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Zhang K, Triphan SMF, Wielpütz MO, Ziener CH, Ladd ME, Schlemmer HP, Kauczor HU, Sedlaczek O, Kurz FT. Navigator-based motion compensation for liver BOLD measurement with five-echo SAGE EPI and breath-hold task. NMR IN BIOMEDICINE 2024:e5173. [PMID: 38783837 DOI: 10.1002/nbm.5173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE The purpose of this work is to apply multi-echo spin- and gradient-echo (SAGE) echo-planar imaging (EPI) combined with a navigator-based (NAV) prospective motion compensation method for a quantitative liver blood oxygen level dependent (BOLD) measurement with a breath-hold (BH) task. METHODS A five-echo SAGE sequence was developed to quantitatively measure T2 and T2* to depict function with sufficient signal-to-noise ratio, spatial resolution and sensitivity to BOLD changes induced by the BH task. To account for respiratory motion, a navigator was employed in the form of a single gradient-echo projection readout, located at the diaphragm along the inferior-superior direction. Prior to each transverse imaging slice of the spin-echo EPI-based readouts, navigator acquisition and fat suppression were incorporated. Motion data was obtained from the navigator and transmitted back to the sequence, allowing real-time adjustments to slice positioning. Six healthy volunteers and three patients with liver carcinoma were included in this study. Quantitative T2 and T2* were calculated at each time point of the BH task. Parameters of t value from first-level analysis using a general linear model and hepatovascular reactivity (HVR) of Echo1, T2 and T2* were calculated. RESULTS The motion caused by respiratory activity was successfully compensated using the navigator signal. The average changes of T2 and T2* during breath-hold were about 1% and 0.7%, respectively. With the help of NAV prospective motion compensation whole liver t values could be obtained without motion artifacts. The quantified liver T2 (34.7 ± 0.7 ms) and T2* (29 ± 1.2 ms) values agreed with values from literature. In healthy volunteers, the distribution of statistical t value and HVR was homogeneous throughout the whole liver. In patients with liver carcinoma, the distribution of t value and HVR was inhomogeneous due to metastases or therapy. CONCLUSIONS This study demonstrates the feasibility of using a NAV prospective motion compensation technique in conjunction with five-echo SAGE EPI for the quantitative measurement of liver BOLD with a BH task.
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Affiliation(s)
- Ke Zhang
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Mark O Wielpütz
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Christian H Ziener
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Mark E Ladd
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
- Faculty of Physics and Astronomy, Heidelberg University, Heidelberg, Germany
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | | | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Sedlaczek
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Felix T Kurz
- Division of Radiology, German Cancer Research Center, Heidelberg, Germany
- Division of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
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McCabe A, Martin S, Rowe S, Shah J, Morgan PS, Borys D, Panek R. Oxygen-enhanced MRI assessment of tumour hypoxia in head and neck cancer is feasible and well tolerated in the clinical setting. Eur Radiol Exp 2024; 8:27. [PMID: 38443722 PMCID: PMC10914657 DOI: 10.1186/s41747-024-00429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/08/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Tumour hypoxia is a recognised cause of radiotherapy treatment resistance in head and neck squamous cell carcinoma (HNSCC). Current positron emission tomography-based hypoxia imaging techniques are not routinely available in many centres. We investigated if an alternative technique called oxygen-enhanced magnetic resonance imaging (OE-MRI) could be performed in HNSCC. METHODS A volumetric OE-MRI protocol for dynamic T1 relaxation time mapping was implemented on 1.5-T clinical scanners. Participants were scanned breathing room air and during high-flow oxygen administration. Oxygen-induced changes in T1 times (ΔT1) and R2* rates (ΔR2*) were measured in malignant tissue and healthy organs. Unequal variance t-test was used. Patients were surveyed on their experience of the OE-MRI protocol. RESULTS Fifteen patients with HNSCC (median age 59 years, range 38 to 76) and 10 non-HNSCC subjects (median age 46.5 years, range 32 to 62) were scanned; the OE-MRI acquisition took less than 10 min and was well tolerated. Fifteen histologically confirmed primary tumours and 41 malignant nodal masses were identified. Median (range) of ΔT1 times and hypoxic fraction estimates for primary tumours were -3.5% (-7.0 to -0.3%) and 30.7% (6.5 to 78.6%) respectively. Radiotherapy-responsive and radiotherapy-resistant primary tumours had mean estimated hypoxic fractions of 36.8% (95% confidence interval [CI] 17.4 to 56.2%) and 59.0% (95% CI 44.6 to 73.3%), respectively (p = 0.111). CONCLUSIONS We present a well-tolerated implementation of dynamic, volumetric OE-MRI of the head and neck region allowing discernment of differing oxygen responses within biopsy-confirmed HNSCC. TRIAL REGISTRATION ClinicalTrials.gov, NCT04724096 . Registered on 26 January 2021. RELEVANCE STATEMENT MRI of tumour hypoxia in head and neck cancer using routine clinical equipment is feasible and well tolerated and allows estimates of tumour hypoxic fractions in less than ten minutes. KEY POINTS • Oxygen-enhanced MRI (OE-MRI) can estimate tumour hypoxic fractions in ten-minute scanning. • OE-MRI may be incorporable into routine clinical tumour imaging. • OE-MRI has the potential to predict outcomes after radiotherapy treatment.
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Affiliation(s)
- Alastair McCabe
- Academic Unit of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.
| | - Stewart Martin
- Academic Unit of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Selene Rowe
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jagrit Shah
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Paul S Morgan
- Mental Health & Clinical Neurosciences Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Medical Physics & Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Damian Borys
- Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Rafal Panek
- Mental Health & Clinical Neurosciences Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Medical Physics & Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Gouel P, Decazes P, Vera P, Gardin I, Thureau S, Bohn P. Advances in PET and MRI imaging of tumor hypoxia. Front Med (Lausanne) 2023; 10:1055062. [PMID: 36844199 PMCID: PMC9947663 DOI: 10.3389/fmed.2023.1055062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Tumor hypoxia is a complex and evolving phenomenon both in time and space. Molecular imaging allows to approach these variations, but the tracers used have their own limitations. PET imaging has the disadvantage of low resolution and must take into account molecular biodistribution, but has the advantage of high targeting accuracy. The relationship between the signal in MRI imaging and oxygen is complex but hopefully it would lead to the detection of truly oxygen-depleted tissue. Different ways of imaging hypoxia are discussed in this review, with nuclear medicine tracers such as [18F]-FMISO, [18F]-FAZA, or [64Cu]-ATSM but also with MRI techniques such as perfusion imaging, diffusion MRI or oxygen-enhanced MRI. Hypoxia is a pejorative factor regarding aggressiveness, tumor dissemination and resistance to treatments. Therefore, having accurate tools is particularly important.
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Affiliation(s)
- Pierrick Gouel
- Département d’Imagerie, Centre Henri Becquerel, Rouen, France,QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France
| | - Pierre Decazes
- Département d’Imagerie, Centre Henri Becquerel, Rouen, France,QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France
| | - Pierre Vera
- Département d’Imagerie, Centre Henri Becquerel, Rouen, France,QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France
| | - Isabelle Gardin
- Département d’Imagerie, Centre Henri Becquerel, Rouen, France,QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France
| | - Sébastien Thureau
- QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France,Département de Radiothérapie, Centre Henri Becquerel, Rouen, France
| | - Pierre Bohn
- Département d’Imagerie, Centre Henri Becquerel, Rouen, France,QuantIF-LITIS, EA 4108, IRIB, Université de Rouen, Rouen, France,*Correspondence: Pierre Bohn,
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Bluemke E, Bertrand A, Chu KY, Syed N, Murchison AG, Cooke R, Greenhalgh T, Burns B, Craig M, Taylor N, Shah K, Gleeson F, Bulte D. Oxygen-enhanced MRI and radiotherapy in patients with oropharyngeal squamous cell carcinoma. Clin Transl Radiat Oncol 2022; 39:100563. [PMID: 36655119 PMCID: PMC9841018 DOI: 10.1016/j.ctro.2022.100563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background and purpose This study aimed to assess the role of T1 mapping and oxygen-enhanced MRI in patients undergoing radical dose radiotherapy for HPV positive oropharyngeal cancer, which has not yet been examined in an OE-MRI study. Materials and methods Variable Flip Angle T1 maps were acquired on a 3T MRI scanner while patients (n = 12) breathed air and/or 100 % oxygen, before and after fraction 10 of the planned 30 fractions of chemoradiotherapy ('visit 1' and 'visit 2', respectively). The analysis aimed to assess to what extent (1) native R1 relates to patient outcome; (2) OE-MRI response relates to patient outcome; (3) changes in mean R1 before and after radiotherapy related to clinical outcome in patients with oropharyngeal squamous cell carcinoma. Results Due to the radiotherapy being largely successful, the sample sizes of non-responder groups were small, and therefore it was not possible to properly assess the predictive nature of OE-MRI. The tumour R1 increased in some patients while decreasing in others, in a pattern that was overall consistent with the underlying OE-MRI theory and previously reported tumour OE-MRI responses. In addition, we discuss some practical challenges faced when integrating this technique into a clinical trial, with the aim that sharing this is helpful to researchers planning to use OE-MRI in future clinical studies. Conclusion Altogether, these results suggest that further clinical OE-MRI studies to assess hypoxia and radiotherapy response are worth pursuing, and that there is important work to be done to improve the robustness of the OE-MRI technique in human applications in order for it to be useful as a widespread clinical technique.
