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Utsumi H, Masumizu T, Kobayashi R, Tahira T, Hyodo F, Shimizu T, Naganuma T, Anzai K. Development and Preclinical Study of Free Radical Imaging Using Field-Cycling Dynamic Nuclear Polarization MRI. Anal Chem 2021; 93:14138-14145. [PMID: 34649431 DOI: 10.1021/acs.analchem.1c02578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Free radicals, such as metabolic intermediates, reactive oxygen species, and metal enzymes, are key substances in organisms, although they can also cause various oxidative diseases. Thus, in vivo free radical imaging should be considered as the ultimate form of metabolic imaging. Unfortunately, electron spin resonance (ESR) imaging has inherent disadvantages, such as free radicals with large linewidths generating blurred images and the presence of two or more free radicals resulting in a complicated imaging procedure. Dynamic nuclear polarization-magnetic resonance imaging (DNP-MRI) is a noninvasive imaging method to visualize in vivo free radicals, theoretically, with the same resolution as the MRI anatomical resolution, and fixed low-field DNP-MRI provides unique information on oxidative diseases and cancer. However, the large gyromagnetic ratio of the electron spin, which is 660-fold greater than that of a proton, requires field cycling, wherein the external magnetic field should be varied during DNP-MRI observations. This causes difficulties in developing a DNP-MRI system for clinical purposes. We developed a novel field-cycling DNP-MRI system for a preclinical study. In the said system, the magnetic field is switched by rotationally moving two magnets, with a magnetic flux density of 0.3 T for MRI and 5 mT for ESR. The image quality was examined using various pulse sequences and ESR irradiation using nitroxyl radical as the phantom, and the optimum conditions were established. Using the system, we performed a preclinical study involving free radical imaging by placing the free radicals under the palm of a human hand.
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Affiliation(s)
- Hideo Utsumi
- Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka 812-8582, Japan.,School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka 422-8526, Japan
| | - Toshiki Masumizu
- Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka 812-8582, Japan.,School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka 422-8526, Japan
| | - Ryoma Kobayashi
- Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka 812-8582, Japan
| | - Tomoko Tahira
- Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka 812-8582, Japan
| | - Fuminori Hyodo
- Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka 812-8582, Japan
| | - Tatsuya Shimizu
- Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi 409-3898 Japan
| | | | - Kazunori Anzai
- Faculty of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama 362-0806, Japan
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Charvériat M, Lafon V, Mouthon F, Zimmer L. Innovative approaches in CNS drug discovery. Therapie 2021; 76:101-109. [DOI: 10.1016/j.therap.2020.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 12/15/2022]
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Shahbazali E, Billaud EMF, Fard AS, Meuldijk J, Bormans G, Noel T, Hessel V. Photo isomerization of cis-cyclooctene to trans-cyclooctene: Integration of a micro-flow reactor and separation by specific adsorption. AIChE J 2021; 67:e17067. [PMID: 33380744 PMCID: PMC7757390 DOI: 10.1002/aic.17067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/19/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
Liquid-phase adsorption has hardly been established in micro-flow, although this constitutes an industrially vital method for product separation. A micro-flow UV-photo isomerization process converts cis-cyclooctene partly into trans-cyclooctene, leaving an isomeric mixture. Trans-cyclooctene adsorption and thus separation was achieved in a fixed-bed micro-flow reactor, packed with AgNO3/SiO2 powder, while the cis-isomer stays in the flow. The closed-loop recycling-flow has been presented as systemic approach to enrich the trans-cyclooctene from its cis-isomer. In-flow adsorption in recycling-mode has hardly been reported so that a full theoretical study has been conducted. This insight is used to evaluate three process design options to reach an optimum yield of trans-cyclooctene. These differ firstly in the variation of the individual residence times in the reactor and separator, the additional process option of refreshing the adsorption column under use, and the periodicity of the recycle flow.
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Affiliation(s)
- Elnaz Shahbazali
- Department of Chemical Engineering and Chemistry, Micro Flow Chemistry and Process TechnologyEindhoven University of TechnologyEindhovenThe Netherlands
| | - Emilie M. F. Billaud
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
| | - Arash Sarhangi Fard
- Materials Technology InstituteEindhoven University of TechnologyEindhovenThe Netherlands
| | - Jan Meuldijk
- Department of Chemical Engineering and Chemistry, Micro Flow Chemistry and Process TechnologyEindhoven University of TechnologyEindhovenThe Netherlands
| | - Guy Bormans
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
| | - Timothy Noel
- Department of Chemical Engineering and Chemistry, Micro Flow Chemistry and Process TechnologyEindhoven University of TechnologyEindhovenThe Netherlands
| | - Volker Hessel
- Department of Chemical Engineering and Chemistry, Micro Flow Chemistry and Process TechnologyEindhoven University of TechnologyEindhovenThe Netherlands
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Rubin DL, Ugur Akdogan M, Altindag C, Alkim E. ePAD: An Image Annotation and Analysis Platform for Quantitative Imaging. ACTA ACUST UNITED AC 2020; 5:170-183. [PMID: 30854455 PMCID: PMC6403025 DOI: 10.18383/j.tom.2018.00055] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Medical imaging is critical for assessing the response of patients to new cancer therapies. Quantitative lesion assessment on images is time-consuming, and adopting new promising quantitative imaging biomarkers of response in clinical trials is challenging. The electronic Physician Annotation Device (ePAD) is a freely available web-based zero-footprint software application for viewing, annotation, and quantitative analysis of radiology images designed to meet the challenges of quantitative evaluation of cancer lesions. For imaging researchers, ePAD calculates a variety of quantitative imaging biomarkers that they can analyze and compare in ePAD to identify potential candidates as surrogate endpoints in clinical trials. For clinicians, ePAD provides clinical decision support tools for evaluating cancer response through reports summarizing changes in tumor burden based on different imaging biomarkers. As a workflow management and study oversight tool, ePAD lets clinical trial project administrators create worklists for users and oversee the progress of annotations created by research groups. To support interoperability of image annotations, ePAD writes all image annotations and results of quantitative imaging analyses in standardized file formats, and it supports migration of annotations from various propriety formats. ePAD also provides a plugin architecture supporting MATLAB server-side modules in addition to client-side plugins, permitting the community to extend the ePAD platform in various ways for new cancer use cases. We present an overview of ePAD as a platform for medical image annotation and quantitative analysis. We also discuss use cases and collaborations with different groups in the Quantitative Imaging Network and future directions.
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Affiliation(s)
- Daniel L Rubin
- Department of Biomedical Data Science, Radiology, and Medicine (Biomedical Informatics Research), Stanford University, Stanford, CA
| | - Mete Ugur Akdogan
- Department of Biomedical Data Science, Radiology, and Medicine (Biomedical Informatics Research), Stanford University, Stanford, CA
| | - Cavit Altindag
- Department of Biomedical Data Science, Radiology, and Medicine (Biomedical Informatics Research), Stanford University, Stanford, CA
| | - Emel Alkim
- Department of Biomedical Data Science, Radiology, and Medicine (Biomedical Informatics Research), Stanford University, Stanford, CA
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5
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Zimmer L. [PET imaging for better understanding of normal and pathological neurotransmission]. Biol Aujourdhui 2019; 213:109-120. [PMID: 31829931 DOI: 10.1051/jbio/2019025] [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: 09/17/2019] [Indexed: 11/14/2022]
Abstract
Positron emission tomography imaging is still an expanding field of preclinical and clinical investigations exploring the brain and its normal and pathological functions. In addition to technological improvements in PET scanners, the availability of suitable radiotracers for unexplored pharmacological targets is a key factor in this expansion. Many radiotracers (or radiopharmaceuticals, when administered to humans) have been developed by multidisciplinary teams to visualize and quantify a growing numbers of brain receptors, transporters, enzymes and other targets. The development of new PET radiotracers still represents an exciting challenge, given the large number of neurochemical functions that remain to be explored. In this article, we review the development context of the first preclinical radiotracers and their passage to humans. The main current contributions of PET radiotracers are described in terms of imaging neuronal metabolism, quantification of receptors and transporters, neurodegenerative and neuroinflammatory imaging. The different approaches to functional imaging of neurotransmission are also discussed. Finally, the contributions of PET imaging to the research and development of new brain drugs are described.
