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Abston E, Zhou IY, Saenger JA, Shuvaev S, Akam E, Esfahani SA, Hariri LP, Rotile NJ, Crowley E, Montesi SB, Humblet V, Arabasz G, Khandekar M, Catana C, Fintelmann FJ, Caravan P, Lanuti M. Noninvasive Quantification of Radiation-Induced Lung Injury Using a Targeted Molecular Imaging Probe. Int J Radiat Oncol Biol Phys 2024; 118:1228-1239. [PMID: 38072325 DOI: 10.1016/j.ijrobp.2023.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Radiation-induced lung injury (RILI) is a progressive inflammatory process seen after irradiation for lung cancer. The disease can be insidious, often characterized by acute pneumonitis followed by chronic fibrosis with significant associated morbidity. No therapies are approved for RILI, and accurate disease quantification is a major barrier to improved management. Here, we sought to noninvasively quantify RILI using a molecular imaging probe that specifically targets type 1 collagen in mouse models and patients with confirmed RILI. METHODS AND MATERIALS Using a murine model of lung radiation, mice were imaged with EP-3533, a type 1 collagen probe, to characterize the development of RILI and to assess disease mitigation after losartan treatment. The human analog probe 68Ga-CBP8, targeting type 1 collagen, was tested on excised human lung tissue containing RILI and was quantified via autoradiography. 68Ga-CBP8 positron emission tomography was used to assess RILI in vivo in 6 human subjects. RESULTS Murine models demonstrated that probe signal correlated with progressive RILI severity over 6 months. The probe was sensitive to mitigation of RILI by losartan. Excised human lung tissue with RILI had increased binding versus unirradiated control tissue, and 68Ga-CBP8 uptake correlated with collagen proportional area. Human imaging revealed significant 68Ga-CBP8 uptake in areas of RILI and minimal background uptake. CONCLUSIONS These findings support the ability of a molecular imaging probe targeted at type 1 collagen to detect RILI in preclinical models and human disease, suggesting a role for targeted molecular imaging of collagen in the assessment of RILI.
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Affiliation(s)
- Eric Abston
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Iris Y Zhou
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonathan A Saenger
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sergey Shuvaev
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Eman Akam
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Shadi A Esfahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lida P Hariri
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nicholas J Rotile
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Elizabeth Crowley
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sydney B Montesi
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Grae Arabasz
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Melin Khandekar
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts; Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Florian J Fintelmann
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Lanuti
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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2
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Abston E, Zhou IY, Saenger JA, Shuvaev S, Akam E, Esfahani SA, Hariri LP, Rotile NJ, Crowley E, Montesi SB, Humblet V, Arabasz G, Catana C, Fintelmann FJ, Caravan P, Lanuti M. Noninvasive Quantification of Radiation-Induced Lung Injury using a Targeted Molecular Imaging Probe. medRxiv 2023:2023.09.25.23295897. [PMID: 37808864 PMCID: PMC10557816 DOI: 10.1101/2023.09.25.23295897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Rationale Radiation-induced lung injury (RILI) is a progressive inflammatory process commonly seen following irradiation for lung cancer. The disease can be insidious, often characterized by acute pneumonitis followed by chronic fibrosis with significant associated morbidity. No therapies are approved for RILI, and accurate disease quantification is a major barrier to improved management. Objective To noninvasively quantify RILI, utilizing a molecular imaging probe that specifically targets type 1 collagen in mouse models and patients with confirmed RILI. Methods Using a murine model of lung radiation, mice were imaged with EP-3533, a type 1 collagen probe to characterize the development of RILI and to assess disease mitigation following losartan treatment. The human analog probe targeted against type 1 collagen, 68Ga-CBP8, was tested on excised human lung tissue containing RILI and quantified via autoradiography. Finally, 68Ga-CBP8 PET was used to assess RILI in vivo in six human subjects. Results Murine models demonstrated that probe signal correlated with progressive RILI severity over six-months. The probe was sensitive to mitigation of RILI by losartan. Excised human lung tissue with RILI had increased binding vs unirradiated control tissue and 68Ga-CBP8 uptake correlated with collagen proportional area. Human imaging revealed significant 68Ga-CBP8 uptake in areas of RILI and minimal background uptake. Conclusions These findings support the ability of a molecular imaging probe targeted at type 1 collagen to detect RILI in preclinical models and human disease, suggesting a role for targeted molecular imaging of collagen in the assessment of RILI.Clinical trial registered with www.clinicaltrials.gov (NCT04485286, NCT03535545).