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Affiliation(s)
- Emma Bluemke
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, UK,Corresponding author at: Old Road Campus Research Building, University of Oxford, Headington, Oxford OX3 7DQ, UK.
| | - Ambre Bertrand
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, UK
| | - Kwun-Ye Chu
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, UK,Radiotherapy Department, Oxford University Hospitals NHS Foundation Trust, UK
| | - Nigar Syed
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, UK
| | - Andrew G. Murchison
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, UK
| | - Rosie Cooke
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, UK,Radiotherapy Department, Oxford University Hospitals NHS Foundation Trust, UK
| | - Tessa Greenhalgh
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, UK,University Hospital Southampton NHS Foundation Trust, UK
| | | | | | - Nia Taylor
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, UK
| | - Ketan Shah
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, UK,Radiotherapy Department, Oxford University Hospitals NHS Foundation Trust, UK
| | - Fergus Gleeson
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, UK
| | - Daniel Bulte
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, UK
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Bluemke E, Stride E, Bulte DP. Modeling the Effect of Hyperoxia on the Spin-Lattice Relaxation Rate R1 of Tissues. Magn Reson Med 2022; 88:1867-1885. [PMID: 35678239 PMCID: PMC9545427 DOI: 10.1002/mrm.29315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Inducing hyperoxia in tissues is common practice in several areas of research, including oxygen-enhanced MRI (OE-MRI), which attempts to use the resulting signal changes to detect regions of tumor hypoxia or pulmonary disease. The linear relationship between PO2 and R1 has been reproduced in phantom solutions and body fluids such as vitreous fluid; however, in tissue and blood experiments, factors such as changes in deoxyhemoglobin levels can also affect the ΔR1. THEORY AND METHODS This manuscript proposes a three-compartment model for estimating the hyperoxia-induced changes in R1 of tissues depending on B0, SO2 , blood volume, hematocrit, oxygen extraction fraction, and changes in blood and tissue PO2 . The model contains two blood compartments (arterial and venous) and a tissue compartment. This model has been designed to be easy for researchers to tailor to their tissue of interest by substituting their preferred model for tissue oxygen diffusion and consumption. A specific application of the model is demonstrated by calculating the resulting ΔR1 expected in healthy, hypoxic and necrotic tumor tissues. In addition, the effect of sex-based hematocrit differences on ΔR1 is assessed. RESULTS The ΔR1 values predicted by the model are consistent with reported literature OE-MRI results: with larger positive changes in the vascular periphery than hypoxic and necrotic regions. The observed sex-based differences in ΔR1 agree with findings by Kindvall et al. suggesting that differences in hematocrit levels may sometimes be a confounding factor in ΔR1. CONCLUSION This model can be used to estimate the expected tissue ΔR1 in oxygen-enhanced MRI experiments.
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Affiliation(s)
- Emma Bluemke
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
| | - Eleanor Stride
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
| | - Daniel Peter Bulte
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
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Gallez B. The Role of Imaging Biomarkers to Guide Pharmacological Interventions Targeting Tumor Hypoxia. Front Pharmacol 2022; 13:853568. [PMID: 35910347 PMCID: PMC9335493 DOI: 10.3389/fphar.2022.853568] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/23/2022] [Indexed: 12/12/2022] Open
Abstract
Hypoxia is a common feature of solid tumors that contributes to angiogenesis, invasiveness, metastasis, altered metabolism and genomic instability. As hypoxia is a major actor in tumor progression and resistance to radiotherapy, chemotherapy and immunotherapy, multiple approaches have emerged to target tumor hypoxia. It includes among others pharmacological interventions designed to alleviate tumor hypoxia at the time of radiation therapy, prodrugs that are selectively activated in hypoxic cells or inhibitors of molecular targets involved in hypoxic cell survival (i.e., hypoxia inducible factors HIFs, PI3K/AKT/mTOR pathway, unfolded protein response). While numerous strategies were successful in pre-clinical models, their translation in the clinical practice has been disappointing so far. This therapeutic failure often results from the absence of appropriate stratification of patients that could benefit from targeted interventions. Companion diagnostics may help at different levels of the research and development, and in matching a patient to a specific intervention targeting hypoxia. In this review, we discuss the relative merits of the existing hypoxia biomarkers, their current status and the challenges for their future validation as companion diagnostics adapted to the nature of the intervention.
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Using Variable Flip Angle (VFA) and Modified Look-Locker Inversion Recovery (MOLLI) T1 mapping in clinical OE-MRI. Magn Reson Imaging 2022; 89:92-99. [PMID: 35341905 DOI: 10.1016/j.mri.2022.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/16/2022] [Accepted: 03/19/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE The imaging technique known as Oxygen-Enhanced MRI is under development as a noninvasive technique for imaging hypoxia in tumours and pulmonary diseases. While promising results have been shown in preclinical experiments, clinical studies have mentioned experiencing difficulties with patient motion, image registration, and the limitations of single-slice images compared to 3D volumes. As clinical studies begin to assess feasibility of using OE-MRI in patients, it is important for researchers to communicate about the practical challenges experienced when using OE-MRI on patients to help the technique advance. MATERIALS AND METHODS We report on our experience with using two types of T1 mapping (MOLLI and VFA) for a recently completed OE-MRI clinical study on oropharyngeal squamous cell carcinoma. RESULTS We report: (1) the artefacts and practical difficulties encountered in this study; (2) the difference in estimated T1 from each method used - the VFA T1 estimation was higher than the MOLLI estimation by 27% on average; (3) the standard deviation within the tumour ROIs - there was no significant difference in the standard deviation seen within the tumour ROIs from the VFA versus MOLLI; and (4) the OE-MRI response collected from either method. Lastly, we collated the MRI acquisition details from over 45 relevant manuscripts as a convenient reference for researchers planning future studies. CONCLUSION We have reported our practical experience from an OE-MRI clinical study, with the aim that sharing this is helpful to researchers planning future studies. In this study, VFA was a more useful technique for using OE-MRI in tumours than MOLLI T1 mapping.
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Oxygen-Challenge Blood Oxygen Level-Dependent Magnetic Resonance Imaging for Evaluation of Early Change of Hepatocellular Carcinoma to Chemoembolization: A Feasibility Study. Acad Radiol 2021; 28 Suppl 1:S13-S19. [PMID: 32747180 DOI: 10.1016/j.acra.2020.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/06/2020] [Accepted: 06/10/2020] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of oxygen-challenge blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) at 3T for evaluating the early change of blood oxygenation before and after transcatheter arterial embolization (TACE) in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS Thirty HCC patients with cirrhosis (HCC group, n = 30) and 30 healthy volunteers (control group, n = 30) were included in this study. Patients in the HCC group underwent BOLD before and 1 month after TACE. Oxygen was administered via a mask. Differences between pre- and post-O2 T2* values were evaluated using a pairwise t-test. Analysis of variance was performed to assess the statistical differences in the T2* values measured in HCC group pre-TACE and post-TACE and in healthy volunteers. RESULTS In the HCC group, the pre- and post-O2 T2* values of the cancerous area before TACE were 26.03 ± 3.30 and 26.84 ± 3.42 msec, respectively, and both decreased significantly to 8.67 ± 1.76 and 8.82 ± 1.80 msec, respectively, at 1 month after TACE (p < 0.001). The respective pre- and post-O2 T2* values of the noncancerous area increased significantly from 14.96 ± 2.32 and 15.33 ± 2.28 msec at baseline to 16.38 ± 2.22 and 16.89 ± 2.24 msec at 1 month after TACE (p < 0.001). No significant response to BOLD was observed in the control group (p = 0.059). CONCLUSION Oxygen-challenge BOLD MRI is feasible to assess post-TACE changes in HCC patients.
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D'Alonzo RA, Gill S, Rowshanfarzad P, Keam S, MacKinnon KM, Cook AM, Ebert MA. In vivo noninvasive preclinical tumor hypoxia imaging methods: a review. Int J Radiat Biol 2021; 97:593-631. [PMID: 33703994 DOI: 10.1080/09553002.2021.1900943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Tumors exhibit areas of decreased oxygenation due to malformed blood vessels. This low oxygen concentration decreases the effectiveness of radiation therapy, and the resulting poor perfusion can prevent drugs from reaching areas of the tumor. Tumor hypoxia is associated with poorer prognosis and disease progression, and is therefore of interest to preclinical researchers. Although there are multiple different ways to measure tumor hypoxia and related factors, there is no standard for quantifying spatial and temporal tumor hypoxia distributions in preclinical research or in the clinic. This review compares imaging methods utilized for the purpose of assessing spatio-temporal patterns of hypoxia in the preclinical setting. Imaging methods provide varying levels of spatial and temporal resolution regarding different aspects of hypoxia, and with varying advantages and disadvantages. The choice of modality requires consideration of the specific experimental model, the nature of the required characterization and the availability of complementary modalities as well as immunohistochemistry.
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Affiliation(s)
- Rebecca A D'Alonzo
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Australia
| | - Suki Gill
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Australia.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Pejman Rowshanfarzad
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Australia
| | - Synat Keam
- School of Medicine, The University of Western Australia, Crawley, Australia
| | - Kelly M MacKinnon
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Australia
| | - Alistair M Cook
- School of Medicine, The University of Western Australia, Crawley, Australia
| | - Martin A Ebert
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Australia.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.,5D Clinics, Claremont, Australia
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Cao‐Pham T, Tran‐Ly‐Binh A, Heyerick A, Fillée C, Joudiou N, Gallez B, Jordan BF. Combined endogenous MR biomarkers to assess changes in tumor oxygenation induced by an allosteric effector of hemoglobin. NMR IN BIOMEDICINE 2020; 33:e4181. [PMID: 31762121 PMCID: PMC7003919 DOI: 10.1002/nbm.4181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 06/10/2023]
Abstract
Hypoxia is a crucial factor in cancer therapy, determining prognosis and the effectiveness of treatment. Although efforts are being made to develop methods for assessing tumor hypoxia, no markers of hypoxia are currently used in routine clinical practice. Recently, we showed that the combined endogenous MR biomarkers, R1 and R2 *, which are sensitive to [dissolved O2 ] and [dHb], respectively, were able to detect changes in tumor oxygenation induced by a hyperoxic breathing challenge. In this study, we further validated the ability of the combined MR biomarkers to assess the change in tumor oxygenation induced by an allosteric effector of hemoglobin, myo-inositol trispyrophosphate (ITPP), on rat tumor models. ITPP induced an increase in tumor pO2 , as observed using L-band electron paramagnetic resonance oximetry, as well as an increase in both R1 and R2 * MR parameters. The increase in R1 indicated an increase in [O2 ], whereas the increase in R2 * resulted from an increase in O2 release from blood, inducing an increase in [dHb]. The impact of ITPP was then evaluated on factors that can influence tumor oxygenation, including tumor perfusion, saturation rate of hemoglobin, blood pH and oxygen consumption rate (OCR). ITPP decreased blood [HbO2 ] and significantly increased blood acidity, which is also a factor that right-shifts the oxygen dissociation curve. No change in tumor perfusion was observed after ITPP treatment. Interestingly, ITPP decreased OCR in both tumor cell lines. In conclusion, ITPP increased tumor pO2 via a combined mechanism involving a decrease in OCR and an allosteric effect on hemoglobin that was further enhanced by a decrease in blood pH. MR biomarkers could assess the change in tumor oxygenation induced by ITPP. At the intra-tumoral level, a majority of tumor voxels were responsive to ITPP treatment in both of the models studied.