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Affiliation(s)
- Luc Zimmer
- Centre de Recherche en Neurosciences de Lyon (CNRS - INSERM - Université Claude Bernard Lyon 1), Lyon, France - CERMEP-Imagerie du Vivant, Hospices Civils de Lyon, Bron, France - Institut National des Sciences et Techniques Nucléaires, CEA, Saclay, France
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6
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Kurhanewicz J, Vigneron DB, Ardenkjaer-Larsen JH, Bankson JA, Brindle K, Cunningham CH, Gallagher FA, Keshari KR, Kjaer A, Laustsen C, Mankoff DA, Merritt ME, Nelson SJ, Pauly JM, Lee P, Ronen S, Tyler DJ, Rajan SS, Spielman DM, Wald L, Zhang X, Malloy CR, Rizi R. Hyperpolarized 13C MRI: Path to Clinical Translation in Oncology. Neoplasia 2019; 21:1-16. [PMID: 30472500 PMCID: PMC6260457 DOI: 10.1016/j.neo.2018.09.006] [Citation(s) in RCA: 278] [Impact Index Per Article: 55.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/22/2022]
Abstract
This white paper discusses prospects for advancing hyperpolarization technology to better understand cancer metabolism, identify current obstacles to HP (hyperpolarized) 13C magnetic resonance imaging's (MRI's) widespread clinical use, and provide recommendations for overcoming them. Since the publication of the first NIH white paper on hyperpolarized 13C MRI in 2011, preclinical studies involving [1-13C]pyruvate as well a number of other 13C labeled metabolic substrates have demonstrated this technology's capacity to provide unique metabolic information. A dose-ranging study of HP [1-13C]pyruvate in patients with prostate cancer established safety and feasibility of this technique. Additional studies are ongoing in prostate, brain, breast, liver, cervical, and ovarian cancer. Technology for generating and delivering hyperpolarized agents has evolved, and new MR data acquisition sequences and improved MRI hardware have been developed. It will be important to continue investigation and development of existing and new probes in animal models. Improved polarization technology, efficient radiofrequency coils, and reliable pulse sequences are all important objectives to enable exploration of the technology in healthy control subjects and patient populations. It will be critical to determine how HP 13C MRI might fill existing needs in current clinical research and practice, and complement existing metabolic imaging modalities. Financial sponsorship and integration of academia, industry, and government efforts will be important factors in translating the technology for clinical research in oncology. This white paper is intended to provide recommendations with this goal in mind.
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Affiliation(s)
- John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | | | - James A Bankson
- Department of Imaging Physics, MD Anderson Medical Center, Houston, TX, USA
| | - Kevin Brindle
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | | | | | - Kayvan R Keshari
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY, New York, USA
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Denmark
| | | | - David A Mankoff
- Department of Radiology, University of Pennsylvania, PA, USA
| | - Matthew E Merritt
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - John M Pauly
- Department of Electric Engineering, Stanford University, USA
| | - Philips Lee
- Functional Metabolism Group, Singapore Biomedical Consortium, Agency for Science, Technology and Research, Singapore
| | - Sabrina Ronen
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Damian J Tyler
- Department of Biomedical Science, University of Oxford, Oxford, UK
| | - Sunder S Rajan
- Center for Devices and Radiological Health (CDRH), FDA, White Oak, MD, USA
| | - Daniel M Spielman
- Departments of Radiology and Electric Engineering, Stanford University, USA
| | - Lawrence Wald
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Xiaoliang Zhang
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Craig R Malloy
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rahim Rizi
- Department of Radiology, University of Pennsylvania, PA, USA
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Neupane R, Gaudana R, Boddu SHS. Imaging Techniques in the Diagnosis and Management of Ocular Tumors: Prospects and Challenges. AAPS JOURNAL 2018; 20:97. [PMID: 30187172 DOI: 10.1208/s12248-018-0259-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/23/2018] [Indexed: 12/23/2022]
Abstract
Different types of imaging modalities are used in the diagnosis of ocular cancer. Selection of an imaging modality is based on the features of a tumor as well as the inherent characteristics of the imaging technique. It is vital to select an appropriate imaging modality in diagnosis of ocular tumor with confidence. This review focuses on five most commonly used imaging modalities, i.e., positron emission tomography-computed tomography (PET/CT), single photon emission computed tomography (SPECT), optical coherence tomography (OCT), ultrasound (US), and magnetic resonance imaging (MRI). The principal of imaging modalities is briefly explained, along with their role in the diagnosis and management of the most common ocular tumors such as retinoblastoma and uveal melanoma. Further, the diagnostic features of ocular tumors corresponding to each imaging modality and possibilities of utilizing imaging techniques in the process of ocular drug development are included in this review.
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Affiliation(s)
- Rabin Neupane
- College of Pharmacy and Pharmaceutical Sciences, The University of Toledo Health Science Campus, Toledo, OH, 43614, USA
| | - Ripal Gaudana
- Principal Scientist, Par Pharmaceuticals, 1 Ram Ridge Rd, Spring Valley, New York, 10977, USA
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, P.O. Box 346, Ajman, United Arab Emirates.
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8
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Monitoring disease activity noninvasively in the mdx model of Duchenne muscular dystrophy. Proc Natl Acad Sci U S A 2018; 115:7741-7746. [PMID: 29987034 DOI: 10.1073/pnas.1802425115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a rare, muscle degenerative disease resulting from the absence of the dystrophin protein. DMD is characterized by progressive loss of muscle fibers, muscle weakness, and eventually loss of ambulation and premature death. Currently, there is no cure for DMD and improved methods of disease monitoring are crucial for the development of novel treatments. In this study, we describe a new method of assessing disease progression noninvasively in the mdx model of DMD. The reporter mice, which we term the dystrophic Degeneration Reporter strains, contain an inducible CRE-responsive luciferase reporter active in mature myofibers. In these mice, muscle degeneration is reflected in changes in the level of luciferase expression, which can be monitored using noninvasive, bioluminescence imaging. We monitored the natural history and disease progression in these dystrophic report mice and found that decreases in luciferase signals directly correlated with muscle degeneration. We further demonstrated that this reporter strain, as well as a previously reported Regeneration Reporter strain, successfully reveals the effectiveness of a gene therapy treatment following systemic administration of a recombinant adeno-associated virus-6 (rAAV-6) encoding a microdystrophin construct. Our data demonstrate the value of these noninvasive imaging modalities for monitoring disease progression and response to therapy in mouse models of muscular dystrophy.
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9
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Online molecular image repository and analysis system: A multicenter collaborative open-source infrastructure for molecular imaging research and application. Comput Biol Med 2018; 96:233-240. [PMID: 29653352 DOI: 10.1016/j.compbiomed.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 12/17/2022]
Abstract
Molecular imaging serves as an important tool for researchers and clinicians to visualize and investigate complex biochemical phenomena using specialized instruments; these instruments are either used individually or in combination with targeted imaging agents to obtain images related to specific diseases with high sensitivity, specificity, and signal-to-noise ratios. However, molecular imaging, which is a multidisciplinary research field, faces several challenges, including the integration of imaging informatics with bioinformatics and medical informatics, requirement of reliable and robust image analysis algorithms, effective quality control of imaging facilities, and those related to individualized disease mapping, data sharing, software architecture, and knowledge management. As a cost-effective and open-source approach to address these challenges related to molecular imaging, we develop a flexible, transparent, and secure infrastructure, named MIRA, which stands for Molecular Imaging Repository and Analysis, primarily using the Python programming language, and a MySQL relational database system deployed on a Linux server. MIRA is designed with a centralized image archiving infrastructure and information database so that a multicenter collaborative informatics platform can be built. The capability of dealing with metadata, image file format normalization, and storing and viewing different types of documents and multimedia files make MIRA considerably flexible. With features like logging, auditing, commenting, sharing, and searching, MIRA is useful as an Electronic Laboratory Notebook for effective knowledge management. In addition, the centralized approach for MIRA facilitates on-the-fly access to all its features remotely through any web browser. Furthermore, the open-source approach provides the opportunity for sustainable continued development. MIRA offers an infrastructure that can be used as cross-boundary collaborative MI research platform for the rapid achievement in cancer diagnosis and therapeutics.
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10
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Sex Differences in Regional Brain Glucose Metabolism Following Opioid Withdrawal and Replacement. Neuropsychopharmacology 2017; 42:1841-1849. [PMID: 28393895 PMCID: PMC5520789 DOI: 10.1038/npp.2017.69] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/30/2017] [Accepted: 04/03/2017] [Indexed: 01/21/2023]
Abstract
Methadone and buprenorphine are currently the most common pharmacological treatments for opioid dependence. Interestingly, the clinical response to these drugs appears to be sex specific. That is, females exhibit superior therapeutic efficacy, defined as extended periods of abstinence and longer time to relapse, compared with males. However, the underlying metabolic effects of opioid withdrawal and replacement have not been examined. Therefore, using 18FDG and microPET, we measured differences in regional brain glucose metabolism in males and females following morphine withdrawal and subsequent methadone or buprenorphine replacement. In both males and females, spontaneous opioid withdrawal altered glucose metabolism in regions associated with reward and drug dependence. Specifically, metabolic increases in the thalamus, as well as metabolic decreases in insular cortex and the periaqueductal gray, were noted. However, compared with males, females exhibited increased metabolism in the preoptic area, primary motor cortex, and the amygdala, and decreased metabolism in the caudate/putamen and medial geniculate nucleus. Methadone and buprenorphine initially abolished these changes uniformly, but subsequently produced their own regional metabolic alterations that varied by treatment and sex. Compared with sex-matched control animals undergoing spontaneous opioid withdrawal, male animals treated with methadone exhibited increased caudate/putamen metabolism, whereas buprenorphine produced increased ventral striatum and motor cortex metabolism in females, and increased ventral striatum and somatosensory cortex metabolism in males. Notably, when treatment effects were compared between sexes, methadone-treated females showed increased cingulate cortex metabolism, whereas buprenorphine-treated females showed decreased metabolism in cingulate cortex and increased metabolism in the globus pallidus. Perhaps the initial similarities in males and females underlie early therapeutic efficacy, whereas these posttreatment sex differences contribute to clinical treatment failure more commonly experienced by the former.
