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Welsh FK, Connell JJ, Kelly M, Gooding S, Banerjee R, Rees M. Precision medicine for liver tumours with quantitative MRI and whole genome sequencing (Precision1 trial): study protocol for observational cohort study. BMJ Open 2022; 12:e057163. [PMID: 35383076 PMCID: PMC8984042 DOI: 10.1136/bmjopen-2021-057163] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Radiogenomic analysis of patients being considered for liver resection is seldom performed in the clinic despite recent evidence indicating that quantitative MRI could improve posthepatectomy outcomes. Meanwhile, the increasingly accessible results from whole genome sequencing reporting on clinically actionable genetic biomarkers are yet to be fully integrated into the clinical care pathway. METHODS AND ANALYSIS A prospective observational cohort study of up to 200 participants is planned, recruiting adults with primary or secondary liver cancer being considered for liver resection at Hampshire Hospitals NHS Foundation Trust. The data will be evaluated to address the primary endpoint to calculate the proportion of participants in which the results from whole genome sequencing would have resulted in a change in clinical management. Participants will be offered an additional non-invasive quantitative MRI scan prior to the operation and the impact of the imaging results on treatment decision-making will be evaluated. ETHICS AND DISSEMINATION This study was reviewed by the NHS Health Research Authority and given favourable opinion by the Brighton and Sussex Research Ethics Committee (REC reference: 20/PR/0222). Research findings will be discussed with a patient and public involvement and engagement group, presented at relevant scientific conferences and published in open access journals. TRIAL REGISTRATION NUMBER NCT04597710.
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Affiliation(s)
- Fenella K Welsh
- Department of Hepatobiliary Surgery, Basingstoke and North Hampshire Hospital, Basingstoke, UK
| | | | | | - Sarah Gooding
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | | | - Myrddin Rees
- Department of Hepatobiliary Surgery, Basingstoke and North Hampshire Hospital, Basingstoke, UK
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2
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Baker RR, Payne C, Yu Y, Mohseni M, Connell JJ, Lin F, Harrison IF, Southern P, Rudrapatna US, Stuckey DJ, Kalber TL, Siow B, Thorne L, Punwani S, Jones DK, Emberton M, Pankhurst QA, Lythgoe MF. Image-Guided Magnetic Thermoseed Navigation and Tumor Ablation Using a Magnetic Resonance Imaging System. Adv Sci (Weinh) 2022; 9:e2105333. [PMID: 35106965 PMCID: PMC9036015 DOI: 10.1002/advs.202105333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Medical therapies achieve their control at expense to the patient in the form of a range of toxicities, which incur costs and diminish quality of life. Magnetic resonance navigation is an emergent technique that enables image-guided remote-control of magnetically labeled therapies and devices in the body, using a magnetic resonance imaging (MRI) system. Minimally INvasive IMage-guided Ablation (MINIMA), a novel, minimally invasive, MRI-guided ablation technique, which has the potential to avoid traditional toxicities, is presented. It comprises a thermoseed navigated to a target site using magnetic propulsion gradients generated by an MRI scanner, before inducing localized cell death using an MR-compatible thermoablative device. The authors demonstrate precise thermoseed imaging and navigation through brain tissue using an MRI system (0.3 mm), and they perform thermoablation in vitro and in vivo within subcutaneous tumors, with the focal ablation volume finely controlled by heating duration. MINIMA is a novel theranostic platform, combining imaging, navigation, and heating to deliver diagnosis and therapy in a single device.
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Affiliation(s)
- Rebecca R. Baker
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Christopher Payne
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Yichao Yu
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Matin Mohseni
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - John J. Connell
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Fangyu Lin
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
| | - Ian F. Harrison
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Paul Southern
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
| | - Umesh S. Rudrapatna
- Cardiff University Brain Research Imaging CentreMaindy RoadCardiffCF24 4HQUK
| | - Daniel J. Stuckey
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Tammy L. Kalber
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Bernard Siow
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Lewis Thorne
- Victor Horsley Department of NeurosurgeryThe National Hospital for Neurology and NeurosurgeryQueen SquareLondonWC1N 3BGUK
| | - Shonit Punwani
- Centre for Medical ImagingUniversity College LondonCharles Bell House, 43‐45 Foley StreetLondonW1W 7TSUK
| | - Derek K. Jones
- Cardiff University Brain Research Imaging CentreMaindy RoadCardiffCF24 4HQUK
| | - Mark Emberton
- Division of Surgery and Interventional ScienceUniversity College LondonCharles Bell House, 43–45 Foley StreetLondonW1W 7JNUK
| | - Quentin A. Pankhurst
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
- UCL Healthcare Biomagnetics LaboratoryUniversity College London21 Albemarle StreetLondonW1S 4BSUK
| | - Mark F. Lythgoe
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
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Mole DJ, Fallowfield JA, Sherif AE, Kendall T, Semple S, Kelly M, Ridgway G, Connell JJ, McGonigle J, Banerjee R, Brady JM, Zheng X, Hughes M, Neyton L, McClintock J, Tucker G, Nailon H, Patel D, Wackett A, Steven M, Welsh F, Rees M. Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer. PLoS One 2020; 15:e0238568. [PMID: 33264327 PMCID: PMC7710097 DOI: 10.1371/journal.pone.0238568] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery.