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Affiliation(s)
- Thanh‐Trang Cao‐Pham
- Louvain Drug Research Institute, Biomedical Magnetic Resonance Research GroupUniversité catholique de LouvainBrusselsBelgium
| | - An Tran‐Ly‐Binh
- Louvain Drug Research Institute, Biomedical Magnetic Resonance Research GroupUniversité catholique de LouvainBrusselsBelgium
| | | | - Catherine Fillée
- Institut de Recherche Expérimentale et Clinique (IREC), UCLouvainUniversite catholique de LouvainBrusselsBelgium
| | - Nicolas Joudiou
- Louvain Drug Research Institute, Biomedical Magnetic Resonance Research GroupUniversité catholique de LouvainBrusselsBelgium
| | - Bernard Gallez
- Louvain Drug Research Institute, Biomedical Magnetic Resonance Research GroupUniversité catholique de LouvainBrusselsBelgium
| | - Bénédicte F. Jordan
- Louvain Drug Research Institute, Biomedical Magnetic Resonance Research GroupUniversité catholique de LouvainBrusselsBelgium
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Keller S, Chapiro J, Brangsch J, Reimann C, Collettini F, Sack I, Savic LJ, Hamm B, Goldberg SN, Makowski M. Quantitative MRI for Assessment of Treatment Outcomes in a Rabbit VX2 Hepatic Tumor Model. J Magn Reson Imaging 2019; 52:668-685. [PMID: 31713973 DOI: 10.1002/jmri.26968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 12/24/2022] Open
Abstract
Globally, primary and secondary liver cancer is one of the most common cancer types, accounting 8.2% of deaths worldwide in 2018. One of the key strategies to improve the patient's prognosis is the early diagnosis, when liver function is still preserved. In hepatocellular carcinoma (HCC), the typical wash-in/wash-out pattern in conventional magnetic resonance imaging (MRI) reaches a sensitivity of 60% and specificity of 96-100%. However, in recent years functional MRI sequences such as hepatocellular-specific gadolinium-based dynamic-contrast enhanced MRI, diffusion-weighted imaging (DWI), and magnetic resonance spectroscopy (MRS) have been demonstrated to improve the evaluation of treatment success and thus the therapeutic decision-making and the patient's outcome. In the preclinical research setting, the VX2 liver rabbit tumor, which once originated from a virus-induced anaplastic squamous cell carcinoma, has played a longstanding role in experimental interventional oncology. Especially the high tumor vascularity allows assessing the treatment response of locoregional interventions such as radiofrequency ablation (RFA) and transcatheter arterial embolization (TACE). Functional MRI has been used to monitor the tumor growth and viability following interventional treatment. Besides promising results, a comprehensive overview of functional MRI sequences used so far in different treatment setting is lacking, thus lowering the comparability of study results. This review offers a comprehensive overview of study protocols, results, and limitations of quantitative MRI sequences applied to evaluate the treatment outcome of VX2 hepatic tumor models, thus generating a unique basis for future MRI studies and potential translation into the clinical setting. Level of Evidence: 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2020;52:668-685.
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Affiliation(s)
- Sarah Keller
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Julia Brangsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Carolin Reimann
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Federico Collettini
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lynn Jeanette Savic
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Shraga Nahum Goldberg
- Department of Radiology, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Marcus Makowski
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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12
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Yang DM, Arai TJ, Campbell JW, Gerberich JL, Zhou H, Mason RP. Oxygen-sensitive MRI assessment of tumor response to hypoxic gas breathing challenge. NMR IN BIOMEDICINE 2019; 32:e4101. [PMID: 31062902 PMCID: PMC6581571 DOI: 10.1002/nbm.4101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/16/2019] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
Oxygen-sensitive MRI has been extensively used to investigate tumor oxygenation based on the response (R2 * and/or R1 ) to a gas breathing challenge. Most studies have reported response to hyperoxic gas indicating potential biomarkers of hypoxia. Few studies have examined hypoxic gas breathing and we have now evaluated acute dynamic changes in rat breast tumors. Rats bearing syngeneic subcutaneous (n = 15) or orthotopic (n = 7) 13762NF breast tumors were exposed to a 16% O2 gas breathing challenge and monitored using blood oxygen level dependent (BOLD) R2 * and tissue oxygen level dependent (TOLD) T1 -weighted measurements at 4.7 T. As a control, we used a traditional hyperoxic gas breathing challenge with 100% O2 on a subset of the subcutaneous tumor bearing rats (n = 6). Tumor subregions identified as responsive on the basis of R2 * dynamics coincided with the viable tumor area as judged by subsequent H&E staining. As expected, R2 * decreased and T1 -weighted signal increased in response to 100% O2 breathing challenge. Meanwhile, 16% O2 breathing elicited an increase in R2 *, but divergent response (increase or decrease) in T1 -weighted signal. The T1 -weighted signal increase may signify a dominating BOLD effect triggered by 16% O2 in the relatively more hypoxic tumors, whereby the influence of increased paramagnetic deoxyhemoglobin outweighs decreased pO2 . The results emphasize the importance of combined BOLD and TOLD measurements for the correct interpretation of tumor oxygenation properties.
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Affiliation(s)
- Donghan M Yang
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Tatsuya J Arai
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - James W Campbell
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Heling Zhou
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ralph P Mason
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
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13
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Dependency of the blood oxygen level dependent-response to hyperoxic challenges on the order of gas administration in intracranial malignancies. Neuroradiology 2019; 61:783-793. [PMID: 30949747 DOI: 10.1007/s00234-019-02200-5] [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: 11/09/2018] [Accepted: 03/12/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE Literature reports contradicting results on the response of brain tumors to vascular stimuli measured in T2*-weighted MRI. Here, we analyzed the potential dependency of the MRI-response to (hypercapnic) hyperoxia on the order of the gas administration. METHODS T2* values were quantified at 3 Tesla in eight consenting patients at rest and during inhalation of hyperoxic/hypercapnic gas mixtures. Patients were randomly divided into two groups undergoing different gas administration protocols (group A: medical air-pure oxygen-carbogen; group B: medical air-carbogen-pure oxygen). Mann-Whitney U test and Wilcoxon signed rank test have been used to proof differences in T2* regarding respiratory challenge or different groups, respectively. RESULTS T2* values at rest for gray and white matter were 50.3 ± 2.6 ms and 46.1 ± 2.0 ms, respectively, and slightly increased during challenge. In tumor areas, T2* at rest were: necrosis = 74.1 ± 10.1 ms; edema = 60.3 ± 17.6 ms; contrast-enhancing lesions = 48.6 ± 20.7 ms; and solid T2-hyperintense lesions = 45.0 ± 3.0 ms. Contrast-enhancing lesions strongly responded to oxygen (+ 20.7%) regardless on the gas protocol (p = 0.482). However, the response to carbogen significantly depended on the order of gas administration (group A, + 18.6%; group B, - 6.4%, p = 0.042). In edemas, a different trend between group was found when breathing oxygen (group A, - 9.9%; group B, + 19.5%, p = 0.057). CONCLUSION Preliminary results show a dependency of the T2* response of contrast-enhancing brain tumor lesions on the order of the gas administration. The gas administration protocol is an important factor in the interpretation of the T2*-response in areas of abnormal vascular growth.
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14
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O'Connor JPB, Robinson SP, Waterton JC. Imaging tumour hypoxia with oxygen-enhanced MRI and BOLD MRI. Br J Radiol 2019; 92:20180642. [PMID: 30272998 PMCID: PMC6540855 DOI: 10.1259/bjr.20180642] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 01/06/2023] Open
Abstract
Hypoxia is known to be a poor prognostic indicator for nearly all solid tumours and also is predictive of treatment failure for radiotherapy, chemotherapy, surgery and targeted therapies. Imaging has potential to identify, spatially map and quantify tumour hypoxia prior to therapy, as well as track changes in hypoxia on treatment. At present no hypoxia imaging methods are available for routine clinical use. Research has largely focused on positron emission tomography (PET)-based techniques, but there is gathering evidence that MRI techniques may provide a practical and more readily translational alternative. In this review we focus on the potential for imaging hypoxia by measuring changes in longitudinal relaxation [R1; termed oxygen-enhanced MRI or tumour oxygenation level dependent (TOLD) MRI] and effective transverse relaxation [R2*; termed blood oxygenation level dependent (BOLD) MRI], induced by inhalation of either 100% oxygen or the radiosensitising hyperoxic gas carbogen. We explain the scientific principles behind oxygen-enhanced MRI and BOLD and discuss significant studies and their limitations. All imaging biomarkers require rigorous validation in order to translate into clinical use and the steps required to further develop oxygen-enhanced MRI and BOLD MRI into decision-making tools are discussed.