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Marchand S, Chauzy A, Dahyot-Fizelier C, Couet W. Microdialysis as a way to measure antibiotics concentration in tissues. Pharmacol Res 2016; 111:201-207. [DOI: 10.1016/j.phrs.2016.06.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 06/02/2016] [Indexed: 11/16/2022]
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12
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Rosenkrantz AB, Mendiratta-Lala M, Bartholmai BJ, Ganeshan D, Abramson RG, Burton KR, Yu JPJ, Scalzetti EM, Yankeelov TE, Subramaniam RM, Lenchik L. Clinical utility of quantitative imaging. Acad Radiol 2015; 22:33-49. [PMID: 25442800 DOI: 10.1016/j.acra.2014.08.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 12/24/2022]
Abstract
Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently used in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice.
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Affiliation(s)
- Andrew B Rosenkrantz
- Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016.
| | - Mishal Mendiratta-Lala
- Henry Ford Hospital, Abdominal and Cross-sectional Interventional Radiology, Detroit, Michigan
| | - Brian J Bartholmai
- Division of Radiology Informatics, Mayo Clinic in Rochester, Rochester, Minnesota
| | | | - Richard G Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Kirsteen R Burton
- Department of Medical Imaging and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - John-Paul J Yu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Ernest M Scalzetti
- Department of Radiology, SUNY Upstate Medical University, Syracuse New York
| | - Thomas E Yankeelov
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee
| | - Rathan M Subramaniam
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
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Peñuelas I, Gambhir SS. Imaging studies for evaluating gene therapy in translational research. DRUG DISCOVERY TODAY. TECHNOLOGIES 2014; 2:335-43. [PMID: 24982010 DOI: 10.1016/j.ddtec.2005.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Molecular imaging of gene expression in living subjects is leading to significant advances in the field of gene therapy. Three different technologies have been utilized for monitoring gene expression: optical imaging, radionuclide imaging and magnetic resonance imaging. In the present review, we focus on the latest developments including multimodality approaches and recent imaging of human gene therapy to noninvasively determine the location(s), magnitude and time-variation of gene therapy. Continued development should lead to greater use of these technologies in gene therapy and also help to shed light towards optimizing gene therapy in preclinical models and in the clinical setting.:
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Affiliation(s)
- Iván Peñuelas
- MicroPET Research Unit, CIMA-CUN, University of Navarra, Pamplona, Spain.
| | - Sanjiv S Gambhir
- Molecular Imaging Program at Stanford (MIPS), Departments of Radiology and Bioengineering, Bio-X Program, Stanford University, Stanford, CA, USA
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Preferences for structured reporting of measurement data: an institutional survey of medical oncologists, oncology registrars, and radiologists. Acad Radiol 2014; 21:785-96. [PMID: 24809319 DOI: 10.1016/j.acra.2014.02.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/08/2014] [Accepted: 02/10/2014] [Indexed: 11/21/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to determine whether key radiology report "consumers" in our institution prefer structured measurement reporting in a dedicated report section over the current practice of embedding measurements throughout the "Findings" section, given the availability of new tools for quantitative imaging interpretation that enable automated structured reporting of measurement data. MATERIALS AND METHODS Oncologic clinicians and radiologists at our institution were surveyed regarding their preferences for a standard report versus three reports each having uniquely formatted dedicated "Measurements" sections and regarding their impressions of various characteristics of report quality demonstrated by these reports. The online survey was completed by 25 radiologists, 16 oncologists, and 17 oncology nurses and research assistants (registrars). RESULTS Aggregation of respondents' preferences by group into single orderings using the Kemeny-Young method revealed that both oncology groups preferred all proposed reports to the standard report but that radiologists only preferred two of the proposed reports to the standard report. All preferences for proposed reports in the two oncology groups were statistically significant based on Wilcoxon tests, but the preference for only one of the proposed reports was significant for radiologists. Additional results suggest that these preferences are driven by respondent favor for the readability of and confidence conveyed by the proposed reports compared to the standard report. CONCLUSIONS Oncologic clinicians responding to our survey preferred communication of lesion measurements in a separate report section to the current practice of embedding measurements throughout the "Findings" section, based on their assessments of reports containing simulated measurement sections assembled from a single sample report using standardized formatting.
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Buckler AJ, Paik D, Ouellette M, Danagoulian J, Wernsing G, Suzek BE. A novel knowledge representation framework for the statistical validation of quantitative imaging biomarkers. J Digit Imaging 2014; 26:614-29. [PMID: 23546775 DOI: 10.1007/s10278-013-9598-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Quantitative imaging biomarkers are of particular interest in drug development for their potential to accelerate the drug development pipeline. The lack of consensus methods and carefully characterized performance hampers the widespread availability of these quantitative measures. A framework to support collaborative work on quantitative imaging biomarkers would entail advanced statistical techniques, the development of controlled vocabularies, and a service-oriented architecture for processing large image archives. Until now, this framework has not been developed. With the availability of tools for automatic ontology-based annotation of datasets, coupled with image archives, and a means for batch selection and processing of image and clinical data, imaging will go through a similar increase in capability analogous to what advanced genetic profiling techniques have brought to molecular biology. We report on our current progress on developing an informatics infrastructure to store, query, and retrieve imaging biomarker data across a wide range of resources in a semantically meaningful way that facilitates the collaborative development and validation of potential imaging biomarkers by many stakeholders. Specifically, we describe the semantic components of our system, QI-Bench, that are used to specify and support experimental activities for statistical validation in quantitative imaging.
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Liu Y, Litière S, de Vries EG, Sargent D, Shankar L, Bogaerts J, Seymour L. The role of response evaluation criteria in solid tumour in anticancer treatment evaluation: results of a survey in the oncology community. Eur J Cancer 2013; 50:260-6. [PMID: 24239447 DOI: 10.1016/j.ejca.2013.10.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE With the increasing use of novel targeted agents and the development of high imaging techniques, response evaluation criteria in solid tumour (RECIST) 1.1 developed primarily for cytotoxic agents and anatomic imaging, has demonstrated limitations. A survey was conducted of RECIST users to identify concerns and their suggestions for future RECIST criteria. METHODS 140 key partners of the RECIST collaboration were asked to complete a questionnaire. The 49 questions concerned (a) satisfaction and concerns with RECIST 1.1; (b) use of modified RECIST criteria and (c) suggestions for the next RECIST Version. RESULTS Sixty-five replies were received. 52.3% responders were satisfied with RECIST 1.1, while 10.8% indicated dissatisfaction. Areas of potential weakness included: (a) lack of incorporation of potential early indicators of response such as functional imaging, (b) lack of validation in rarer tumour types and (c) lack of validation for novel (targeted) agents. Suggestions were multiple, with highest numbers on two points: developing sub-criteria for certain disease types and including advanced imaging techniques for the evaluation. CONCLUSIONS Constructive suggestions were received for optimising the next version. Ongoing data collection will make it possible to investigate the possible utilisation of fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging in tumour assessment, to verify whether RECIST is/can still be applicable in novel targeted therapy and to consider the need for criteria for specific disease types.
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Affiliation(s)
- Yan Liu
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
| | - Saskia Litière
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Elisabeth Ge de Vries
- Department of Medical Oncology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Daniel Sargent
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Jan Bogaerts
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Lesley Seymour
- National Cancer Institute of Canada Clinical trials group, Queens University, Kingston, Canada
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Melhem M. Translation of Central Nervous System Occupancy from Animal Models: Application of Pharmacokinetic/Pharmacodynamic Modeling. J Pharmacol Exp Ther 2013; 347:2-6. [DOI: 10.1124/jpet.112.199794] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
INTRODUCTION Magnetic resonance spectroscopy (MRS) will continue to play an ever increasing role in drug discovery because MRS does readily define biomarkers for several hundreds of clinically distinct diseases. Published evidence based medicine (EBM) surveys, which generally conclude the opposite, are seriously flawed and do a disservice to the field of drug discovery. AREAS COVERED This article presents MRS and how it has guided several hundreds of practical human 'drug discovery' endeavors since its development. Specifically, the author looks at the process of 'reverse-translation' and its influence in the expansion of the number of preclinical drug discoveries from in vivo MRS. The author also provides a structured approach of eight criteria, including EBM acceptance, which could potentially re-open the field of MRS for productive exploration of existing and repurposed drugs and cost-effective drug-discovery. EXPERT OPINION MRS-guided drug discovery is poised for future expansion. The cost of clinical trials has escalated and the use of biomarkers has become increasingly useful in improving patient selection for drug trials. Clinical MRS has uncovered a treasure-trove of novel biomarkers and clinical MRS itself has become better standardized and more widely available on 'routine' clinical MRI scanners. When combined with available new MRI sequences, MRS can provide a 'one stop shop' with multiple potential outcome measures for the disease and the drug in question.