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Affiliation(s)
- Eric Abston
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Iris Y Zhou
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
- The Institute for Innovation in Imaging Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jonathan A Saenger
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Sergey Shuvaev
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
- The Institute for Innovation in Imaging Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Eman Akam
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shadi A Esfahani
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Lida P Hariri
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicholas J Rotile
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
- The Institute for Innovation in Imaging Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elizabeth Crowley
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Sydney B Montesi
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Grae Arabasz
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- The Institute for Innovation in Imaging Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Florian J Fintelmann
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
- The Institute for Innovation in Imaging Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael Lanuti
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Byrd D, Christopfel R, Arabasz G, Catana C, Karp J, Lodge MA, Laymon C, Moros EG, Budzevich M, Nehmeh S, Scheuermann J, Sunderland J, Zhang J, Kinahan P. Erratum: Measuring temporal stability of positron emission tomography standardized uptake value bias using long-lived sources in a multicenter network. J Med Imaging (Bellingham) 2019; 6:019801. [PMID: 30944844 DOI: 10.1117/1.jmi.6.1.019801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
[This corrects the article DOI: 10.1117/1.JMI.5.1.011016.].
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Affiliation(s)
- Darrin Byrd
- University of Washington, Department of Radiology, Seattle, Washington, United States
| | - Rebecca Christopfel
- University of Washington, Department of Radiology, Seattle, Washington, United States
| | - Grae Arabasz
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, United States
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, United States
| | - Joel Karp
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - Martin A Lodge
- Johns Hopkins University, Department of Radiology and Radiological Science, Baltimore, Maryland, United States
| | - Charles Laymon
- University of Pittsburgh, Presbyterian University Hospital, Department of Radiology, Pittsburgh, Pennsylvania, United States
| | | | | | - Sadek Nehmeh
- Weill Cornell Medical College, Department of Radiology, New York, United States
| | - Joshua Scheuermann
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - John Sunderland
- University of Iowa, Department of Radiology, Iowa City, Iowa, United States
| | - Jun Zhang
- The Ohio State University, Department of Radiology, Columbus, Ohio, United States
| | - Paul Kinahan
- University of Washington, Department of Radiology, Seattle, Washington, United States
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Byrd D, Christopfel R, Arabasz G, Catana C, Karp J, Lodge MA, Laymon C, Moros EG, Budzevich M, Nehmeh S, Scheuermann J, Sunderland J, Zhang J, Kinahan P. Measuring temporal stability of positron emission tomography standardized uptake value bias using long-lived sources in a multicenter network. J Med Imaging (Bellingham) 2018; 5:011016. [PMID: 29322068 DOI: 10.1117/1.jmi.5.1.011016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/20/2017] [Indexed: 12/16/2022] Open
Abstract
Positron emission tomography (PET) is a quantitative imaging modality, but the computation of standardized uptake values (SUVs) requires several instruments to be correctly calibrated. Variability in the calibration process may lead to unreliable quantitation. Sealed source kits containing traceable amounts of [Formula: see text] were used to measure signal stability for 19 PET scanners at nine hospitals in the National Cancer Institute's Quantitative Imaging Network. Repeated measurements of the sources were performed on PET scanners and in dose calibrators. The measured scanner and dose calibrator signal biases were used to compute the bias in SUVs at multiple time points for each site over a 14-month period. Estimation of absolute SUV accuracy was confounded by bias from the solid phantoms' physical properties. On average, the intrascanner coefficient of variation for SUV measurements was 3.5%. Over the entire length of the study, single-scanner SUV values varied over a range of 11%. Dose calibrator bias was not correlated with scanner bias. Calibration factors from the image metadata were nearly as variable as scanner signal, and were correlated with signal for many scanners. SUVs often showed low intrascanner variability between successive measurements but were also prone to shifts in apparent bias, possibly in part due to scanner recalibrations that are part of regular scanner quality control. Biases of key factors in the computation of SUVs were not correlated and their temporal variations did not cancel out of the computation. Long-lived sources and image metadata may provide a check on the recalibration process.
