeys and humans determined by using whole-body PET/CT. Nucl Med Commun 2011; 31:1016-24. [PMID: 20948452 DOI: 10.1097/mnm.0b013e3283407950] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES F-HX4 is a novel positron emission tomography (PET) tracer for imaging hypoxia. The purpose of this study was to determine the biodistribution and estimate the radiation dose of F-HX4 using whole-body PET/computed tomography (CT) scans in monkeys and humans. METHODS Successive whole-body PET/CT scans were done after the injection of F-HX4 in four healthy humans (422±142 MBq) and in three rhesus monkeys (189±3 MBq). Biodistribution was determined from PET images and organ doses were estimated using OLINDA/EXM software. RESULTS The bladder, liver, and kidneys showed the highest percentage of the injected radioactivity for humans and monkeys. For humans, approximately 45% of the activity is eliminated by bladder voiding in 3.6 h, and for monkeys 60% is in the bladder content after 3 h. The critical organ is the urinary bladder wall with the highest absorbed radiation dose of 415±18 (monkeys) and 299±38 μGy/MBq (humans), in the 4.8-h bladder voiding interval model. The average value of effective dose for the adult male was estimated at 42±4.2 μSv/MBq from monkey data and 27±2 μSv/MBq from human data. CONCLUSION Bladder, kidneys, and liver have the highest uptake of injected F-HX4 activity for both monkeys and humans. The urinary bladder wall receives the highest dose of F-HX4 and is the critical organ. Thus, patients should be encouraged to maintain adequate hydration and void frequently. The effective dose of F-HX4 is comparable with that of other F-based imaging agents.
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Parametric mapping of [18F]fluoromisonidazole positron emission tomography using basis functions. J Cereb Blood Flow Metab 2011; 31:648-57. [PMID: 20736963 PMCID: PMC3049519 DOI: 10.1038/jcbfm.2010.141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this study, we show a basis function method (BAFPIC) for voxelwise calculation of kinetic parameters (K(1), k(2), k(3), K(i)) and blood volume using an irreversible two-tissue compartment model. BAFPIC was applied to rat ischaemic stroke micro-positron emission tomography data acquired with the hypoxia tracer [(18)F]fluoromisonidazole because irreversible two-tissue compartmental modelling provided good fits to data from both hypoxic and normoxic tissues. Simulated data show that BAFPIC produces kinetic parameters with significantly lower variability and bias than nonlinear least squares (NLLS) modelling in hypoxic tissue. The advantage of BAFPIC over NLLS is less pronounced in normoxic tissue. K(i) determined from BAFPIC has lower variability than that from the Patlak-Gjedde graphical analysis (PGA) by up to 40% and lower bias, except for normoxic tissue at mid-high noise levels. Consistent with the simulation results, BAFPIC parametric maps of real data suffer less noise-induced variability than do NLLS and PGA. Delineation of hypoxia on BAFPIC k(3) maps is aided by low variability in normoxic tissue, which matches that in K(i) maps. BAFPIC produces K(i) values that correlate well with those from PGA (r(2)=0.93 to 0.97; slope 0.99 to 1.05, absolute intercept <0.00002 mL/g per min). BAFPIC is a computationally efficient method of determining parametric maps with low bias and variance.
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Planning study for available dose of hypoxic tumor volume using fluorine-18-labeled fluoromisonidazole positron emission tomography for treatment of the head and neck cancer. Radiother Oncol 2010; 97:176-82. [DOI: 10.1016/j.radonc.2010.04.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 03/11/2010] [Accepted: 04/05/2010] [Indexed: 11/19/2022]
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Metz S, Ganter C, Lorenzen S, van Marwick S, Herrmann K, Lordick F, Nekolla SG, Rummeny EJ, Wester HJ, Brix G, Schwaiger M, Beer AJ. Phenotyping of Tumor Biology in Patients by Multimodality Multiparametric Imaging: Relationship of Microcirculation, αvβ3 Expression, and Glucose Metabolism. J Nucl Med 2010; 51:1691-8. [DOI: 10.2967/jnumed.110.077719] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Li G, Xie H, Ning H, Citrin D, Kaushal A, Camphausen K, Miller RW. Correction of motion-induced misalignment in co-registered PET/CT and MRI (T1/T2/FLAIR) head images for stereotactic radiosurgery. J Appl Clin Med Phys 2010; 12:3306. [PMID: 21330976 PMCID: PMC5718587 DOI: 10.1120/jacmp.v12i1.3306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 08/11/2010] [Accepted: 08/16/2010] [Indexed: 11/23/2022] Open
Abstract
The purpose was to evaluate and correct the co‐registration of diagnostic PET/CT and MRI/MRI images for stereotactic radiosurgery (SRS) using 3D volumetric image registration (3DVIR). The 3DVIR utilizes the homogeneity of color distribution over a volumetric anatomical landmark as the registration criterion with submillimeter accuracy. Fifty‐three PET/CT and MRI (T1, T2 and FLAIR) image sets of patients with brain lesions were acquired sequentially from a hybrid PET/CT or an MRI scanner with common diagnostic head holding devices. Twenty‐five sets of head 18F−FDG−PET/CT images were scanned over a 10‐minute interval and 14 whole‐body sets were scanned over a 30‐minute interval. Fourteen sets of MRI images were acquired, and each 3‐modal image set (T1, T2 and FLAIR) was scanned in sequence at time 0, ~5 and ~20 minutes. The misalignments in these “co‐registered” images were evaluated and corrected using the 3DVIR. Using the head immobilization devices commonly found in diagnostic PET/CT and MRI/MRI imaging, 80%–100% of these “co‐registered” images were identified as misaligned. For PET/CT, the magnitude of misalignment was 0.4°±0.5° and 0.7±0.4mm for 10‐minute scans, and 0.8°±1.2° and 2.7±1.7mm for 30‐minute scans. For MRI/MRI, the magnitude was 0.2°±0.4° and 0.3±0.2mm for 5‐minute scan intervals, and 1.1°±0.7° and 1.2±1.4mm for 20‐minute intervals. Small, but significant, misalignment is present in the co‐registered diagnostic PET/CT and MRI/MRI images and can be corrected in SRS treatment planning using the volumetric image registration for improved target localization within the clinical error tolerance. PACS numbers: 87.53.Ly, 87.57.nj, 87.57.uk, 87.57.Q‐, 87.61.jc, 87.19.xc Conflict of Interest Statement: The authors do not have any conflict of interest on this research report.
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Affiliation(s)
- Guang Li
- Radiation Oncology Branch, Center for Clinical Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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