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Affiliation(s)
- Damian J. Mole
- Clinical Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Jonathan A. Fallowfield
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Ahmed E. Sherif
- Clinical Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, United Kingdom
- Department of HPB Surgery, National Liver Institute, Menoufia University, Shibin Elkom, Egypt
| | - Timothy Kendall
- Institute of Genetics and Molecular Medicine, Edinburgh, United Kingdom
- Department of Pathology, NHS Lothian, Edinburgh, United Kingdom
| | - Scott Semple
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Matt Kelly
- Perspectum, Gemini One, Oxford, United Kingdom
| | | | | | | | | | | | - Xiaozhong Zheng
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Michael Hughes
- Clinical Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, United Kingdom
| | - Lucile Neyton
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | | | - Garry Tucker
- Clinical Research Facility, NHS Lothian, Edinburgh, United Kingdom
| | - Hilary Nailon
- Clinical Research Facility, NHS Lothian, Edinburgh, United Kingdom
| | - Dilip Patel
- Clinical Radiology, NHS Lothian, Edinburgh, United Kingdom
| | | | | | - Fenella Welsh
- Hampshire Hospitals Foundation Trust, Basingstoke, United Kingdom
| | - Myrddin Rees
- Hampshire Hospitals Foundation Trust, Basingstoke, United Kingdom
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Zaw Thin M, Allan H, Bofinger R, Kostelec TD, Guillaume S, Connell JJ, Patrick PS, Hailes HC, Tabor AB, Lythgoe MF, Stuckey DJ, Kalber TL. Multi-modal imaging probe for assessing the efficiency of stem cell delivery to orthotopic breast tumours. Nanoscale 2020; 12:16570-16585. [PMID: 32749427 PMCID: PMC7586303 DOI: 10.1039/d0nr03237a] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/09/2020] [Indexed: 05/05/2023]
Abstract
Stem cells have been utilised as anti-cancer agents due to their ability to home to and integrate within tumours. Methods to augment stem cell homing to tumours are being investigated with the goal of enhancing treatment efficacy. However, it is currently not possible to evaluate both cell localisation and cell viability after engraftment, hindering optimisation of therapy. In this study, luciferase-expressing human adipocyte-derived stem cells (ADSCs) were incubated with Indium-111 radiolabelled iron oxide nanoparticles to produce cells with tri-modal imaging capabilities. ADSCs were administered intravenously (IV) or intracardially (IC) to mice bearing orthotopic breast tumours. Cell fate was monitored using bioluminescence imaging (BLI) as a measure of cell viability, magnetic resonance imaging (MRI) for cell localisation and single photon emission computer tomography (SPECT) for cell quantification. Serial monitoring with multi-modal imaging showed the presence of viable ADSCs within tumours as early as 1-hour post IC injection and the percentage of ADSCs within tumours to be 2-fold higher after IC than IV. Finally, histological analysis was used to validate engraftment of ADSC within tumour tissue. These findings demonstrate that multi-modal imaging can be used to evaluate the efficiency of stem cell delivery to tumours and that IC cell administration is more effective for tumour targeting.
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Affiliation(s)
- May Zaw Thin
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
| | - Helen Allan
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - Robin Bofinger
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - Tomas D Kostelec
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - Simon Guillaume
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - John J Connell
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
| | - P Stephen Patrick
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
| | - Helen C Hailes
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - Alethea B Tabor
- Department of Chemistry, University College London, 20, Gordon Street, London, WC1H 0AJ, UK
| | - Mark F Lythgoe
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
| | - Daniel J Stuckey
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
| | - Tammy L Kalber
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK.