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Affiliation(s)
- Darrin Byrd
- University of Washington, Department of Radiology, Seattle, Washington, United States
| | - Rebecca Christopfel
- University of Washington, Department of Radiology, Seattle, Washington, United States
| | - Grae Arabasz
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, United States
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, United States
| | - Joel Karp
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - Martin A Lodge
- Johns Hopkins University, Department of Radiology and Radiological Science, Baltimore, Maryland, United States
| | - Charles Laymon
- University of Pittsburgh, Presbyterian University Hospital, Department of Radiology, Pittsburgh, Pennsylvania, United States
| | | | | | - Sadek Nehmeh
- Weill Cornell Medical College, Department of Radiology, New York, United States
| | - Joshua Scheuermann
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - John Sunderland
- University of Iowa, Department of Radiology, Iowa City, Iowa, United States
| | - Jun Zhang
- The Ohio State University, Department of Radiology, Columbus, Ohio, United States
| | - Paul Kinahan
- University of Washington, Department of Radiology, Seattle, Washington, United States
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Atkinson W, Catana C, Abramson JS, Arabasz G, McDermott S, Catalano O, Muse V, Blake MA, Barnes J, Shelly M, Hochberg E, Rosen BR, Guimaraes AR. Hybrid FDG-PET/MR compared to FDG-PET/CT in adult lymphoma patients. Abdom Radiol (NY) 2016; 41:1338-48. [PMID: 27315095 DOI: 10.1007/s00261-016-0638-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE The goal of this study is to evaluate the diagnostic performance of simultaneous FDG-PET/MR including diffusion compared to FDG-PET/CT in patients with lymphoma. METHODS Eighteen patients with a confirmed diagnosis of non-Hodgkin's (NHL) or Hodgkin's lymphoma (HL) underwent an IRB-approved, single-injection/dual-imaging protocol consisting of a clinical FDG-PET/CT and subsequent FDG-PET/MR scan. PET images from both modalities were reconstructed iteratively. Attenuation correction was performed using low-dose CT data for PET/CT and Dixon-MR sequences for PET/MR. Diffusion-weighted imaging was performed. SUVmax was measured and compared between modalities and the apparent diffusion coefficient (ADC) using ROI analysis by an experienced radiologist using OsiriX. Strength of correlation between variables was measured using the Pearson correlation coefficient (r p). RESULTS Of the 18 patients included in this study, 5 had HL and 13 had NHL. The median age was 51 ± 14.8 years. Sixty-five FDG-avid lesions were identified. All FDG-avid lesions were visible with comparable contrast, and therefore initial and follow-up staging was identical between both examinations. SUVmax from FDG-PET/MR [(mean ± sem) (21.3 ± 2.07)] vs. FDG-PET/CT (mean 23.2 ± 2.8) demonstrated a strongly positive correlation [r s = 0.95 (0.94, 0.99); p < 0.0001]. There was no correlation found between ADCmin and SUVmax from FDG-PET/MR [r = 0.17(-0.07, 0.66); p = 0.09]. CONCLUSION FDG-PET/MR offers an equivalent whole-body staging examination as compared with PET/CT with an improved radiation safety profile in lymphoma patients. Correlation of ADC to SUVmax was weak, understating their lack of equivalence, but not undermining their potential synergy and differing importance.
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Affiliation(s)
- Wendy Atkinson
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Ciprian Catana
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Jeremy S Abramson
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Grae Arabasz
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Shanaugh McDermott
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Onofrio Catalano
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Victorine Muse
- Division of Thoracic Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Michael A Blake
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Jeffrey Barnes
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Martin Shelly
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Ephraim Hochberg
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Bruce R Rosen
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Alexander R Guimaraes
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA.
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Division of Body Imaging, Department of Diagnostic Radiology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd., Mail Code L340, Portland, OR, 97239, USA.