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Affiliation(s)
- Brian D Ross
- Huntington Medical Research Institutes, Magnetic Resonance Spectroscopy Unit, 10 Pico Street, Pasadena 91105, USA.
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Zimmer L, Le Bars D. Current status of positron emission tomography radiotracers for serotonin receptors in humans. J Labelled Comp Radiopharm 2013; 56:105-13. [DOI: 10.1002/jlcr.3001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 12/19/2022]
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Kar RK, Suryadevara P, Sahoo BR, Sahoo GC, Dikhit MR, Das P. Exploring novel KDR inhibitors based on pharmaco-informatics methodology. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2013; 24:215-234. [PMID: 23437769 DOI: 10.1080/1062936x.2013.765912] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Kinase-insert domain-containing receptor (KDR) is one of the important mediators of Vascular endothelial growth factor (VEGF) function in endothelial cells. Inhibition of KDR can be therapeutically advantageous for treatment of a number of diseases. The present study focuses on exploring novel KDR inhibitors by means of pharmaco-informatics methodologies. Three-dimensional quantitative structure-activity relationship (3D-QSAR) analysis by atom-based pharmacophore mapping over a set of 85 molecules provides a proposition regarding the molecular fingerprint that can be optimized for designing more active inhibitors. The model was statistically validated with Q(2) = 0.865 for training and r(2) = 0.789, Pearson-r = 0.903 for test set molecules; r(2)(0.925) by external validation suggests model robustness and indicates it as a strong query for screening any compound library. Virtual screening shows the importance of active site and hinge region residue for interaction with KDR inhibitors. Remarkably the retrieved hits contain a urea backbone, implicating urea derivatives as promising candidate for designing KDR inhibitors. The hydrophobicity of active site, which has until now been overlooked, has been raised into the picture by this study. This can impact on KDR drug development. The study thus quantifies crucial structural requirements necessary for a favourable interaction with the receptor binding site while the cooperative pattern provides important structural clues to chemists for framing potent medicinal agents in future.
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Affiliation(s)
- R K Kar
- Biomedical Informatics Centre, Rajendra Memorial Research Institute of Medical Sciences, Patna, India
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21
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Mudd SR, Holich KD, Voorbach MJ, Cole TB, Reuter DR, Tapang P, Bukofzer G, Chakravartty A, Donawho CK, Palma JP, Fox GB, Day M, Luo Y. Pharmacodynamic evaluation of irinotecan therapy by FDG and FLT PET/CT imaging in a colorectal cancer xenograft model. Mol Imaging Biol 2013; 14:617-24. [PMID: 22167582 DOI: 10.1007/s11307-011-0529-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE Longitudinal changes of 3'-[(18) F]fluoro-3'-deoxythymidine (FLT) and 2-deoxy-2-[(18) F]fluoro-D-glucose (FDG) in response to irinotecan therapy in an animal model of colorectal cancer were compared. PROCEDURES SCID/CB-17 mice with HCT116 tumors were treated with 50 mg/kg irinotecan by intraperitoneal injection weekly for 3 weeks. FLT and FDG-positron emission tomography (PET) were performed at baseline, the day after each treatment, and 5 days after the first treatment. Proliferation and apoptosis were evaluated by immunohistochemistry (IHC) after day 15 of imaging. RESULTS Irinotecan treatment resulted in a suppression of tumor growth. Tumor FLT uptake was decreased the day after each treatment but to a lesser extent 5 days after the first treatment. FDG uptake increased the day after each treatment with a continuous increase throughout the experiment. IHC analysis of phospho-H3 and Ki67 confirmed FLT-PET results, indicating a decrease in proliferation the day after the final irinotecan treatment. Increased apoptosis monitored by caspase-3 was observed after day 15 with irinotecan treatment. CONCLUSIONS FLT-PET may be a better method than FDG-PET for assessing treatment response to irinotecan. Changes in imaging occur before changes in tumor volume.
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Affiliation(s)
- Sarah R Mudd
- Translational Imaging and Biochemical Biomarkers, Advanced Technology, Global Pharmaceutical Research and Development, Abbott Laboratories, Abbott Park, IL, USA.
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Pinato DJ, Stavraka C, Tanner M, Esson A, Jacobson EW, Wilkins MR, Libri V. Clinical, ethical and financial implications of incidental imaging findings: experience from a phase I trial in healthy elderly volunteers. PLoS One 2012; 7:e49814. [PMID: 23166776 PMCID: PMC3500322 DOI: 10.1371/journal.pone.0049814] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 10/17/2012] [Indexed: 12/05/2022] Open
Abstract
Background The detection of incidental findings (IF) in magnetic resonance imaging (MRI) studies is common and increases as a function of age. Responsible handling of IF is required, with implications for the conduct of research and the provision of good clinical care. Aim To investigate the prevalence and clinical significance of IF in a prospective cohort of healthy elderly volunteers who underwent MRI of the torso as a baseline investigation for a phase I trial. We assessed the follow-up pathway with consequent cost implications and impact on trial outcomes. Methods A total of 29 elderly healthy volunteers (mean age 67, range 61–77, 59% female) were eligible at screening and underwent MRI for assessment of visceral and subcutaneous fat. Results IF were detected in 19 subjects (66%). Suspected IF of high and low clinical significance were found in 14% and 52% of participants, respectively. Follow up of IF was conducted in 18 individuals, confirming abnormalities in 13 subjects, 3 of whom were recommended for deferred clinical re-evaluation. The remaining 5 subjects had false positive IF based on second line imaging tests. Costs of follow-up medical care were considerable. Conclusion MRI abnormalities are common in elderly individuals, as a result of age and non-diagnostic quality of research scans. In the presence of IF in the context of clinical trials, immediate referrals and follow up assessments may be required to rule out suspected pathology prior to exposing trial participants to investigational medicine products (IMP). Unanticipated costs, ethical implication and the possible impact of IF on trial outcomes need to be taken into account when designing and conducting trials with an IMP.
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Affiliation(s)
- David J. Pinato
- The National Institute for Health Research (NIHR)-Wellcome Trust Imperial College Clinical Research Facility, Imperial Centre for Translational and Experimental Medicine, Imperial College, Hammersmith Hospital Campus, London, United Kingdom
| | - Chara Stavraka
- The National Institute for Health Research (NIHR)-Wellcome Trust Imperial College Clinical Research Facility, Imperial Centre for Translational and Experimental Medicine, Imperial College, Hammersmith Hospital Campus, London, United Kingdom
| | - Mark Tanner
- Imanova Centre for Imaging Sciences, London, United Kingdom
| | - Audrey Esson
- The National Institute for Health Research (NIHR)-Wellcome Trust Imperial College Clinical Research Facility, Imperial Centre for Translational and Experimental Medicine, Imperial College, Hammersmith Hospital Campus, London, United Kingdom
| | - Eric W. Jacobson
- Sirtris Pharmaceuticals Inc., Cambridge, Massachusetts, United States of America
| | - Martin R. Wilkins
- The National Institute for Health Research (NIHR)-Wellcome Trust Imperial College Clinical Research Facility, Imperial Centre for Translational and Experimental Medicine, Imperial College, Hammersmith Hospital Campus, London, United Kingdom
| | - Vincenzo Libri
- The National Institute for Health Research (NIHR)-Wellcome Trust Imperial College Clinical Research Facility, Imperial Centre for Translational and Experimental Medicine, Imperial College, Hammersmith Hospital Campus, London, United Kingdom
- * E-mail:
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Ding H, Wu F. Image guided biodistribution and pharmacokinetic studies of theranostics. Am J Cancer Res 2012; 2:1040-53. [PMID: 23227121 PMCID: PMC3516836 DOI: 10.7150/thno.4652] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 06/17/2012] [Indexed: 11/05/2022] Open
Abstract
Image guided technique is playing an increasingly important role in the investigation of the biodistribution and pharmacokinetics of drugs or drug delivery systems in various diseases, especially cancers. Besides anatomical imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), molecular imaging strategy including optical imaging, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) will facilitate the localization and quantization of radioisotope or optical probe labeled nanoparticle delivery systems in the category of theranostics. The quantitative measurement of the bio-distribution and pharmacokinetics of theranostics in the fields of new drug/probe development, diagnosis and treatment process monitoring as well as tracking the brain-blood-barrier (BBB) breaking through by high sensitive imaging method, and the applications of the representative imaging modalities are summarized in this review.
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Wang YX, Deng M. Medical imaging in new drug clinical development. J Thorac Dis 2012; 2:245-52. [PMID: 22263053 DOI: 10.3978/j.issn.2072-1439.2010.11.10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 11/28/2010] [Indexed: 11/14/2022]
Abstract
Medical imaging can help answer key questions that arise during the drug development process. The role of medical imaging in new drug clinical trials includes identification of likely responders; detection and diagnosis of lesions and evaluation of their severity; and therapy monitoring and follow-up. Nuclear imaging techniques such as PET can be used to monitor drug pharmacokinetics and distribution and study specific molecular endpoints. In assessing drug efficacy, imaging biomarkers and imaging surrogate endpoints can be more objective and faster to measure than clinical outcomes, and allow small group sizes, quick results and good statistical power. Imaging also has important role in drug safety monitoring, particularly when there is no other suitable biomarkers available. Despite the long history of radiological sciences, its application to the drug development process is relatively recent. This review highlights the processes, opportunities, and challenges of medical imaging in new drug development.