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Finnerty E, Ramasawmy R, O’Callaghan J, Connell JJ, Lythgoe M, Shmueli K, Thomas DL, Walker‐Samuel S. Noninvasive quantification of oxygen saturation in the portal and hepatic veins in healthy mice and those with colorectal liver metastases using QSM MRI. Magn Reson Med 2019; 81:2666-2675. [PMID: 30450573 PMCID: PMC6588010 DOI: 10.1002/mrm.27571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/10/2018] [Accepted: 09/26/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE This preclinical study investigated the use of QSM MRI to noninvasively measure venous oxygen saturation (SvO2) in the hepatic and portal veins. METHODS QSM data were acquired from a cohort of healthy mice (n = 10) on a 9.4 Tesla MRI scanner under normoxic and hyperoxic conditions. Susceptibility was measured in the portal and hepatic veins and used to calculate SvO2 in each vessel under each condition. Blood was extracted from the inferior vena cava of 3 of the mice under each condition, and SvO2 was measured with a blood gas analyzer for comparison. QSM data were also acquired from a cohort of mice bearing liver tumors under normoxic conditions. Susceptibility was measured, and SvO2 calculated in the portal and hepatic veins and compared to the healthy mice. Statistical significance was assessed using a Wilcoxon matched-pairs signed rank test (normoxic vs. hyperoxic) or a Mann-Whitney test (healthy vs. tumor bearing). RESULTS SvO2 calculated from QSM measurements in healthy mice under hyperoxia showed significant increases of 15% in the portal vein (P < 0.05) and 21% in the hepatic vein (P < 0.01) versus normoxia. These values agreed with inferior vena cava measurements from the blood gas analyzer (26% increase). SvO2 in the hepatic vein was significantly lower in the colorectal liver metastases cohort (30% ± 11%) than the healthy mice (53% ± 17%) (P < 0.05); differences in the portal vein were not significant. CONCLUSION QSM is a feasible tool for noninvasively measuring SvO2 in the liver and can detect differences due to increased oxygen consumption in livers bearing colorectal metastases.
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Affiliation(s)
- Eoin Finnerty
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - Rajiv Ramasawmy
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - James O’Callaghan
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - John J. Connell
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - Mark Lythgoe
- Department of MedicineUCL Institute of Child Health, University College LondonLondonUnited Kingdom
| | - Karin Shmueli
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - David L. Thomas
- Institute of NeurologyUniversity College LondonLondonUnited Kingdom
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Ogunlade O, Connell JJ, Huang JL, Zhang E, Lythgoe MF, Long DA, Beard P. In vivo three-dimensional photoacoustic imaging of the renal vasculature in preclinical rodent models. Am J Physiol Renal Physiol 2018; 314:F1145-F1153. [PMID: 29357432 DOI: 10.1152/ajprenal.00337.2017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Noninvasive imaging of the kidney vasculature in preclinical murine models is important for the assessment of renal development, studying diseases and evaluating new therapies but is challenging to achieve using existing imaging modalities. Photoacoustic imaging is a promising new technique that is particularly well suited to visualizing the vasculature and could provide an alternative to existing preclinical imaging methods for studying renal vascular anatomy and function. To investigate this, an all-optical Fabry-Perot-based photoacoustic scanner was used to image the abdominal region of mice. High-resolution three-dimensional, noninvasive, label-free photoacoustic images of the mouse kidney and renal vasculature were acquired in vivo. The scanner was also used to visualize and quantify differences in the vascular architecture of the kidney in vivo due to polycystic kidney disease. This study suggests that photoacoustic imaging could be utilized as a novel preclinical imaging tool for studying the biology of renal disease.
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Affiliation(s)
- Olumide Ogunlade
- Department of Medical Physics and Biomedical Engineering, University College London , London , United Kingdom
| | - John J Connell
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London , London , United Kingdom
| | - Jennifer L Huang
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London , London , United Kingdom
| | - Edward Zhang
- Department of Medical Physics and Biomedical Engineering, University College London , London , United Kingdom
| | - Mark F Lythgoe
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London , London , United Kingdom
| | - David A Long
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London , London , United Kingdom
| | - Paul Beard
- Department of Medical Physics and Biomedical Engineering, University College London , London , United Kingdom
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Connell JJ, Patrick PS, Yu Y, Lythgoe MF, Kalber TL. Advanced cell therapies: targeting, tracking and actuation of cells with magnetic particles. Regen Med 2015; 10:757-72. [PMID: 26390317 DOI: 10.2217/rme.15.36] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 01/10/2023] Open
Abstract
Regenerative medicine would greatly benefit from a new platform technology that enabled measurable, controllable and targeting of stem cells to a site of disease or injury in the body. Superparamagnetic iron-oxide nanoparticles offer attractive possibilities in biomedicine and can be incorporated into cells, affording a safe and reliable means of tagging. This review describes three current and emerging methods to enhance regenerative medicine using magnetic particles to guide therapeutic cells to a target organ; track the cells using MRI and assess their spatial localization with high precision and influence the behavior of the cell using magnetic actuation. This approach is complementary to the systemic injection of cell therapies, thus expanding the horizon of stem cell therapeutics.