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6
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Borra RJ, Cho HS, Bowen SL, Attenberger U, Arabasz G, Catana C, Josephson L, Rosen BR, Guimaraes AR, Hooker JM. Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model. EJNMMI Phys 2015; 2:6. [PMID: 26501808 PMCID: PMC4544618 DOI: 10.1186/s40658-015-0109-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 02/04/2015] [Indexed: 12/29/2022] Open
Abstract
Background Simultaneous PET/MR imaging depends on MR-derived attenuation maps (mu-maps) for accurate attenuation correction of PET data. Currently, these maps are derived from gradient-echo-based MR sequences, which are sensitive to susceptibility changes. Iron oxide magnetic nanoparticles have been used in the measurement of blood volume, tumor microvasculature, tumor-associated macrophages, and characterizing lymph nodes. Our aim in this study was to assess whether the susceptibility effects associated with iron oxide nanoparticles can potentially affect measured 18F-FDG PET standardized uptake values (SUV) through effects on MR-derived attenuation maps. Methods The study protocol was approved by the Institutional Animal Care and Use Committee. Using a Siemens Biograph mMR PET/MR scanner, we evaluated the effects of increasing concentrations of ferumoxytol and ferumoxytol aggregates on MR-derived mu-maps using an agarose phantom. In addition, we performed a baboon experiment evaluating the effects of a single i.v. ferumoxytol dose (10 mg/kg) on the liver, spleen, and pancreas 18F-FDG SUV at baseline (ferumoxytol-naïve), within the first hour and at 1, 3, 5, and 11 weeks. Results Phantom experiments showed mu-map artifacts starting at ferumoxytol aggregate concentrations of 10 to 20 mg/kg. The in vivo baboon data demonstrated a 53% decrease of observed 18F-FDG SUV compared to baseline within the first hour in the liver, persisting at least 11 weeks. Conclusions A single ferumoxytol dose can affect measured SUV for at least 3 months, which should be taken into account when administrating ferumoxytol in patients needing sequential PET/MR scans. Advances in knowledge 1. Ferumoxytol aggregates, but not ferumoxytol alone, produce significant artifacts in MR-derived attenuation correction maps at approximate clinical dose levels of 10 mg/kg. 2. When performing simultaneous whole-body 18F-FDG PET/MR, a single dose of ferumoxytol can result in observed SUV decreases up to 53%, depending on the amount of ferumoxytol aggregates in the studied tissue. Implications for patient care Administration of a single, clinically relevant, dose of ferumoxytol can potentially result in changes in observed SUV for a prolonged period of time in the setting of simultaneous PET/MR. These potential changes should be considered in particular when administering ferumoxytol to patients with expected future PET/MR studies, as ferumoxytol-induced SUV changes might interfere with therapy assessment. Electronic supplementary material The online version of this article (doi:10.1186/s40658-015-0109-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ronald Jh Borra
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. .,Medical Imaging Centre of Southwest Finland, Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland.
| | - Hoon-Sung Cho
- Center for Advanced Medical Imaging Sciences, Massachusetts General Hospital, Charlestown, MA, USA. .,School of Materials Science and Engineering, Chonnam National University, Gwangju, South Korea.
| | - Spencer L Bowen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA.
| | - Ulrike Attenberger
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
| | - Grae Arabasz
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA.
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA.
| | - Lee Josephson
- Center for Advanced Medical Imaging Sciences, Massachusetts General Hospital, Charlestown, MA, USA.
| | - Bruce R Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. .,Department of Meridian & Acupuncture, Collaborating Center for Traditional Medicine, East-West Medical Research Institute and School of Korean Medicine, Kyung Hee University, Seoul, South Korea.
| | - Alexander R Guimaraes
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. .,Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jacob M Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA.