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Affiliation(s)
- Yi-Xiang Wang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Ginat DT, Mangla R, Yeaney G, Schaefer PW, Wang H. Correlation between dynamic contrast-enhanced perfusion MRI relative cerebral blood volume and vascular endothelial growth factor expression in meningiomas. Acad Radiol 2012; 19:986-90. [PMID: 22591719 DOI: 10.1016/j.acra.2012.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/03/2012] [Accepted: 04/04/2012] [Indexed: 12/23/2022]
Abstract
PURPOSE To determine whether there is a correlation between vascular endothelial growth factor (VEGF) expression and cerebral blood flow (CBV) measurements in dynamic contrast-enhanced susceptibility perfusion magnetic resonance imaging (MRI) and to correlate the perfusion characteristics in high- versus low-grade meningiomas. METHODS AND MATERIALS A total of 48 (24 high-grade and 24 low-grade) meningiomas with available dynamic susceptibility-weighted MRI were retrospectively reviewed for maximum CBV and semiquantitative VEGF immunoreactivity. Correlation between normalized CBV and VEGF was made using the Spearman rank test and comparison between CBV in high- versus low-grade meningiomas was made using the Wilcoxon test. RESULTS There was a significant (P = .01) correlation between normalized maximum CBV and VEGF scores with a Spearman correlation coefficient of 0.37. In addition, there was a significant (P < .01) difference in normalized maximum CBV ratios between high-grade meningiomas (mean 12.6; standard deviation 5.2) and low-grade meningiomas (mean 8.2; standard deviation 5.2). CONCLUSION The data suggest that CBV accurately reflects VEGF expression and tumor grade in meningiomas. Perfusion-weighted MRI can potentially serve as a useful biomarker for meningiomas, pending prospective studies.
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Zimmer L, Luxen A. PET radiotracers for molecular imaging in the brain: Past, present and future. Neuroimage 2012; 61:363-70. [DOI: 10.1016/j.neuroimage.2011.12.037] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 12/15/2011] [Indexed: 12/22/2022] Open
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Predicting brain occupancy from plasma levels using PET: superiority of combining pharmacokinetics with pharmacodynamics while modeling the relationship. J Cereb Blood Flow Metab 2012; 32:759-68. [PMID: 22186667 PMCID: PMC3318151 DOI: 10.1038/jcbfm.2011.180] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Positron emission tomography (PET) studies of dopamine receptor occupancy can be used to assess dosing of antipsychotics. Typically, studies of antipsychotics have applied pharmacodynamic (PD) modeling alone to characterize the relationship between antipsychotic dose and its effect on the brain. However, a limitation of this approach is that it does not account for the discrepancy between the time courses of plasma concentration and receptor occupancy by antipsychotics. Combined pharmacokinetic-PD (PK-PD) modeling, by incorporating the time dependence of occupancy, is better suited for the reliable analysis of the concentration-occupancy relationship. To determine the effect of time on the concentration-occupancy relationship as a function of analysis approach, we measured dopamine receptor occupancy after the administration of aripiprazole using [(11)C]raclopride PET and obtained serial measurements of the plasma aripiprazole concentration in 18 volunteers. We then developed a PK-PD model for the relationship, and compared it with conventional approach (PD modeling alone). The hysteresis characteristics were observed in the competitor concentration-occupancy relationship and the value of EC(50) was different according to the analysis approach (EC(50) derived from PD modeling alone=11.1 ng/mL (95% confidence interval (CI)=10.1 to 12.1); while that derived from combined PK-PD modeling=8.63 ng/mL (95% CI=7.75 to 9.51)). This finding suggests that PK-PD modeling is required to obtain reliable prediction of brain occupancy by antipsychotics.
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Mudd SR, Voorbach MJ, Reuter DR, Tapang P, Hickson JA, Refici-Buhr M, Fox GB, Albert DH, Luo Y, Day M. FDG-PET as a pharmacodynamic biomarker for early assessment of treatment response to linifanib (ABT-869) in a non-small cell lung cancer xenograft model. Cancer Chemother Pharmacol 2012; 69:1669-72. [PMID: 22327787 DOI: 10.1007/s00280-012-1840-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 01/29/2012] [Indexed: 11/25/2022]
Abstract
Linifanib (ABT-869) is a multitargeted receptor tyrosine kinase inhibitor. This work aims to evaluate F-fluorodeoxyglucose-positron emission tomography (FDG-PET) as a pharmacodynamic (PD) biomarker for linifanib treatment utilizing the Calu-6 model of human non-small cell lung (NSCLC) cancer in SCID-beige mice. Animals received either vehicle or 12.5 mg/kg linifanib orally twice a day for the duration of the study. Imaging was performed at -1, 1, 3, and 7 days after beginning treatment (n = 12-14 per group). Linifanib inhibited tumor growth and suppressed tumor metabolic activity. Changes in tumor FDG uptake were observed as early as 1 day after beginning linifanib treatment and were sustained for the duration of the study. This study confirms that linifanib is efficacious in this xenograft model of human NSCLC and confirms FDG-PET is a potential PD biomarker strategy for linifanib therapy.
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Affiliation(s)
- Sarah R Mudd
- Advanced Technology Translational Sciences, Global Pharmaceutical R & D, Abbott Laboratories, Abbott Park, IL 60064, USA.
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Minas G, Rigat F, Nichols TE, Aston JAD, Stallard N. A hybrid procedure for detecting global treatment effects in multivariate clinical trials: theory and applications to fMRI studies. Stat Med 2011; 31:253-68. [PMID: 22170084 DOI: 10.1002/sim.4395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 08/01/2011] [Indexed: 11/10/2022]
Abstract
In multivariate clinical trials, a key research endpoint is ascertaining whether a candidate treatment is more efficacious than an established alternative. This global endpoint is clearly of high practical value for studies, such as those arising from neuroimaging, where the outcome dimensions are not only numerous but they are also highly correlated and the available sample sizes are typically small. In this paper, we develop a two-stage procedure testing the null hypothesis of global equivalence between treatments effects and demonstrate its application to analysing phase II neuroimaging trials. Prior information such as suitable statistics of historical data or suitably elicited expert clinical opinions are combined with data collected from the first stage of the trial to learn a set of optimal weights. We apply these weights to the outcome dimensions of the second-stage responses to form the linear combination z and t tests statistics while controlling the test's false positive rate. We show that the proposed tests hold desirable asymptotic properties and characterise their power functions under wide conditions. In particular, by comparing the power of the proposed tests with that of Hotelling's T(2), we demonstrate their advantages when sample sizes are close to the dimension of the multivariate outcome. We apply our methods to fMRI studies, where we find that, for sufficiently precise first stage estimates of the treatment effect, standard single-stage testing procedures are outperformed.
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Affiliation(s)
- Giorgos Minas
- Department of Statistics, University of Warwick, Coventry, UK.
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Robertson R, Germanos MS, Manfredi MG, Smith PG, Silva MD. Multimodal imaging with (18)F-FDG PET and Cerenkov luminescence imaging after MLN4924 treatment in a human lymphoma xenograft model. J Nucl Med 2011; 52:1764-9. [PMID: 21994410 DOI: 10.2967/jnumed.111.091710] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Cerenkov luminescence imaging (CLI) is an emerging imaging technique that combines aspects of both optical and nuclear imaging fields. The ability to fully evaluate the correlation and sensitivity of CLI to PET is critical to progress this technique further for use in high-throughput screening of pharmaceutical compounds. To achieve this milestone, it must first be established that CLI data correlate to PET data in an in vivo preclinical antitumor study. We used MLN4924, a phase 2 oncology therapeutic, which targets and inhibits the NEDD8-activating enzyme pathway involved in the ubiquitin-proteasome system. We compared the efficacious effects of MLN4924 using PET and Cerenkov luminescence image values in the same animals. METHODS Imaging of (18)F-FDG uptake was performed at 5 time points after drug treatment in the subcutaneously implanted diffuse large B-cell lymphoma tumor line OCI-Ly10. Data were acquired with both modalities on the same day, with a 15-min delay between CLI and PET. PET data analysis was performed using percentage injected dose per cubic centimeter of tissue (%ID/cm(3)), average standardized uptake values, and total glycolytic volume. CLI measurements were radiance, radiance per injected dose (radiance/ID), and total radiant volume. RESULTS A strong correlation was found between PET total glycolytic volume and CLI total radiant volume (r(2) = 0.99) and various PET and CLI analysis methods, with strong correlations found between PET %ID/cm(3) and CLI radiance (r(2) = 0.83) and CLI radiance/ID (r(2) = 0.82). MLN4924 demonstrated a significant reduction in tumor volume after treatment (volume ratio of treated vs. control, 0.114 at day 29). CONCLUSION The PET and CLI data presented confirm the correlation and dynamic sensitivity of this new imaging modality. CLI provides a preclinical alternative to expensive PET instrumentation. Future high-throughput studies should provide for quicker turnaround and higher cost-to-return benefits in the drug discovery process.