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Affiliation(s)
- John J Connell
- UCL Centre of Advanced Biomedical Imaging, Division of Medicine, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | - P Stephen Patrick
- UCL Centre of Advanced Biomedical Imaging, Division of Medicine, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | - Yichao Yu
- UCL Centre of Advanced Biomedical Imaging, Division of Medicine, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | - Mark F Lythgoe
- UCL Centre of Advanced Biomedical Imaging, Division of Medicine, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | - Tammy L Kalber
- UCL Centre of Advanced Biomedical Imaging, Division of Medicine, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
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Serres S, Martin CJ, Sarmiento Soto M, Bristow C, O'Brien ER, Connell JJ, Khrapitchev AA, Sibson NR. Structural and functional effects of metastases in rat brain determined by multimodal MRI. Int J Cancer 2014; 134:885-96. [PMID: 23913394 DOI: 10.1002/ijc.28406] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 07/10/2013] [Accepted: 07/18/2013] [Indexed: 01/04/2023]
Abstract
Metastasis to the brain results in significant impairment of brain function and poor patient survival. Currently, magnetic resonance imaging (MRI) is under-utilised in monitoring brain metastases and their effects on brain function. Here, we sought to establish a model of focal brain metastasis in the rat that enables serial multimodal structural and functional MRI studies, and to assess the sensitivity of these approaches to metastatic growth. Female Berlin-Druckrey-IX rats were injected intracerebrally with metastatic ENU1564 cells in the ventroposterior medial nucleus (VPM) of the thalamus, a relay node of the whisker-to-barrel cortex pathway. Animals underwent multimodal structural and vascular MRI, as well as functional MRI of the cortical blood oxygenation level dependent (BOLD) responses to whisker pad stimulation. T2 , diffusion, magnetisation transfer and perfusion weighted MRI enabled differentiation between a central area of more advanced metastatic growth and penumbral regions of co-optive perivascular micrometastatic growth, with magnetisation transfer MRI being the most sensitive to micrometastatic growth. Areas of cortical BOLD activation in response to whisker pad stimulation were significantly reduced in the hemisphere containing metastases in the VPM. The reduction in BOLD response correlated with metastatic burden in the thalamus, and was sensitive to the presence of smaller metastases than currently detectable clinically. Our findings suggest that multimodal MRI provides greater sensitivity to tumour heterogeneity and micrometastatic growth than single modality contrast-enhanced MRI. Understanding the relationships between these MRI parameters and the underlying pathology may greatly enhance the utility of MRI in diagnosis, staging and monitoring of brain metastasis.