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Affiliation(s)
| | - Simon P Robinson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
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15
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Olsson LE, Johansson M, Zackrisson B, Blomqvist LK. Basic concepts and applications of functional magnetic resonance imaging for radiotherapy of prostate cancer. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2019; 9:50-57. [PMID: 33458425 PMCID: PMC7807726 DOI: 10.1016/j.phro.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/27/2018] [Accepted: 02/08/2019] [Indexed: 12/30/2022]
Abstract
Recently, the interest to integrate magnetic resonance imaging (MRI) in radiotherapy for prostate cancer has increased considerably. MRI can contribute in all steps of the radiotherapy workflow from diagnosis, staging, and target definition to treatment follow-up. Of particular interest is the ability of MRI to provide a wide range of functional measures. The complexity of MRI as an imaging modality combined with the growing interest of the application to prostate cancer radiotherapy, emphasize the need for dedicated education within the radiation oncology community. In this context, an overview of the most common as well as a few upcoming functional MR imaging techniques is presented: the basic methodology and measurement is described, the link between the functional measures and the underlying biology is established, and finally relevant applications of functional MRI useful for prostate cancer radiotherapy are given.
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Affiliation(s)
- Lars E Olsson
- Department of Medical Radiation Physics, Translational Medicine, Lund University, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Sweden
| | | | | | - Lennart K Blomqvist
- Department of Radiology, Molecular Medicine and Surgery, Karolinska University, Sweden
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16
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Moosvi F, Baker JH, Yung A, Kozlowski P, Minchinton AI, Reinsberg SA. Fast and sensitive dynamic oxygen‐enhanced MRI with a cycling gas challenge and independent component analysis. Magn Reson Med 2018; 81:2514-2525. [DOI: 10.1002/mrm.27584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Firas Moosvi
- Department of Physics & Astronomy University of British Columbia Vancouver Canada
| | - Jennifer H.E. Baker
- Radiation Biology Unit British Columbia Cancer Research Centre Vancouver Canada
| | - Andrew Yung
- UBC MRI Research Centre Life Sciences Centre Vancouver Canada
| | - Piotr Kozlowski
- UBC MRI Research Centre Life Sciences Centre Vancouver Canada
- Department of Radiology University of British Columbia Vancouver Canada
| | | | - Stefan A. Reinsberg
- Department of Physics & Astronomy University of British Columbia Vancouver Canada
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17
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Little RA, Jamin Y, Boult JKR, Naish JH, Watson Y, Cheung S, Holliday KF, Lu H, McHugh DJ, Irlam J, West CML, Betts GN, Ashton G, Reynolds AR, Maddineni S, Clarke NW, Parker GJM, Waterton JC, Robinson SP, O’Connor JPB. Mapping Hypoxia in Renal Carcinoma with Oxygen-enhanced MRI: Comparison with Intrinsic Susceptibility MRI and Pathology. Radiology 2018; 288:739-747. [PMID: 29869970 PMCID: PMC6122194 DOI: 10.1148/radiol.2018171531] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/21/2017] [Indexed: 12/28/2022]
Abstract
Purpose To cross-validate T1-weighted oxygen-enhanced (OE) MRI measurements of tumor hypoxia with intrinsic susceptibility MRI measurements and to demonstrate the feasibility of translation of the technique for patients. Materials and Methods Preclinical studies in nine 786-0-R renal cell carcinoma (RCC) xenografts and prospective clinical studies in eight patients with RCC were performed. Longitudinal relaxation rate changes (∆R1) after 100% oxygen inhalation were quantified, reflecting the paramagnetic effect on tissue protons because of the presence of molecular oxygen. Native transverse relaxation rate (R2*) and oxygen-induced R2* change (∆R2*) were measured, reflecting presence of deoxygenated hemoglobin molecules. Median and voxel-wise values of ∆R1 were compared with values of R2* and ∆R2*. Tumor regions with dynamic contrast agent-enhanced MRI perfusion, refractory to signal change at OE MRI (referred to as perfused Oxy-R), were distinguished from perfused oxygen-enhancing (perfused Oxy-E) and nonperfused regions. R2* and ∆R2* values in each tumor subregion were compared by using one-way analysis of variance. Results Tumor-wise and voxel-wise ∆R1 and ∆R2* comparisons did not show correlative relationships. In xenografts, parcellation analysis revealed that perfused Oxy-R regions had faster native R2* (102.4 sec-1 vs 81.7 sec-1) and greater negative ∆R2* (-22.9 sec-1 vs -5.4 sec-1), compared with perfused Oxy-E and nonperfused subregions (all P < .001), respectively. Similar findings were present in human tumors (P < .001). Further, perfused Oxy-R helped identify tumor hypoxia, measured at pathologic analysis, in both xenografts (P = .002) and human tumors (P = .003). Conclusion Intrinsic susceptibility biomarkers provide cross validation of the OE MRI biomarker perfused Oxy-R. Consistent relationship to pathologic analyses was found in xenografts and human tumors, demonstrating biomarker translation. Published under a CC BY 4.0 license. Online supplemental material is available for this article.
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Affiliation(s)
- Ross A. Little
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Yann Jamin
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Jessica K. R. Boult
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Josephine H. Naish
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Yvonne Watson
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Susan Cheung
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Katherine F. Holliday
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Huiqi Lu
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Damien J. McHugh
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Joely Irlam
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Catharine M. L. West
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Guy N. Betts
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Garry Ashton
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | | | - Satish Maddineni
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Noel W. Clarke
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Geoff J. M. Parker
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - John C. Waterton
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Simon P. Robinson
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - James P. B. O’Connor
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
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18
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Baker LCJ, Sikka A, Price JM, Boult JKR, Lepicard EY, Box G, Jamin Y, Spinks TJ, Kramer-Marek G, Leach MO, Eccles SA, Box C, Robinson SP. Evaluating Imaging Biomarkers of Acquired Resistance to Targeted EGFR Therapy in Xenograft Models of Human Head and Neck Squamous Cell Carcinoma. Front Oncol 2018; 8:271. [PMID: 30083516 PMCID: PMC6064942 DOI: 10.3389/fonc.2018.00271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 07/02/2018] [Indexed: 01/18/2023] Open
Abstract
Background: Overexpression of EGFR is a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). Patients with HNSCC who respond to EGFR-targeted tyrosine kinase inhibitors (TKIs) eventually develop acquired resistance. Strategies to identify HNSCC patients likely to benefit from EGFR-targeted therapies, together with biomarkers of treatment response, would have clinical value. Methods: Functional MRI and 18F-FDG PET were used to visualize and quantify imaging biomarkers associated with drug response within size-matched EGFR TKI-resistant CAL 27 (CALR) and sensitive (CALS) HNSCC xenografts in vivo, and pathological correlates sought. Results: Intrinsic susceptibility, oxygen-enhanced and dynamic contrast-enhanced MRI revealed significantly slower baseline R 2 ∗ , lower hyperoxia-induced Δ R 2 ∗ and volume transfer constant Ktrans in the CALR tumors which were associated with significantly lower Hoechst 33342 uptake and greater pimonidazole-adduct formation. There was no difference in oxygen-induced ΔR1 or water diffusivity between the CALR and CALS xenografts. PET revealed significantly higher relative uptake of 18F-FDG in the CALR cohort, which was associated with significantly greater Glut-1 expression. Conclusions: CALR xenografts established from HNSCC cells resistant to EGFR TKIs are more hypoxic, poorly perfused and glycolytic than sensitive CALS tumors. MRI combined with PET can be used to non-invasively assess HNSCC response/resistance to EGFR inhibition.