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Affiliation(s)
- Robbie Robertson
- Biomedical Imaging Group, Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts 02139, USA.
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The use of healthy volunteers instead of patients to inform drug dosing studies: a [¹¹C]raclopride PET study. Psychopharmacology (Berl) 2011; 217:515-23. [PMID: 21503604 DOI: 10.1007/s00213-011-2306-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 04/07/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE Receptor occupancy study has been performed to evaluate pharmacokinetic profiles in new antipsychotic drug development. While these findings highlight the value of positron emission tomography (PET) for dose-finding study, what is unclear is if it is necessary to conduct these studies in patients with schizophrenia or whether studies in healthy volunteers are adequate. OBJECTIVES To determine if it is necessary to conduct dopamine receptor occupancy studies in patients with schizophrenia or whether studies in healthy volunteers are adequate for dose-finding study, we compared the concentration-occupancy relationship in terms of EC(50) between patients and healthy volunteers. METHODS Ten healthy volunteers and eight patients with schizophrenia participated in the study. We measured dopamine receptor occupancy using [(11)C]raclopride PET and plasma concentration of YKP1358, a novel antipsychotic drug under clinical development, at a number of time points after the administration of YKP1358. Pharmacokinetic data including area under the plasma concentration versus time curve, elimination half-life, maximum observed plasma concentration, and the time to reach the maximum observed plasma concentration were obtained. We explored the relationship between plasma concentration and dopamine D(2) receptor occupancy using E (max) model and calculated EC(50). RESULTS The elimination half-life was longer in healthy volunteers than in patients. Other pharmacokinetic parameters were not significantly different between two groups. The EC(50) was 7.6 ng/ml (95% confidence interval (CI) 6.2-9.0) in healthy volunteers and 8.6 (95% CI 7.4-9.9) in patients. CONCLUSIONS The antipsychotic concentration-occupancy relationship in patients can be estimated from the EC(50) data of healthy volunteers.
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Kim E, Howes OD, Yu KS, Jeong JM, Lee JS, Jang IJ, Shin SG, Kapur S, Kwon JS. Calculating occupancy when one does not have baseline: a comparison of different options. J Cereb Blood Flow Metab 2011; 31:1760-7. [PMID: 21522162 PMCID: PMC3170949 DOI: 10.1038/jcbfm.2011.54] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dopamine D(2) receptor occupancy of antipsychotic drugs is calculated relative to the subject's D(2) receptor binding potential (BP) in the drug-free state (baseline BP). Because baseline BP is seldom known in patients with schizophrenia, population means from unrelated control samples are often used to estimate it. However, this is likely to introduce bias and error into the occupancy measure. There is thus a need for a method to reliably estimate baseline BP for patient populations in whom it may be impractical or unethical to get baseline measurements. It has been previously found that the relationship between plasma concentration and dopamine receptor occupancy by antipsychotic drugs follows a sigmoid E(max) model. Based on this, we developed a method for calculating dopamine D(2) receptor occupancy by antipsychotic drugs using an inhibitory E(max) model (I(max) method) that estimates individual baseline BPs. To validate this, we compared the result from the I(max) method with actual occupancy and estimated occupancy calculated from the average baseline BP (substitution method). The data for validation were obtained from two different receptor occupancy studies with the antipsychotic medications YKP1358 and aripiprazole. We estimated the reliability between the true measured occupancy and the predicted occupancy using the intraclass correlation coefficient (ICC), and the variability of occupancy was also compared between the I(max) and substitution methods. In YKP1358 study, all the ICCs of the I(max) method were above 0.8, but those of the substitution method showed values lower than 0.8. In aripiprazole study, the ICCs of the I(max) method were higher than those of the substitution method, but all the ICCs showed higher values than 0.8. The variability of I(max) method was significantly smaller than that of substitution method in both studies. The I(max) method shows better reliability and less variability than the substitution method. The I(max) method can be applied for receptor occupancy study, and bring more reliability and accuracy to the occupancy study in patients with schizophrenia.
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Affiliation(s)
- Euitae Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Gottlieb RH, Krupinski E, Chalasani P, Cranmer L. Quantified visual scoring of metastatic melanoma patient treatment response using computed tomography: improving on the current standard. J Digit Imaging 2011; 25:258-65. [PMID: 21785917 DOI: 10.1007/s10278-011-9407-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
To assess whether quantitative visual scoring (QVS) is a better early predictor of progression-free survival (PFS) in patients on chemotherapy for metastatic melanoma using CT than the currently used Response Evaluation Criteria in Solid Tumors (RECIST) standard. Retrospective evaluation of 65 consecutive patients with metastatic melanoma on treatment who had a baseline and follow-up CT after two cycles of therapy. QVS was used to code imaging findings on the radiology reports considering size change, brain metastases, new lesions, mixed lesion response, and the number of organ systems involved. RECIST 1.1 criteria placed patients in the progressive disease, stable disease, or partial response groups. Multiple regression analysis was used to correlate the various independent variables with PFS. The Cox hazard proportions ratio, median survival, and Kaplan-Meier curves of the different prognostic groups were calculated. QVS of size change was found more sensitive in detecting patients deteriorating (57.1% versus 37.5%) or improving (23.8% versus 10.7%), more correlated with the median PFS for the deteriorating (1.8 versus 1.7 months), stable (5.6 versus 4.0 month), and improving (8.3 versus 5.5 months) categories and more predictive of PFS (Cox hazard proportion ratio of 3.070 versus 1.860) than RECIST 1.1 categorization. Multiple regression analysis demonstrated QVS of lesion size correlated most closely with PFS among the variables assessed (r = 0.519, p < 0.0001). QVS in this study was superior to standard RECIST categorization in terms of discriminating treated metastatic melanoma patients likely to have longer PFS.
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Affiliation(s)
- Ronald H Gottlieb
- Department of Radiology, University of Arizona, Tucson, AZ 85719, USA.
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Optical and magnetic resonance imaging as complementary modalities in drug discovery. Future Med Chem 2011; 2:317-37. [PMID: 21426169 DOI: 10.4155/fmc.09.175] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Imaging has the ability to study various biological and chemical processes noninvasively in living subjects in a longitudinal way. For this reason, imaging technologies have become an integral part of the drug-discovery and development program and are commonly used in following disease processes and drug action in both preclinical and clinical stages. As the domain of imaging sciences transitions from anatomical/functional to molecular applications, the development of molecular probes becomes crucial for the advancement of the field. This review summarizes the role of two complementary techniques, magnetic resonance and fluorescence optical imaging, in drug discovery. While the first approach exploits intrinsic tissue characteristics as the source of image contrast, the second necessitates the use of appropriate probes for signal generation. The anatomical, functional, metabolic and molecular information that becomes accessible through imaging can provide invaluable insights into disease mechanisms and mechanisms of drug action.
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Land WH, Margolis D, Gottlieb R, Krupinski EA, Yang JY. Improving CT prediction of treatment response in patients with metastatic colorectal carcinoma using statistical learning theory. BMC Genomics 2010; 11 Suppl 3:S15. [PMID: 21143782 PMCID: PMC2999345 DOI: 10.1186/1471-2164-11-s3-s15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Significant interest exists in establishing radiologic imaging as a valid biomarker for assessing the response of cancer to a variety of treatments. To address this problem, we have chosen to study patients with metastatic colorectal carcinoma to learn whether statistical learning theory can improve the performance of radiologists using CT in predicting patient treatment response to therapy compared with the more traditional RECIST (Response Evaluation Criteria in Solid Tumors) standard. Results Predictions of survival after 8 months in 38 patients with metastatic colorectal carcinoma using the Support Vector Machine (SVM) technique improved 30% when using additional information compared to WHO (World Health Organization) or RECIST measurements alone. With both Logistic Regression (LR) and SVM, there was no significant difference in performance between WHO and RECIST. The SVM and LR techniques also demonstrated that one radiologist consistently outperformed another. Conclusions This preliminary research study has demonstrated that SLT algorithms, properly used in a clinical setting, have the potential to address questions and criticisms associated with both RECIST and WHO scoring methods. We also propose that tumor heterogeneity, shape, etc. obtained from CT and/or MRI scans be added to the SLT feature vector for processing.
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Affiliation(s)
- Walker H Land
- Department of Bioengineering, Binghamton University, Binghamton, NY 13903-6000, USA.