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7
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Loggia ML, Chonde DB, Akeju O, Arabasz G, Catana C, Edwards RR, Hill E, Hsu S, Izquierdo-Garcia D, Ji RR, Riley M, Wasan AD, Zürcher NR, Albrecht DS, Vangel MG, Rosen BR, Napadow V, Hooker JM. Evidence for brain glial activation in chronic pain patients. ACTA ACUST UNITED AC 2015; 138:604-15. [PMID: 25582579 DOI: 10.1093/brain/awu377] [Citation(s) in RCA: 328] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although substantial evidence has established that microglia and astrocytes play a key role in the establishment and maintenance of persistent pain in animal models, the role of glial cells in human pain disorders remains unknown. Here, using the novel technology of integrated positron emission tomography-magnetic resonance imaging and the recently developed radioligand (11)C-PBR28, we show increased brain levels of the translocator protein (TSPO), a marker of glial activation, in patients with chronic low back pain. As the Ala147Thr polymorphism in the TSPO gene affects binding affinity for (11)C-PBR28, nine patient-control pairs were identified from a larger sample of subjects screened and genotyped, and compared in a matched-pairs design, in which each patient was matched to a TSPO polymorphism-, age- and sex-matched control subject (seven Ala/Ala and two Ala/Thr, five males and four females in each group; median age difference: 1 year; age range: 29-63 for patients and 28-65 for controls). Standardized uptake values normalized to whole brain were significantly higher in patients than controls in multiple brain regions, including thalamus and the putative somatosensory representations of the lumbar spine and leg. The thalamic levels of TSPO were negatively correlated with clinical pain and circulating levels of the proinflammatory citokine interleukin-6, suggesting that TSPO expression exerts pain-protective/anti-inflammatory effects in humans, as predicted by animal studies. Given the putative role of activated glia in the establishment and or maintenance of persistent pain, the present findings offer clinical implications that may serve to guide future studies of the pathophysiology and management of a variety of persistent pain conditions.
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Affiliation(s)
- Marco L Loggia
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA
| | - Daniel B Chonde
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Oluwaseun Akeju
- 3 Department of Anesthesia, Critical Care and Pain Medicine, MGH/HMS, Boston, MA 02114, USA
| | - Grae Arabasz
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ciprian Catana
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Robert R Edwards
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 4 Department of Psychiatry, Brigham and Women's Hospital, HMS, Boston, MA 02155, USA
| | - Elena Hill
- 5 Tufts University School of Medicine, Boston, MA 02111, USA
| | - Shirley Hsu
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - David Izquierdo-Garcia
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ru-Rong Ji
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 6 Departments of Anesthesiology and Neurobiology, Duke University Medical Center, Durham, NC 27705, USA
| | - Misha Riley
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Ajay D Wasan
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 4 Department of Psychiatry, Brigham and Women's Hospital, HMS, Boston, MA 02155, USA 7 Departments of Anesthesiology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15206, USA
| | - Nicole R Zürcher
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Daniel S Albrecht
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Mark G Vangel
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Bruce R Rosen
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 8 Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Vitaly Napadow
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02155, USA 9 Department of Biomedical Engineering, Kyung Hee University, Seoul 130-872, Republic of Korea
| | - Jacob M Hooker
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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8
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Akeju O, Loggia ML, Catana C, Pavone KJ, Vazquez R, Rhee J, Contreras Ramirez V, Chonde DB, Izquierdo-Garcia D, Arabasz G, Hsu S, Habeeb K, Hooker JM, Napadow V, Brown EN, Purdon PL. Disruption of thalamic functional connectivity is a neural correlate of dexmedetomidine-induced unconsciousness. eLife 2014; 3:e04499. [PMID: 25432022 PMCID: PMC4280551 DOI: 10.7554/elife.04499] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/26/2014] [Indexed: 12/17/2022] Open
Abstract
Understanding the neural basis of consciousness is fundamental to neuroscience research. Disruptions in cortico-cortical connectivity have been suggested as a primary mechanism of unconsciousness. By using a novel combination of positron emission tomography and functional magnetic resonance imaging, we studied anesthesia-induced unconsciousness and recovery using the α2-agonist dexmedetomidine. During unconsciousness, cerebral metabolic rate of glucose and cerebral blood flow were preferentially decreased in the thalamus, the Default Mode Network (DMN), and the bilateral Frontoparietal Networks (FPNs). Cortico-cortical functional connectivity within the DMN and FPNs was preserved. However, DMN thalamo-cortical functional connectivity was disrupted. Recovery from this state was associated with sustained reduction in cerebral blood flow and restored DMN thalamo-cortical functional connectivity. We report that loss of thalamo-cortical