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Affiliation(s)
- Lauren C. J. Baker
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Arti Sikka
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Jonathan M. Price
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Jessica K. R. Boult
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Elise Y. Lepicard
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Gary Box
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Yann Jamin
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Terry J. Spinks
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Gabriela Kramer-Marek
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Martin O. Leach
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne A. Eccles
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Carol Box
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Simon P. Robinson
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
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19
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Featherstone AK, O'Connor JP, Little RA, Watson Y, Cheung S, Babur M, Williams KJ, Matthews JC, Parker GJ. Data-driven mapping of hypoxia-related tumor heterogeneity using DCE-MRI and OE-MRI. Magn Reson Med 2018; 79:2236-2245. [PMID: 28856728 PMCID: PMC5836865 DOI: 10.1002/mrm.26860] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE Previous work has shown that combining dynamic contrast-enhanced (DCE)-MRI and oxygen-enhanced (OE)-MRI binary enhancement maps can identify tumor hypoxia. The current work proposes a novel, data-driven method for mapping tissue oxygenation and perfusion heterogeneity, based on clustering DCE/OE-MRI data. METHODS DCE-MRI and OE-MRI were performed on nine U87 (glioblastoma) and seven Calu6 (non-small cell lung cancer) murine xenograft tumors. Area under the curve and principal component analysis features were calculated and clustered separately using Gaussian mixture modelling. Evaluation metrics were calculated to determine the optimum feature set and cluster number. Outputs were quantitatively compared with a previous non data-driven approach. RESULTS The optimum method located six robustly identifiable clusters in the data, yielding tumor region maps with spatially contiguous regions in a rim-core structure, suggesting a biological basis. Mean within-cluster enhancement curves showed physiologically distinct, intuitive kinetics of enhancement. Regions of DCE/OE-MRI enhancement mismatch were located, and voxel categorization agreed well with the previous non data-driven approach (Cohen's kappa = 0.61, proportional agreement = 0.75). CONCLUSION The proposed method locates similar regions to the previous published method of binarization of DCE/OE-MRI enhancement, but renders a finer segmentation of intra-tumoral oxygenation and perfusion. This could aid in understanding the tumor microenvironment and its heterogeneity. Magn Reson Med 79:2236-2245, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Adam K. Featherstone
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge and Manchester, Cambridge and ManchesterUK
| | - James P.B. O'Connor
- CRUK & EPSRC Cancer Imaging Centre in Cambridge and Manchester, Cambridge and ManchesterUK
- Division of Cancer StudiesThe University of ManchesterManchesterUK
- Department of RadiologyChristie NHS Foundation TrustManchesterUK
| | - Ross A. Little
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
| | - Yvonne Watson
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
| | - Sue Cheung
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
| | - Muhammad Babur
- Division of Pharmacy & OptometryThe University of ManchesterManchesterUK
| | - Kaye J. Williams
- CRUK & EPSRC Cancer Imaging Centre in Cambridge and Manchester, Cambridge and ManchesterUK
- Division of Pharmacy & OptometryThe University of ManchesterManchesterUK
| | - Julian C. Matthews
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge and Manchester, Cambridge and ManchesterUK
| | - Geoff J.M. Parker
- Division of Informatics, Imaging & Data SciencesThe University of ManchesterManchesterUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge and Manchester, Cambridge and ManchesterUK
- Bioxydyn LtdManchesterUK
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20
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Cao-Pham TT, Joudiou N, Van Hul M, Bouzin C, Cani PD, Gallez B, Jordan BF. Combined endogenous MR biomarkers to predict basal tumor oxygenation and response to hyperoxic challenge. NMR IN BIOMEDICINE 2017; 30:e3836. [PMID: 29024086 DOI: 10.1002/nbm.3836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/18/2017] [Accepted: 08/31/2017] [Indexed: 06/07/2023]
Abstract
Hypoxia is a common feature of solid tumors, which translates into increased angiogenesis, malignant phenotype cell selection, change in gene expression and greater resistance to radiotherapy and chemotherapy. Therefore, there is a need for markers of hypoxia to stratify patients, in order to personalize treatment to improve therapeutic outcome. However, no modality has yet been validated for the screening of hypoxia in routine clinical practice. Magnetic resonance imaging (MRI) R1 and R2 * relaxation parameters are sensitive to tissue oxygenation: R1 is sensitive to dissolved oxygen and R2 * is sensitive to intravascular deoxyhemoglobin content. Two rat tumor models with distinct levels of hypoxia, 9L-glioma and rhabdomyosarcoma, were imaged for R1 and R2 * under air and carbogen (95% O2 and 5% CO2 ) breathing conditions. It was observed that the basal tumor oxygenation level had an impact on the amplitude of response to carbogen in the vascular compartment (R2 *), but not in the tissue compartment (R1 ). In addition, the change in tissue oxygenation estimated by ΔR1 correlated with the change in vascular oxygenation estimated by ΔR2 *, which is consistent with an increase in oxygen supply generating an elevated tumor pO2 . At the intra-tumoral level, we identified four types of voxel to which a hypoxic feature was attributed (mild hypoxia, severe hypoxia, normoxia and vascular steal), depending on the carbogen-induced change in R1 and R2 * values for each voxel. The results showed that 9L-gliomas present more normoxic fractions, whereas rhabdomyosarcomas present more hypoxic fractions, which is in accordance with a previous study using 18 F-fluoroazomycin arabinoside (18 F-FAZA) and electron paramagnetic resonance (EPR) oximetry. The response of the combined endogenous MRI contrasts to carbogen challenge could be a useful tool to predict different tumor hypoxic fractions.
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Affiliation(s)
- Thanh-Trang Cao-Pham
- Université catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Nicolas Joudiou
- Université catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Matthias Van Hul
- Université catholique de Louvain, Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Brussels, Belgium
| | - Caroline Bouzin
- Université catholique de Louvain, IREC Imaging Platform, Brussels, Belgium
| | - Patrice D Cani
- Université catholique de Louvain, Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Brussels, Belgium
| | - Bernard Gallez
- Université catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Bénédicte F Jordan
- Université catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
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21
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Cancer Metabolism and Tumor Heterogeneity: Imaging Perspectives Using MR Imaging and Spectroscopy. CONTRAST MEDIA & MOLECULAR IMAGING 2017; 2017:6053879. [PMID: 29114178 PMCID: PMC5654284 DOI: 10.1155/2017/6053879] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/31/2017] [Accepted: 08/27/2017] [Indexed: 12/26/2022]
Abstract
Cancer cells reprogram their metabolism to maintain viability via genetic mutations and epigenetic alterations, expressing overall dynamic heterogeneity. The complex relaxation mechanisms of nuclear spins provide unique and convertible tissue contrasts, making magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) pertinent imaging tools in both clinics and research. In this review, we summarized MR methods that visualize tumor characteristics and its metabolic phenotypes on an anatomical, microvascular, microstructural, microenvironmental, and metabolomics scale. The review will progress from the utilities of basic spin-relaxation contrasts in cancer imaging to more advanced imaging methods that measure tumor-distinctive parameters such as perfusion, water diffusion, magnetic susceptibility, oxygenation, acidosis, redox state, and cell death. Analytical methods to assess tumor heterogeneity are also reviewed in brief. Although the clinical utility of tumor heterogeneity from imaging is debatable, the quantification of tumor heterogeneity using functional and metabolic MR images with development of robust analytical methods and improved MR methods may offer more critical roles of tumor heterogeneity data in clinics. MRI/MRS can also provide insightful information on pharmacometabolomics, biomarker discovery, disease diagnosis and prognosis, and treatment response. With these future directions in mind, we anticipate the widespread utilization of these MR-based techniques in studying in vivo cancer biology to better address significant clinical needs.
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22
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Incorporating Oxygen-Enhanced MRI into Multi-Parametric Assessment of Human Prostate Cancer. Diagnostics (Basel) 2017; 7:diagnostics7030048. [PMID: 28837092 PMCID: PMC5617948 DOI: 10.3390/diagnostics7030048] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/13/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022] Open
Abstract
Hypoxia is associated with prostate tumor aggressiveness, local recurrence, and biochemical failure. Magnetic resonance imaging (MRI) offers insight into tumor pathophysiology and recent reports have related transverse relaxation rate (R2*) and longitudinal relaxation rate (R1) measurements to tumor hypoxia. We have investigated the inclusion of oxygen-enhanced MRI for multi-parametric evaluation of tumor malignancy. Multi-parametric MRI sequences at 3 Tesla were evaluated in 10 patients to investigate hypoxia in prostate cancer prior to radical prostatectomy. Blood oxygen level dependent (BOLD), tissue oxygen level dependent (TOLD), dynamic contrast enhanced (DCE), and diffusion weighted imaging MRI were intercorrelated and compared with the Gleason score. The apparent diffusion coefficient (ADC) was significantly lower in tumor than normal prostate. Baseline R2* (BOLD-contrast) was significantly higher in tumor than normal prostate. Upon the oxygen breathing challenge, R2* decreased significantly in the tumor tissue, suggesting improved vascular oxygenation, however changes in R1 were minimal. R2* of contralateral normal prostate decreased in most cases upon oxygen challenge, although the differences were not significant. Moderate correlation was found between ADC and Gleason score. ADC and R2* were correlated and trends were found between Gleason score and R2*, as well as maximum-intensity-projection and area-under-the-curve calculated from DCE. Tumor ADC and R2* have been associated with tumor hypoxia, and thus the correlations are of particular interest. A multi-parametric approach including oxygen-enhanced MRI is feasible and promises further insights into the pathophysiological information of tumor microenvironment.
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23
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Tomaszewski MR, Gonzalez IQ, O'Connor JPB, Abeyakoon O, Parker GJM, Williams KJ, Gilbert FJ, Bohndiek SE. Oxygen Enhanced Optoacoustic Tomography (OE-OT) Reveals Vascular Dynamics in Murine Models of Prostate Cancer. Theranostics 2017; 7:2900-2913. [PMID: 28824724 PMCID: PMC5562224 DOI: 10.7150/thno.19841] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/02/2017] [Indexed: 02/07/2023] Open
Abstract
Poor oxygenation of solid tumours has been linked with resistance to chemo- and radio-therapy and poor patient outcomes, hence non-invasive imaging of oxygen supply and demand in tumours could improve disease staging and therapeutic monitoring. Optoacoustic tomography (OT) is an emerging clinical imaging modality that provides static images of endogenous haemoglobin concentration and oxygenation. Here, we demonstrate oxygen enhanced (OE)-OT, exploiting an oxygen gas challenge to visualise the spatiotemporal heterogeneity of tumour vascular function. We show that tracking oxygenation dynamics using OE-OT reveals significant differences between two prostate cancer models in nude mice with markedly different vascular function (PC3 & LNCaP), which appear identical in static OT. LNCaP tumours showed a spatially heterogeneous response within and between tumours, with a substantial but slow response to the gas challenge, aligned with ex vivo analysis, which revealed a generally perfused and viable tumour with marked areas of haemorrhage. PC3 tumours had a lower fraction of responding pixels compared to LNCaP with a high disparity between rim and core response. While the PC3 core showed little or no dynamic response, the rim showed a rapid change, consistent with our ex vivo findings of hypoxic and necrotic core tissue surrounded by a rim of mature and perfused vasculature. OE-OT metrics are shown to be highly repeatable and correlate directly on a per-tumour basis to tumour vessel function assessed ex vivo. OE-OT provides a non-invasive approach to reveal the complex dynamics of tumour vessel perfusion, permeability and vasoactivity in real time. Our findings indicate that OE-OT holds potential for application in prostate cancer patients, to improve delineation of aggressive and indolent disease as well as in patient stratification for chemo- and radio-therapy.