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Quantitative imaging in oncology patients: Part 1, radiology practice patterns at major U.S. cancer centers. AJR Am J Roentgenol 2010; 195:101-6. [PMID: 20566802 DOI: 10.2214/ajr.09.2850] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to examine radiologists' opinions and practice patterns concerning tumor measurements in cancer patients. MATERIALS AND METHODS An electronic mail survey was sent to 565 abdominal imaging radiologists at 55 U.S. National Cancer Institute (NCI)-funded cancer centers. The survey contained questions about departmental demographics, procedures for interpretation of imaging in oncologic patients, and opinions concerning the role of radiologists in using the Response Evaluation Criteria in Solid Tumors (RECIST) system for tumor measurements. RESULTS Two hundred ninety-six responses (52%) were received. The distribution of the size of the respondents' abdominal imaging groups was as follows: 1-5 (16/295, 5%), 6-10 (112/295, 38%), 11-15 (77/295, 26%), and > 20 (73/295, 25%). Most respondents dictate some but not all tumor measurements in the first clinical scan (236/270, 87%). For follow-up imaging, 95% (255/268) of respondents dictate tumor measurements for selected index lesions. Most respondents believe inclusion of tumor measurements in the first scan is the responsibility of the radiologist (248/262, 95%). Ninety percent of respondents (235/261) believe inclusion of several index lesion measurements is satisfactory to document disease activity. Eighty-two percent (214/260) of respondents were familiar with RECIST. Forty-two percent (110/262) of respondents' departments have a centralized process for approval of industry-sponsored oncologic trials in which imaging is an important component of the protocol end point. CONCLUSION Most oncologic imaging at NCI-sponsored cancer centers includes tumor measurements on initial and follow-up imaging. Very few radiology departments have a centralized process for approval of clinical trial protocols that require imaging.
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Quantitative imaging in oncology patients: Part 2, oncologists' opinions and expectations at major U.S. cancer centers. AJR Am J Roentgenol 2010; 195:W19-30. [PMID: 20566776 DOI: 10.2214/ajr.09.3541] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The purpose of this article is to examine oncologists' opinions and expectations concerning imaging and tumor measurements in patients with cancer. MATERIALS AND METHODS An electronic mail survey was sent to 2,400 medical, gynecologic, and radiation oncologists at 55 U.S. National Cancer Institute-funded cancer centers. The survey contained questions about departmental demographics, opinions regarding imaging for patients with cancer, PET/CT utilization, and utilization of the Response Evaluation Criteria in Solid Tumors (RECIST) system in therapy protocols that use imaging as a therapeutic end point. RESULTS A total of 492 responses (21%) were received. Sixty percent (294) of respondents were medical oncologists, 9% (45) were gynecologic oncologists, 26% (127) were radiation oncologists, and 5% (25) answered "Other." Ninety-eight percent (431/438) of respondents provide clinical care, and 99% (420/425) have participated in clinical trials. Most respondents (94% [410/438]) expect some or all tumors to be measured at the time of standard initial clinical imaging. Over half (65% [275/426]) think that tumor measurements should be bidimensional. Only 25% (101/400) of respondents' institutions have department rules on the implementation of RECIST measurements. Sixty-eight percent of participants (269/397) think that RECIST is flawed but serviceable. Over half of respondents (56% [221/398]) were not familiar with RECIST 1.1 modifications. CONCLUSION Most oncologists at National Cancer Institute-sponsored cancer centers expect tumor measurements to be made in the routine imaging of patients with cancer. Almost two thirds of respondents think that bidimensional measurements of index lesions are satisfactory in routine oncologic imaging. Little consensus exists in the implementation of RECIST measurements for clinical trials at these centers.
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Quantitative methodology using CT for predicting survival in patients with metastatic colorectal carcinoma: a pilot study. Clin Imaging 2010; 34:196-202. [PMID: 20416484 DOI: 10.1016/j.clinimag.2010.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 01/02/2010] [Accepted: 01/10/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To develop a methodology which quantifies multiple changing lesion features resulting in an optimized computed tomography (CT) response score (CRS) for prediction of overall survival (OS) in response to treatment for metastatic colorectal carcinoma (MCRC). SUBJECTS AND METHODS This Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective study evaluated multiple changing imaging findings and their correlation with OS with a new methodology comparing the baseline and first post-treatment CT scans in 38 MCRC patients on last-line chemotherapy (cetuximab and irinotecan). Tumor size/enhancement changes and interval development of new lesions were quantified with either Likert-type scales (all parameters) or Response Evaluation Criteria in Solid Tumors (RECIST) (size change only). The most predictive parameters for OS were used to generate the CRS with an overall range of -3 (complete disappearance) to +2 (definite tumor increase). The Cox Hazard Ratio was used to assess prediction of survival. Reader agreement was evaluated by the kappa statistic. RESULTS Tumor size was the best predictor of OS using the Likert-type scale or RECIST. The CRS was not improved combining size change with other parameters. Use of the Likert-type scale resulted in predicting OS with a Cox hazard ratio of 1.697 (P=.0004) and good agreement (kappa=0.73, 95% CI=0.41-1.10) between observers with no significant difference using RECIST. CONCLUSION The methodology produces a CRS for MCRC predicting OS resulting from therapy which expands standard RECIST guidelines to allow critical evaluation of multiple additional imaging parameters. Size change alone was found to be the best parameter of those considered in terms of maximizing agreement and prediction of OS.
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Semiquantitative visual approach to scoring lung cancer treatment response using computed tomography: a pilot study. J Comput Assist Tomogr 2009; 33:743-7. [PMID: 19820504 DOI: 10.1097/rct.0b013e3181963b14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to compare a newly developed semiquantitative visual scoring (SVS) method with the current standard, the Response Evaluation Criteria in Solid Tumors (RECIST) method, in the categorization of treatment response and reader agreement for patients with metastatic lung cancer followed by computed tomography. MATERIALS AND METHODS The 18 subjects (5 women and 13 men; mean age, 62.8 years) were from an institutional review board-approved phase 2 study that evaluated a second-line chemotherapy regimen for metastatic (stages III and IV) non-small cell lung cancer. Four radiologists, blinded to the patient outcome and each other's reads, evaluated the change in the patients' tumor burden from the baseline to the first restaging computed tomographic scan using either the RECIST or the SVS method. We compared the numbers of patients placed into the partial response, the stable disease (SD), and the progressive disease (PD) categories (Fisher exact test) and observer agreement (kappa statistic). RESULTS Requiring the concordance of 3 of the 4 readers resulted in the RECIST placing 17 (100%) of 17 patients in the SD category compared with the SVS placing 9 (60%) of 15 patients in the partial response, 5 (33%) of the 15 patients in the SD, and 1 (6.7%) of the 15 patients in the PD categories (P < 0.0001). Interobserver agreement was higher among the readers using the SVS method (kappa, 0.54; P < 0.0001) compared with that of the readers using the RECIST method (kappa, -0.01; P = 0.5378). CONCLUSIONS Using the SVS method, the readers more finely discriminated between the patient response categories with superior agreement compared with the RECIST method, which could potentially result in large differences in early treatment decisions for advanced lung cancer.
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Serdons K, Verbruggen A, Bormans GM. Developing new molecular imaging probes for PET. Methods 2009; 48:104-11. [PMID: 19318126 DOI: 10.1016/j.ymeth.2009.03.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 03/11/2009] [Indexed: 10/21/2022] Open
Abstract
Positron emission tomography (PET) is a fully translational molecular imaging technique that requires specific probes radiolabelled with short-lived positron emitting radionuclides. This review discusses relevant methods which are applied throughout the different steps in the development of new PET probes for in vivo visualization of specific molecular targets related to diagnosis or important for drug development.
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Affiliation(s)
- Kim Serdons
- Laboratory for Radiopharmacy, K.U.Leuven, Herestraat 49 bus 821, BE3000 Leuven, Belgium
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Tilahun A, Maringwa JT, Geys H, Alonso A, Raeymaekers L, Molenberghs G, Kieboom GVD, Drinkenburg P, Bijnens L. Investigating Association Between Behavior, Corticosterone, Heart Rate, and Blood Pressure in Rats Using Surrogate Marker Evaluation Methodology. J Biopharm Stat 2009; 19:133-49. [DOI: 10.1080/10543400802527924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Abel Tilahun
- a Center for Statistics , Hasselt University , Diepenbeek, Belgium
| | - John T. Maringwa
- a Center for Statistics , Hasselt University , Diepenbeek, Belgium
| | - Helena Geys
- b Johnson and Johnson Pharmaceutical Research and Development , A Division of Janssen Pharmaceutica , Beerse, Belgium
| | - Ariel Alonso
- a Center for Statistics , Hasselt University , Diepenbeek, Belgium
| | - Leen Raeymaekers
- b Johnson and Johnson Pharmaceutical Research and Development , A Division of Janssen Pharmaceutica , Beerse, Belgium
| | | | - Gerd Van Den Kieboom
- b Johnson and Johnson Pharmaceutical Research and Development , A Division of Janssen Pharmaceutica , Beerse, Belgium
| | - Pim Drinkenburg
- b Johnson and Johnson Pharmaceutical Research and Development , A Division of Janssen Pharmaceutica , Beerse, Belgium
| | - Luc Bijnens
- b Johnson and Johnson Pharmaceutical Research and Development , A Division of Janssen Pharmaceutica , Beerse, Belgium
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Abstract
Molecular imaging can allow the non-invasive assessment of biological and biochemical processes in living subjects. Such technologies therefore have the potential to enhance our understanding of disease and drug activity during preclinical and clinical drug development, which could aid decisions to select candidates that seem most likely to be successful or to halt the development of drugs that seem likely to ultimately fail. Here, with an emphasis on oncology, we review the applications of molecular imaging in drug development, highlighting successes and identifying key challenges that need to be addressed for successful integration of molecular imaging into the drug development process.