functional connectivity is sufficient to produce unconsciousness. DOI:http://dx.doi.org/10.7554/eLife.04499.001 Although we are all familiar with the experience of being conscious, explaining precisely what consciousness is and how it arises from activity in the brain remains extremely challenging. Indeed, explaining consciousness is so challenging that it is sometimes referred to as ‘the hard question’ of neuroscience. One way to obtain insights into the neural basis of consciousness is to compare patterns of activity in the brains of conscious subjects with patterns of brain activity in the same subjects under anesthesia. The results of some experiments of this kind suggest that loss of consciousness occurs when the communication between specific regions within the outer layer of the brain, the cortex, is disrupted. However, other studies seem to contradict these findings by showing that this communication can sometimes remain intact in unconscious subjects. Akeju, Loggia et al. have now resolved this issue by using brain imaging to examine the changes that occur as healthy volunteers enter and emerge from a light form of anesthesia roughly equivalent to non-REM sleep. An imaging technique called PET revealed that the loss of consciousness in the subjects was accompanied by reduced activity in a structure deep within the brain called the thalamus. Reduced activity was also seen in areas of cortex at the front and back of the brain. A technique called fMRI showed in turn that communication between the cortex and the thalamus was disrupted as subjects drifted into unconsciousness, whereas communication between cortical regions was spared. As subjects awakened from the anesthesia, communication between the thalamus and the cortex was restored. These results suggest that changes within distinct brain regions give rise to different depths of unconsciousness. Loss of communication between the thalamus and the cortex generates the unconsciousness of sleep or light anesthesia, while the additional loss of communication between cortical regions generates the unconsciousness of general anesthesia or coma. In addition to explaining the mixed results seen in previous experiments, this distinction could lead to advances in the diagnosis of patients with disorders of consciousness, and even to the development of therapies that target the thalamus and its connections with cortex. DOI:http://dx.doi.org/10.7554/eLife.04499.002
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Affiliation(s)
- Oluwaseun Akeju
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Marco L Loggia
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Ciprian Catana
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Kara J Pavone
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Rafael Vazquez
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - James Rhee
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Violeta Contreras Ramirez
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Daniel B Chonde
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - David Izquierdo-Garcia
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Grae Arabasz
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Shirley Hsu
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Kathleen Habeeb
- Clinical Research Center, Massachusetts General Hospital, Boston, United States
| | - Jacob M Hooker
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Vitaly Napadow
- MGH/MIT/HMS Athinoula A Martinos Center for Biomedical Imaging, Charlestown, United States
| | - Emery N Brown
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Patrick L Purdon
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
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Wang C, Wilson CM, Moseley CK, Carlin SM, Hsu S, Arabasz G, Schroeder FA, Sander CY, Hooker JM. Evaluation of potential PET imaging probes for the orexin 2 receptors. Nucl Med Biol 2013; 40:1000-5. [PMID: 23953751 DOI: 10.1016/j.nucmedbio.2013.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 06/10/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
A wide range of central nervous system (CNS) disorders, particularly those related to sleep, are associated with the abnormal function of orexin (OX) receptors. Several orexin receptor antagonists have been reported in recent years, but currently there are no imaging tools to probe the density and function of orexin receptors in vivo. To date there are no published data on the pharmacokinetics (PK) and accumulation of some lead orexin receptor antagonists. Evaluation of CNS pharmacokinetics in the pursuit of positron emission tomography (PET) radiotracer development could be used to elucidate the association of orexin receptors with diseases and to facilitate the drug discovery and development. To this end, we designed and evaluated carbon-11 labeled compounds based on diazepane orexin receptor antagonists previously described. One of the synthesized compounds, [(11)C]CW4, showed high brain uptake in rats and further evaluated in non-human primate (NHP) using PET-MR imaging. PET scans performed in a baboon showed appropriate early brain uptake for consideration as a radiotracer. However, [(11)C]CW4 exhibited fast kinetics and high nonspecific binding, as determined after co-administration of [(11)C]CW4 and unlabeled CW4. These properties indicate that [(11)C]CW4 has excellent brain penetrance and could be used as a lead compound for developing new CNS-penetrant PET imaging probes of orexin receptors.
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Affiliation(s)
- Changning Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, United States
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