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Affiliation(s)
- Michal R Tomaszewski
- Department of Physics, University of Cambridge, U.K
- Cancer Research UK Cambridge Institute, University of Cambridge, U.K
| | - Isabel Quiros Gonzalez
- Department of Physics, University of Cambridge, U.K
- Cancer Research UK Cambridge Institute, University of Cambridge, U.K
| | - James PB O'Connor
- Institute of Cancer Sciences, University of Manchester, U.K
- Department of Radiology, The Christie NHS Foundation Trust, U.K
| | | | - Geoff JM Parker
- Centre for Imaging Sciences, University of Manchester, U.K
- Bioxydyn Limited, Manchester, U.K
| | | | | | - Sarah E Bohndiek
- Department of Physics, University of Cambridge, U.K
- Cancer Research UK Cambridge Institute, University of Cambridge, U.K
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24
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Gonçalves MR, Johnson SP, Ramasawmy R, Lythgoe MF, Pedley RB, Walker-Samuel S. The effect of imatinib therapy on tumour cycling hypoxia, tissue oxygenation and vascular reactivity. Wellcome Open Res 2017. [DOI: 10.12688/wellcomeopenres.11715.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Several biomedical imaging techniques have recently been developed to probe hypoxia in tumours, including oxygen-enhanced (OE) and blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI). These techniques have strong potential for measuring both chronic and transient (cycling) changes in hypoxia, and to assess response to vascular-targeting therapies in the clinic. Methods: In this study, we investigated the use of BOLD and OE-MRI to assess changes in cycling hypoxia, tissue oxygenation and vascular reactivity to hyperoxic gas challenges, in mouse models of colorectal therapy, following treatment with the PDGF-receptor inhibitor, imatinib mesylate (Glivec). Results: Whilst no changes were observed in imaging biomarkers of cycling hypoxia (from BOLD) or chronic hypoxia (from OE-MRI), the BOLD response to carbogen-breathing became significantly more positive in some tumour regions and more negative in other regions, thereby increasing overall heterogeneity. Conclusions: Imatinib did not affect the magnitude of cycling hypoxia or OE-MRI signal, but increased the heterogeneity of the spatial distribution of BOLD MRI changes in response to gas challenges.
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25
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Colliez F, Gallez B, Jordan BF. Assessing Tumor Oxygenation for Predicting Outcome in Radiation Oncology: A Review of Studies Correlating Tumor Hypoxic Status and Outcome in the Preclinical and Clinical Settings. Front Oncol 2017; 7:10. [PMID: 28180110 PMCID: PMC5263142 DOI: 10.3389/fonc.2017.00010] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/10/2017] [Indexed: 12/30/2022] Open
Abstract
Tumor hypoxia is recognized as a limiting factor for the efficacy of radiotherapy, because it enhances tumor radioresistance. It is strongly suggested that assessing tumor oxygenation could help to predict the outcome of cancer patients undergoing radiation therapy. Strategies have also been developed to alleviate tumor hypoxia in order to radiosensitize tumors. In addition, oxygen mapping is critically needed for intensity modulated radiation therapy (IMRT), in which the most hypoxic regions require higher radiation doses and the most oxygenated regions require lower radiation doses. However, the assessment of tumor oxygenation is not yet included in day-to-day clinical practice. This is due to the lack of a method for the quantitative and non-invasive mapping of tumor oxygenation. To fully integrate tumor hypoxia parameters into effective improvements of the individually tailored radiation therapy protocols in cancer patients, methods allowing non-invasively repeated, safe, and robust mapping of changes in tissue oxygenation are required. In this review, non-invasive methods dedicated to assessing tumor oxygenation with the ultimate goal of predicting outcome in radiation oncology are presented, including positron emission tomography used with nitroimidazole tracers, magnetic resonance methods using endogenous contrasts (R1 and R2*-based methods), and electron paramagnetic resonance oximetry; the goal is to highlight results of studies establishing correlations between tumor hypoxic status and patients’ outcome in the preclinical and clinical settings.
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Affiliation(s)
- Florence Colliez
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain , Brussels , Belgium
| | - Bernard Gallez
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain , Brussels , Belgium
| | - Bénédicte F Jordan
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain , Brussels , Belgium
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26
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White DA, Zhang Z, Li L, Gerberich J, Stojadinovic S, Peschke P, Mason RP. Developing oxygen-enhanced magnetic resonance imaging as a prognostic biomarker of radiation response. Cancer Lett 2016; 380:69-77. [PMID: 27267808 DOI: 10.1016/j.canlet.2016.06.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 11/19/2022]
Abstract
Oxygen-Enhanced Magnetic Resonance Imaging (OE-MRI) techniques were evaluated as potential non-invasive predictive biomarkers of radiation response. Semi quantitative blood-oxygen level dependent (BOLD) and tissue oxygen level dependent (TOLD) contrast, and quantitative responses of relaxation rates (ΔR1 and ΔR2*) to an oxygen breathing challenge during hypofractionated radiotherapy were applied. OE-MRI was performed on subcutaneous Dunning R3327-AT1 rat prostate tumors (n=25) at 4.7 T prior to each irradiation (2F × 15 Gy) to the gross tumor volume. Response to radiation, while inhaling air or oxygen, was assessed by tumor growth delay measured up to four times the initial irradiated tumor volume (VQT). Radiation-induced hypoxia changes were confirmed using a double hypoxia marker assay. Inhaling oxygen during hypofractionated radiotherapy significantly improved radiation response. A correlation was observed between the difference in the 2nd and 1st ΔR1 (ΔΔR1) and VQT for air breathing rats. The TOLD response before the 2nd fraction showed a moderate correlation with VQT for oxygen breathing rats. The correlations indicate useful prognostic factors to predict tumor response to hypofractionation and could readily be applied for patient stratification and personalized radiotherapy treatment planning.
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Affiliation(s)
- Derek A White
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - Zhang Zhang
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Li Li
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Jeni Gerberich
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Strahinja Stojadinovic
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas 75390, USA
| | | | - Ralph P Mason
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390, USA.
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Cao-Pham TT, Tran LBA, Colliez F, Joudiou N, El Bachiri S, Grégoire V, Levêque P, Gallez B, Jordan BF. Monitoring Tumor Response to Carbogen Breathing by Oxygen-Sensitive Magnetic Resonance Parameters to Predict the Outcome of Radiation Therapy: A Preclinical Study. Int J Radiat Oncol Biol Phys 2016; 96:149-60. [PMID: 27511852 DOI: 10.1016/j.ijrobp.2016.04.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 04/25/2016] [Accepted: 04/30/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE In an effort to develop noninvasive in vivo methods for mapping tumor oxygenation, magnetic resonance (MR)-derived parameters are being considered, including global R1, water R1, lipids R1, and R2*. R1 is sensitive to dissolved molecular oxygen, whereas R2* is sensitive to blood oxygenation, detecting changes in dHb. This work compares global R1, water R1, lipids R1, and R2* with pO2 assessed by electron paramagnetic resonance (EPR) oximetry, as potential markers of the outcome of radiation therapy (RT). METHODS AND MATERIALS R1, R2*, and EPR were performed on rhabdomyosarcoma and 9L-glioma tumor models, under air and carbogen breathing conditions (95% O2, 5% CO2). Because the models demonstrated different radiosensitivity properties toward carbogen, a growth delay (GD) assay was performed on the rhabdomyosarcoma model and a tumor control dose 50% (TCD50) was performed on the 9L-glioma model. RESULTS Magnetic resonance imaging oxygen-sensitive parameters detected the positive changes in oxygenation induced by carbogen within tumors. No consistent correlation was seen throughout the study between MR parameters and pO2. Global and lipids R1 were found to be correlated to pO2 in the rhabdomyosarcoma model, whereas R2* was found to be inversely correlated to pO2 in the 9L-glioma model (P=.05 and .03). Carbogen increased the TCD50 of 9L-glioma but did not increase the GD of rhabdomyosarcoma. Only R2* was predictive (P<.05) for the curability of 9L-glioma at 40 Gy, a dose that showed a difference in response to RT between carbogen and air-breathing groups. (18)F-FAZA positron emission tomography imaging has been shown to be a predictive marker under the same conditions. CONCLUSION This work illustrates the sensitivity of oxygen-sensitive R1 and R2* parameters to changes in tumor oxygenation. However, R1 parameters showed limitations in terms of predicting the outcome of RT in the tumor models studied, whereas R2* was found to be correlated with the outcome in the responsive model.
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Affiliation(s)
- Thanh-Trang Cao-Pham
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Ly-Binh-An Tran
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Florence Colliez
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Nicolas Joudiou
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Sabrina El Bachiri
- Université Catholique de Louvain, IMMAQ Technological Platform, Methodology and Statistical Support, Louvain-la-Neuve, Belgium
| | - Vincent Grégoire
- Université Catholique de Louvain, Institute of Experimental and Clinical Research, Center for Molecular Imaging, Radiotherapy and Oncology, Brussels, Belgium
| | - Philippe Levêque
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Bernard Gallez
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium
| | - Bénédicte F Jordan
- Université Catholique de Louvain, Louvain Drug Research Institute, Biomedical Magnetic Resonance Research Group, Brussels, Belgium.
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O'Connor JPB, Boult JKR, Jamin Y, Babur M, Finegan KG, Williams KJ, Little RA, Jackson A, Parker GJM, Reynolds AR, Waterton JC, Robinson SP. Oxygen-Enhanced MRI Accurately Identifies, Quantifies, and Maps Tumor Hypoxia in Preclinical Cancer Models. Cancer Res 2016; 76:787-95. [PMID: 26659574 PMCID: PMC4757751 DOI: 10.1158/0008-5472.can-15-2062] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/09/2015] [Indexed: 01/10/2023]
Abstract
There is a clinical need for noninvasive biomarkers of tumor hypoxia for prognostic and predictive studies, radiotherapy planning, and therapy monitoring. Oxygen-enhanced MRI (OE-MRI) is an emerging imaging technique for quantifying the spatial distribution and extent of tumor oxygen delivery in vivo. In OE-MRI, the longitudinal relaxation rate of protons (ΔR1) changes in proportion to the concentration of molecular oxygen dissolved in plasma or interstitial tissue fluid. Therefore, well-oxygenated tissues show positive ΔR1. We hypothesized that the fraction of tumor tissue refractory to oxygen challenge (lack of positive ΔR1, termed "Oxy-R fraction") would be a robust biomarker of hypoxia in models with varying vascular and hypoxic features. Here, we demonstrate that OE-MRI signals are accurate, precise, and sensitive to changes in tumor pO2 in highly vascular 786-0 renal cancer xenografts. Furthermore, we show that Oxy-R fraction can quantify the hypoxic fraction in multiple models with differing hypoxic and vascular phenotypes, when used in combination with measurements of tumor perfusion. Finally, Oxy-R fraction can detect dynamic changes in hypoxia induced by the vasomodulator agent hydralazine. In contrast, more conventional biomarkers of hypoxia (derived from blood oxygenation-level dependent MRI and dynamic contrast-enhanced MRI) did not relate to tumor hypoxia consistently. Our results show that the Oxy-R fraction accurately quantifies tumor hypoxia noninvasively and is immediately translatable to the clinic.