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Gottlieb RH, Litwin A, Gupta B, Taylor J, Raczyk C, Mashtare T, Wilding G, Fakih M. Qualitative radiology assessment of tumor response: does it measure up? Clin Imaging 2008; 32:136-40. [PMID: 18313578 DOI: 10.1016/j.clinimag.2007.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 11/20/2007] [Indexed: 11/20/2022]
Abstract
Our purpose was to assess whether a simpler qualitative evaluation of tumor response by computed tomography is as reproducible and predictive of clinical outcome as the Response Evaluation Criteria in Solid Tumors (RECIST) and World Health Organization (WHO) methods. This study was a two-reader retrospective evaluation in which qualitative assessment resulted in agreement in 21 of 23 patients with metastatic colorectal carcinoma (91.3%, kappa=0.78; 95% CI, 0.51-1.00). Hepatic metastases were classified as increased, decreased, or unchanged, compared with agreement in 20 of 23 patients (87.0%) for RECIST (kappa=0.62; 95% CI, 0.23-1.00) and WHO (kappa=0.67; 95% CI, 0.34-1.00) methods. Patients were placed into partial response, stable disease, and disease progression categories. Time to progression of disease was better predicted qualitatively than by RECIST or WHO. Our pilot data suggest that our qualitative scoring system is more reproducible and predictive of patient clinical outcome than the RECIST and WHO methods.
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Abstract
Pacific Biomarkers, Inc. is a recently incorporated, wholly owned subsidiary of Pacific Biometrics, Inc. (PBI), a specialty clinical trials laboratory. Pacific Biomarkers was created to provide biomarker testing services for clinical drug development, specifically in the areas of ligand-binding assays, multiplexing and immunogenicity testing, in a regulatory-compliant environment.
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Affiliation(s)
- Mario R Ehlers
- Pacific Biomarkers, Inc., 220 West Harrison Street, Seattle, WA 98119, USA
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Jacobsen M, Mattow J, Repsilber D, Kaufmann SH. Novel strategies to identify biomarkers in tuberculosis. Biol Chem 2008; 389:487-95. [DOI: 10.1515/bc.2008.053] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The more we learn about the immune response against tuberculosis (TB) and particularly about the features which distinguish protective immunity, disease susceptibility and pathology, the better we can define biomarkers which correlate with these different stages of infection. The most widely used biomarker in TB, which without a doubt is an important component of protective immunity, is IFNγ secreted by antigen-specific CD4 T-cells. However, the complexity of the immune response against TB makes it more than likely that additional biomarkers are required for a reliable correlate of protection. As a corollary, we assume that a set of biomarkers will be required, termed a biosignature.
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Nunn AD. Molecular imaging and personalized medicine: an uncertain future. Cancer Biother Radiopharm 2008; 22:722-39. [PMID: 18158763 DOI: 10.1089/cbr.2007.0417] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Food and Drug Administration has described their view of the role that imaging will play in the approval, and perhaps postapproval, use of new therapeutic drugs. The therapeutic drug industry and regulatory authorities have turned to imaging to help them achieve better efficiency and efficacy. We must extend this initiative by demonstrating that molecular imaging can also improve the efficiency and efficacy of routine treatment with these same drugs. The role of molecular imaging in personalized medicine, using targeted drugs in oncology, is very attractive because of the regional information that it provides (in many cases, with a functional or dynamic component), which cannot be provided by in vitro methods ("regional proteomics"). There is great potential for molecular imaging to play a major role in selecting appropriate patients and providing early proof of response, which is critical to addressing the conflict between the high price of treatment and limited reimbursement budgets. This is a new venture in both molecular imaging and targeted drugs. However, there are various regulatory, financial, and practical barriers that must be overcome to achieve this aim, in addition to the normal scientific challenges of drug discovery. There is an urgent need to reduce the cost (i.e., time and money) of developing imaging agents for routine clinical use. The mismatch between the current regulations and personalized medicine includes molecular imaging and requires the engagement of the regulatory authorities to correct. Therapeutic companies must be engaged early in the development of new targeted drugs and molecular imaging agents to improve the fit between the two drug types. Clinical trials must be performed to generate data that not only shows the efficacy of imaging plus therapy in a medical sense, but also in a financial sense. Molecular imaging must be accepted as not just good science but also as central to routine patient management in the personalized medicine of the future.
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The Use of Imaging in the Early Development of Neuropharmacological Drugs: A Survey of Approved NDAs. Clin Pharmacol Ther 2007; 84:69-74. [DOI: 10.1038/sj.clpt.6100422] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Santamaria F, Andreucci MV, Parenti G, Polverino M, Viggiano D, Montella S, Cesaro A, Ciccarelli R, Capaldo B, Andria G. Upper airway obstructive disease in mucopolysaccharidoses: polysomnography, computed tomography and nasal endoscopy findings. J Inherit Metab Dis 2007; 30:743-9. [PMID: 17570075 DOI: 10.1007/s10545-007-0555-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Revised: 04/11/2007] [Accepted: 04/19/2007] [Indexed: 10/23/2022]
Abstract
In mucopolysaccharidoses, upper airway obstruction has multiple causative factors and progressive respiratory disease may severely affect morbidity and mortality. In a cross-sectional study over 2 years we evaluated upper airway obstructive disease through overnight polysomnography, upper airway computed tomography and nasal endoscopy in 5 children and 6 adults with mucopolysaccharidoses of various types. Measurements of apnoea and apnoea-hypopnoea index, arousal index, and sleep efficiency were obtained through polysomnography. Retropalatal and retroglossal spaces were calculated through computed tomography, and the degree of adenoid hypertrophy was assessed through endoscopy. Apnoea index and apnoea-hypopnoea index were significantly higher in children than in adults with mucopolysaccharidoses (p = 0.03 and p = 0.03, respectively). Compared to healthy controls, retropalatal and retroglossal spaces were significantly smaller in children (p = 0.03 and p = 0.004, respectively) or adults with mucopolysaccharidoses (p = 0.004 and p = 0.004, respectively). All subjects had adenoid hypertrophy causing first-degree (36%) or second-degree (64%) obstruction at endoscopy. Overnight polysomnography, upper airway computed tomography and nasal endoscopy are useful tools for diagnosing obstructive sleep apnoea syndrome in mucopolysaccharidoses, and identifying the site and severity of airway obstruction.
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Affiliation(s)
- F Santamaria
- Department of Pediatrics, Federico II University, Via Pansini 5, 80131, Naples, Italy
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Turowski SG, Seshadri M, Loecher M, Podniesinski E, Spernyak JA, Mazurchuk RV. Performance of a novel piezoelectric motor at 4.7 T: applications and initial tests. Magn Reson Imaging 2007; 26:426-32. [PMID: 17826943 DOI: 10.1016/j.mri.2007.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Accepted: 07/16/2007] [Indexed: 12/11/2022]
Abstract
The focus of this report was to test the performance of a novel piezoelectric motor under high magnetic field strength conditions and to investigate its potential applications in small animal magnetic resonance imaging (MRI). The device is made entirely of nonferrous materials and consists of four piezoelectric ceramic plates connected to a threaded metal tube through which a screw migrates. Ultrasonic vibrations of the threads inherent to the tube result in rotational and translational motion of the screw. Potential applications of the piezoelectric motor were investigated at 4.7 T. Firstly, phantom studies showed the motor was capable of accurately delivering low injection volumes ( approximately 0.01 ml). Dynamic contrast-enhanced MRI (DCE-MRI) studies performed in vivo using serially acquired T1-weighted, spin-echo imaging demonstrated the ability of the motor to reliably administer MR contrast-enhancing agent into live tumor-bearing mice without the introduction of image artifacts. In a second set of experiments, the motor allowed for controlled, dynamic repositioning of an anatomic slice of interest in a live animal to magnetic field isocenter, which resulted in reduced geometric distortion and image artifact due to improved radiofrequency and gradient field homogeneity. In conclusion, piezoelectric motors are MR compatible and offer great potential for improving MRI efficiency and throughput, particularly in a preclinical setting. Further investigation into applications such as automated capacitor tuning and impedance matching for MR transceiver coils is warranted.
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Affiliation(s)
- Steven G Turowski
- Preclinical Imaging Resource, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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Lucignani G. Imaging biomarkers: from research to patient care—a shift in view. Eur J Nucl Med Mol Imaging 2007; 34:1693-7. [PMID: 17823797 DOI: 10.1007/s00259-007-0569-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Giovanni Lucignani
- Institute of Radiological Sciences, University of Milan, Unit of Nuclear Medicine, Hospital San Paolo, Via Antonio di Rudinì, 8, 20142 Milan, Italy.
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