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Affiliation(s)
- Sébastien Serres
- CR-UK/MRC Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Churchill Hospital, Oxford, OX3 7LJ, United Kingdom
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Connell JJ, Chatain G, Cornelissen B, Vallis KA, Hamilton A, Seymour L, Anthony DC, Sibson NR. Selective permeabilization of the blood-brain barrier at sites of metastasis. J Natl Cancer Inst 2013; 105:1634-43. [PMID: 24108809 PMCID: PMC3818170 DOI: 10.1093/jnci/djt276] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 08/30/2013] [Accepted: 09/06/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Effective chemotherapeutics for primary systemic tumors have limited access to brain metastases because of the blood-brain barrier (BBB). The aim of this study was to develop a strategy for specifically permeabilizing the BBB at sites of cerebral metastases. METHODS BALB/c mice were injected intracardially to induce brain metastases. After metastasis induction, either tumor necrosis factor (TNF) or lymphotoxin (LT) was administered intravenously, and 2 to 24 hours later gadolinium- diethylenetriaminepentaacetic acid, horseradish peroxidase, or radiolabeled trastuzumab ((111)In-BnDTPA-Tz) was injected intravenously. BBB permeability was assessed in vivo using gadolinium-enhanced T1-weighted magnetic resonance imaging and confirmed histochemically. Brain uptake of (111)In-BnDTPA-Tz was determined using in vivo single photon emission computed tomography/computed tomography. Endothelial expression of TNF receptors was determined immunohistochemically in both mouse and human brain tissue containing metastases. Group differences were analyzed with one-way analysis of variance followed by post hoc tests, Wilcoxon signed rank test, and Kruskal-Wallis with Dunn's multiple comparison test. All statistical tests were two-sided. RESULTS Localized expression of TNF receptor 1 (TNFR1) was evident on the vascular endothelium associated with brain metastases. Administration of TNF or LT permeabilized the BBB to exogenous tracers selectively at sites of brain metastasis, with peak effect at 6 hours. Metastasis-specific uptake ratio of (111)In-BnDTPA-Tz was also demonstrated after systemic TNF administration vs control (0.147±0.066 vs 0.001±0.001). Human brain metastases displayed a similar TNF receptor profile compared with the mouse model, with predominantly vascular TNFR1 expression. CONCLUSIONS These findings describe a new approach to selectively permeabilize the BBB at sites of brain metastases to aid in detection of micrometastases and facilitate tumor-specific access of chemotherapeutic agents. We hypothesize that this permeabilization works primarily though TNFR1 activation and has the potential for clinical translation.
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MESH Headings
- Analysis of Variance
- Animals
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/metabolism
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/metabolism
- Blood-Brain Barrier/metabolism
- Brain/metabolism
- Brain Neoplasms/metabolism
- Brain Neoplasms/secondary
- Breast Neoplasms/pathology
- Contrast Media/metabolism
- Disease Models, Animal
- Drug Administration Schedule
- Female
- Gadolinium DTPA/metabolism
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Lymphotoxin-alpha/administration & dosage
- Lymphotoxin-alpha/metabolism
- Magnetic Resonance Imaging
- Mice
- Mice, Inbred BALB C
- Permeability/drug effects
- Receptors, Tumor Necrosis Factor, Type I/analysis
- Tomography, Emission-Computed, Single-Photon
- Tomography, X-Ray Computed
- Trastuzumab
- Tumor Necrosis Factor-alpha/administration & dosage
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- John J Connell
- Affiliations of authors: CRUK/MRC Gray Institute for Radiation Oncology and Biology, Churchill Hospital, Oxford, UK (JJC, GC, BC, KAV, AH, NRS); Department of Pharmacology (JJC, AH, DCA) and Department of Oncology (JJC, GC, BC, KAV, AH, LS, NRS), University of Oxford, Oxford, UK
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Simpson JA, Connell JJ, Lopate C, McKibben RB, Zhang M, Anglin JD, Ferrando P, Rastoin C, Raviart A, Heber B, Muiller-Meliin R, Kunow H, Sierks H, Wibberenz G, Bothmer V, Marsden RG, Sanderson TR, Trattner KJ, Wenzel KP, Paizis C. Cosmic Ray and Solar Particle Investigations Over the South Polar Regions of the Sun. Science 1995; 268:1019-23. [PMID: 17774228 DOI: 10.1126/science.268.5213.1019] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Observations of galactic cosmic radiation and anomalous component nuclei with charged particle sensors on the Ulysses spacecraft showed that heliospheric magnetic field structure over the south solar pole does not permit substantially more direct access to the local interstellar cosmic ray spectrum than is possible in the equatorial zone. Fluxes of galactic cosmic rays and the anomalous component increased as a result of latitude gradients by less than 50% from the equator to -80 degrees . Thus, the modulated cosmic ray nucleon, electron, and anomalous component fluxes are nearly spherically symmetric in the inner solar system. The cosmic rays and the anomalous nuclear component underwent a continuous, -26 day recurrent modulation to -80.2 degrees , whereas all recurring magnetic field compressions and recurring streams in the solar wind disappeared above approximately 55 degrees S latitude.
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Connell JJ, Howgate PF. Sensory and objective measurements of the quality of frozen stored haddock of different initial freshnesses. J Sci Food Agric 1969; 20:469-476. [PMID: 5817706 DOI: 10.1002/jsfa.2740200805] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Connell JJ. The use of sodium dodecyl sulphate in the study of protein interactions during the storage of cod flesh at minus 14 degrees. J Sci Food Agric 1965; 16:769-783. [PMID: 5892860 DOI: 10.1002/jsfa.2740161214] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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