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Affiliation(s)
- James P B O'Connor
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom. Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom. Department of Radiology, Christie NHS Foundation Trust, Manchester, United Kingdom. james.o'
| | - Jessica K R Boult
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Yann Jamin
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Muhammad Babur
- Manchester Pharmacy School, University of Manchester, Manchester, United Kingdom
| | - Katherine G Finegan
- Manchester Pharmacy School, University of Manchester, Manchester, United Kingdom
| | - Kaye J Williams
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom. Manchester Pharmacy School, University of Manchester, Manchester, United Kingdom
| | - Ross A Little
- Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom
| | - Alan Jackson
- Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom
| | - Geoff J M Parker
- Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom
| | - Andrew R Reynolds
- Tumour Biology Team, Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - John C Waterton
- Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom
| | - Simon P Robinson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
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Bane O, Besa C, Wagner M, Oesingmann N, Zhu H, Fiel MI, Taouli B. Feasibility and reproducibility of BOLD and TOLD measurements in the liver with oxygen and carbogen gas challenge in healthy volunteers and patients with hepatocellular carcinoma. J Magn Reson Imaging 2015; 43:866-76. [PMID: 26417669 DOI: 10.1002/jmri.25051] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/02/2015] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To quantify baseline relaxation rates R2* and R1 in the abdomen, their changes after respiratory challenges, and their reproducibility in healthy volunteers and patients with hepatocellular carcinoma (HCC) at 1.5T and 3.0T. MATERIALS AND METHODS R2* measurements were acquired in the liver in 8 volunteers and 27 patients with 34 HCCs using multiecho T2* at baseline and after respiratory challenges with 100% oxygen (O2 ) and carbogen (CB = 95%O2 /5%CO2 ). R1 was measured at 1.5T in one volunteer and 21 patients with 23 HCCs. Test-retest coefficient of variation (CV) was assessed in 10 subjects. Intra- and interobserver variability of R2* and R1 measurements was assessed in 12 and 10 patients, respectively. Parameters for HCC, liver, and muscle were compared between baseline and after gas challenges. RESULTS We observed that R2* and R1 imaging of HCCs with O2 and CB is feasible and reproducible (test-retest CV R2*<15%/R1 <5%; intra- and interobserver intraclass correlation coefficient R2*>0.88/R1 >0.7 and CV R2*<7%/R1 <3% at 1.5T). R2* measurements were observed to be less reproducible at 3.0T (CV<35%). There was a statistically significant decrease in R2* values in HCC before and after O2 (P = 0.02) and increase in R1 after O2 (P = 0.004). CB had no significant effect (P R2* = 0.47/R1 = 0.278). CONCLUSION R2* measurements in HCC and liver parenchyma are more reproducible at 1.5T than at 3.0T, and with O2 than with CB challenge. We observed a decrease in R2* and an increase in R1 of HCCs from baseline in response to O2 challenge, as expected with increased tissue and blood oxygenation.
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Affiliation(s)
- Octavia Bane
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cecilia Besa
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Hongfa Zhu
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria Isabel Fiel
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Colliez F, Safronova MM, Magat J, Joudiou N, Peeters AP, Jordan BF, Gallez B, Duprez T. Oxygen Mapping within Healthy and Acutely Infarcted Brain Tissue in Humans Using the NMR Relaxation of Lipids: A Proof-Of-Concept Translational Study. PLoS One 2015; 10:e0135248. [PMID: 26267901 PMCID: PMC4534037 DOI: 10.1371/journal.pone.0135248] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/20/2015] [Indexed: 02/06/2023] Open
Abstract
The clinical applicability of brain oxygenation mapping using the MOBILE (Mapping of Oxygen By Imaging Lipids relaxation Enhancement) magnetic resonance (MR) technique was assessed in the clinical setting of normal brain and of acute cerebral ischemia as a founding proof-of-concept translational study. Changes in the oxygenation level within healthy brain tissue can be detected by analyzing the spin-lattice proton relaxation (‘Global T1’ combining water and lipid protons) because of the paramagnetic properties of molecular oxygen. It was hypothesized that selective measurement of the relaxation of the lipid protons (‘Lipids T1’) would result in enhanced sensitivity of pO2 mapping because of higher solubility of oxygen in lipids than in water, and this was demonstrated in pre-clinical models using the MOBILE technique. In the present study, 12 healthy volunteers and eight patients with acute (48–72 hours) brain infarction were examined with the same clinical 3T MR system. Both Lipids R1 (R1 = 1/T1) and Global R1 were significantly different in the infarcted area and the contralateral unaffected brain tissue, with a higher statistical significance for Lipids R1 (median difference: 0.408 s-1; p<0.0001) than for Global R1 (median difference: 0.154 s-1; p = 0.027). Both Lipids R1 and Global R1 values in the unaffected contralateral brain tissue of stroke patients were not significantly different from the R1 values calculated in the brain tissue of healthy volunteers. The main limitations of the present prototypic version of the MOBILE sequence are the long acquisition time (4 min), hampering robustness of data in uncooperative patients, and a 2 mm slice thickness precluding accurate measurements in small infarcts because of partial volume averaging effects.
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Affiliation(s)
- Florence Colliez
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Marta M. Safronova
- Department of Radiology and Medical Imaging, Cliniques universitaires UCL-Saint-Luc, Brussels, Belgium
| | - Julie Magat
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Nicolas Joudiou
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - André P. Peeters
- Department of Neurology, Cliniques universitaires UCL-Saint-Luc, Brussels, Belgium
| | - Bénédicte F. Jordan
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Bernard Gallez
- Biomedical Magnetic Resonance Group, Louvain Drug Research Institute, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Thierry Duprez
- Department of Radiology and Medical Imaging, Cliniques universitaires UCL-Saint-Luc, Brussels, Belgium
- * E-mail:
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Zhao D, Pacheco-Torres J, Hallac RR, White D, Peschke P, Cerdán S, Mason RP. Dynamic oxygen challenge evaluated by NMR T1 and T2*--insights into tumor oxygenation. NMR IN BIOMEDICINE 2015; 28:937-947. [PMID: 26058575 PMCID: PMC4506740 DOI: 10.1002/nbm.3325] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 04/10/2015] [Accepted: 04/14/2015] [Indexed: 05/03/2023]
Abstract
There is intense interest in developing non-invasive prognostic biomarkers of tumor response to therapy, particularly with regard to hypoxia. It has been suggested that oxygen sensitive MRI, notably blood oxygen level-dependent (BOLD) and tissue oxygen level-dependent (TOLD) contrast, may provide relevant measurements. This study examined the feasibility of interleaved T2*- and T1-weighted oxygen sensitive MRI, as well as R2* and R1 maps, of rat tumors to assess the relative sensitivity to changes in oxygenation. Investigations used cohorts of Dunning prostate R3327-AT1 and R3327-HI tumors, which are reported to exhibit distinct size-dependent levels of hypoxia and response to hyperoxic gas breathing. Proton MRI R1 and R2* maps were obtained for tumors of anesthetized rats (isoflurane/air) at 4.7 T. Then, interleaved gradient echo T2*- and T1-weighted images were acquired during air breathing and a 10 min challenge with carbogen (95% O2 -5% CO2). Signals were stable during air breathing, and each type of tumor showed a distinct signal response to carbogen. T2* (BOLD) response preceded T1 (TOLD) responses, as expected. Smaller HI tumors (reported to be well oxygenated) showed the largest BOLD and TOLD responses. Larger AT1 tumors (reported to be hypoxic and resist modulation by gas breathing) showed the smallest response. There was a strong correlation between BOLD and TOLD signal responses, but ΔR2* and ΔR1 were only correlated for the HI tumors. The magnitude of BOLD and TOLD signal responses to carbogen breathing reflected expected hypoxic fractions and oxygen dynamics, suggesting potential value of this test as a prognostic biomarker of tumor hypoxia.
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Affiliation(s)
- Dawen Zhao
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA 75390
| | - Jesús Pacheco-Torres
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA 75390
- Laboratory for Imaging and Spectroscopy by Magnetic Resonance LISMAR, Instituto de Investigaciones Biomédicas “Alberto Sols” CSIC/UAM, Arturo Duperier 4, Madrid 28029, Spain
| | - Rami R. Hallac
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA 75390
| | - Derek White
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA 75390
| | - Peter Peschke
- Clinical Cooperation Unit Molecular Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Cerdán
- Laboratory for Imaging and Spectroscopy by Magnetic Resonance LISMAR, Instituto de Investigaciones Biomédicas “Alberto Sols” CSIC/UAM, Arturo Duperier 4, Madrid 28029, Spain
| | - Ralph P. Mason
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA 75390
- To whom correspondence should be addressed: Ralph P. Mason, PhD Department of Radiology UT Southwestern Medical Center 5323 Harry Hines Blvd. Dallas, TX 75390-9058 USA Phone: +1 (214) 648-8926 Fax: +1 (214) 648-2991
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Huang CH, Shih YYI, Siow TY, Hsu YH, Chen CCV, Lin TN, Jaw FS, Chang C. Temporal assessment of vascular reactivity and functionality using MRI during postischemic proangiogenenic vascular remodeling. Magn Reson Imaging 2015; 33:903-10. [PMID: 25944092 DOI: 10.1016/j.mri.2015.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/13/2015] [Accepted: 04/26/2015] [Indexed: 11/18/2022]
Abstract
Postischemic angiogenesis is an important recovery mechanism. Both arteries and veins are upregulated during angiogenesis, but eventually there are more angiogenic veins than arteries in terms of number and length. It is critical to understand how the veins are modulated after ischemia and then transitioned into angiogenic vessels during the proangiogenic stage to finally serve as a restorative strength to the injured area. Using a rat model of transient focal cerebral ischemia, the hypercapnic blood oxygen level-dependent (BOLD) response was used to evaluate vascular reactivity, while the hyperoxic BOLD and tissue oxygen level-dependent (TOLD) responses were used to evaluate the vascular functionality at 1, 3, and 7days after ischemia. Vessel-like venous signals appeared on R2* maps on days 3 and 7, but not on day 1. The large hypercapnic BOLD responses on days 3 and 7 indicated that these areas have high vascular reactivity. The temporal correlation between vascular reactivity and the immunoreactivity to desmin and VEGF further indicates that the integrity of vascular reactivity is associated with the pericyte coverage as regulated by the VEGF level. Vascular functionality remained low on days 1, 3, and 7, as reflected by the small hyperoxic BOLD and large hyperoxic TOLD responses, indicating the low oxygen consumption of the ischemic tissues. These functional changes in proangiogenic veins may be critical for angiogenesis.
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Affiliation(s)
- Chien-Hsiang Huang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Yen-Yu Ian Shih
- Experimental Neuroimaging Laboratory, Department of Neurology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA
| | - Tiing-Yee Siow
- Department of Medical Imaging and Intervention, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yi-Hua Hsu
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Chiao-Chi V Chen
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Teng-Nan Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
| | - Chen Chang
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan.
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Danhier P, Gallez B. Electron paramagnetic resonance: a powerful tool to support magnetic resonance imaging research. CONTRAST MEDIA & MOLECULAR IMAGING 2014; 10:266-81. [PMID: 25362845 DOI: 10.1002/cmmi.1630] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/18/2014] [Indexed: 12/31/2022]
Abstract
The purpose of this paper is to describe some of the areas where electron paramagnetic resonance (EPR) has provided unique information to MRI developments. The field of application mainly encompasses the EPR characterization of MRI paramagnetic contrast agents (gadolinium and manganese chelates, nitroxides) and superparamagnetic agents (iron oxide particles). The combined use of MRI and EPR has also been used to qualify or disqualify sources of contrast in MRI. Illustrative examples are presented with attempts to qualify oxygen sensitive contrast (i.e. T1 - and T2 *-based methods), redox status or melanin content in tissues. Other areas are likely to benefit from the combined EPR/MRI approach, namely cell tracking studies. Finally, the combination of EPR and MRI studies on the same models provides invaluable data regarding tissue oxygenation, hemodynamics and energetics. Our description will be illustrative rather than exhaustive to give to the readers a flavour of 'what EPR can do for MRI'.
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Affiliation(s)
- Pierre Danhier
- Biomedical Magnetic Resonance Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Bernard Gallez
- Biomedical Magnetic Resonance Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
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Colliez F, Neveu MA, Magat J, Cao Pham TT, Gallez B, Jordan BF. Qualification of a Noninvasive Magnetic Resonance Imaging Biomarker to Assess Tumor Oxygenation. Clin Cancer Res 2014; 20:5403-11. [DOI: 10.1158/1078-0432.ccr-13-3434] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hammond EM, Asselin MC, Forster D, O'Connor JPB, Senra JM, Williams KJ. The meaning, measurement and modification of hypoxia in the laboratory and the clinic. Clin Oncol (R Coll Radiol) 2014; 26:277-88. [PMID: 24602562 DOI: 10.1016/j.clon.2014.02.002] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 01/23/2014] [Accepted: 02/04/2014] [Indexed: 01/12/2023]
Abstract
Hypoxia was identified as a microenvironmental component of solid tumours over 60 years ago and was immediately recognised as a potential barrier to therapy through the reliance of radiotherapy on oxygen to elicit maximal cytotoxicity. Over the last two decades both clinical and experimental studies have markedly enhanced our understanding of how hypoxia influences cellular behaviour and therapy response. Furthermore, they have confirmed early assumptions that low oxygenation status in tumours is an exploitable target in cancer therapy. Generally such approaches will be more beneficial to patients with hypoxic tumours, necessitating the use of biomarkers that reflect oxygenation status. Tissue biomarkers have shown utility in many studies. Further significant advances have been made in the non-invasive measurement of tumour hypoxia with positron emission tomography, magnetic resonance imaging and other imaging modalities. Here, we describe the complexities of defining and measuring tumour hypoxia and highlight the therapeutic approaches to combat it.
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Affiliation(s)
- E M Hammond
- The Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Oxford, UK
| | - M-C Asselin
- Wolfson Molecular Imaging Centre, Manchester, UK
| | - D Forster
- Wolfson Molecular Imaging Centre, Manchester, UK
| | - J P B O'Connor
- Centre for Imaging Sciences, Institute of Population Health, Manchester, UK
| | - J M Senra
- The Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Oxford, UK
| | - K J Williams
- Manchester Pharmacy School, Cambridge-Manchester Cancer Research UK Comprehensive Imaging Centre, Manchester Academic Health Sciences Centre, The University Manchester, Manchester, UK.
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Linnik IV, Scott MLJ, Holliday KF, Woodhouse N, Waterton JC, O'Connor JPB, Barjat H, Liess C, Ulloa J, Young H, Dive C, Hodgkinson CL, Ward T, Roberts D, Mills SJ, Thompson G, Buonaccorsi GA, Cheung S, Jackson A, Naish JH, Parker GJM. Noninvasive tumor hypoxia measurement using magnetic resonance imaging in murine U87 glioma xenografts and in patients with glioblastoma. Magn Reson Med 2014; 71:1854-62. [PMID: 23798369 DOI: 10.1002/mrm.24826] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/16/2013] [Accepted: 05/05/2013] [Indexed: 01/05/2023]
Abstract
PURPOSE There is a clinical need for noninvasive, nonionizing imaging biomarkers of tumor hypoxia and oxygenation. We evaluated the relationship of T1 -weighted oxygen-enhanced magnetic resonance imaging (OE-MRI) measurements to histopathology measurements of tumor hypoxia in a murine glioma xenograft and demonstrated technique translation in human glioblastoma multiforme. METHODS Preclinical evaluation was performed in a subcutaneous murine human glioma xenograft (U87MG). Animals underwent OE-MRI followed by dynamic contrast-enhanced MRI (DCE-MRI) and histological measurement including reduced pimonidazole adducts and CD31 staining. Area under the curve (AUC) was measured for the R1 curve for OE-MRI and the gadolinium concentration curve for DCE-MRI. Clinical evaluation in five patients used analogous imaging protocols and analyses. RESULTS Changes in AUC of OE-MRI (AUCOE ) signal were regionally heterogeneous across all U87MG tumors. Tumor regions with negative AUCOE typically had low DCE-MRI perfusion, had positive correlation with hypoxic area (P = 0.029), and had negative correlation with vessel density (P = 0.004). DCE-MRI measurements did not relate to either hypoxia or vessel density in U87MG tumors. Clinical data confirmed comparable signal changes in patients with glioblastoma. CONCLUSION These data support further investigation of T1 -weighted OE-MRI to identify regional tumor hypoxia. The quantification of AUCOE has translational potential as a clinical biomarker of hypoxia.
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Affiliation(s)
- Inna V Linnik
- Centre for Imaging Sciences, The University of Manchester, Manchester, UK; University of Manchester Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
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Baker LCJ, Boult JKR, Jamin Y, Gilmour LD, Walker-Samuel S, Burrell JS, Ashcroft M, Howe FA, Griffiths JR, Raleigh JA, van der Kogel AJ, Robinson SP. Evaluation and immunohistochemical qualification of carbogen-induced ΔR₂ as a noninvasive imaging biomarker of improved tumor oxygenation. Int J Radiat Oncol Biol Phys 2013; 87:160-7. [PMID: 23849692 DOI: 10.1016/j.ijrobp.2013.04.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/16/2013] [Accepted: 04/29/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate and histologically qualify carbogen-induced ΔR2 as a noninvasive magnetic resonance imaging biomarker of improved tumor oxygenation using a double 2-nitroimidazole hypoxia marker approach. METHODS AND MATERIALS Multigradient echo images were acquired from mice bearing GH3 prolactinomas, preadministered with the hypoxia marker CCI-103F, to quantify tumor R2 during air breathing. With the mouse remaining positioned within the magnet bore, the gas supply was switched to carbogen (95% O2, 5% CO2), during which a second hypoxia marker, pimonidazole, was administered via an intraperitoneal line, and an additional set of identical multigradient echo images acquired to quantify any changes in tumor R2. Hypoxic fraction was quantified histologically using immunofluorescence detection of CCI-103F and pimonidazole adduct formation from the same whole tumor section. Carbogen-induced changes in tumor pO2 were further validated using the Oxylite fiberoptic probe. RESULTS Carbogen challenge significantly reduced mean tumor R2 from 116 ± 13 s(-1) to 97 ± 9 s(-1) (P<.05). This was associated with a significantly lower pimonidazole adduct area (2.3 ± 1%), compared with CCI-103F (6.3 ± 2%) (P<.05). A significant correlation was observed between ΔR2 and Δhypoxic fraction (r=0.55, P<.01). Mean tumor pO2 during carbogen breathing significantly increased from 6.3 ± 2.2 mm Hg to 36.0 ± 7.5 mm Hg (P<.01). CONCLUSIONS The combined use of intrinsic susceptibility magnetic resonance imaging with a double hypoxia marker approach corroborates carbogen-induced ΔR2 as a noninvasive imaging biomarker of increased tumor oxygenation.
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Affiliation(s)
- Lauren C J Baker
- Cancer Research UK & EPSRC Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, UK.
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