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Kessler DA, Graves MJ. Editorial for "The Effect of Image Resampling on the Performance of Radiomics-Based Artificial Intelligence in Multicenter Prostate MRI". J Magn Reson Imaging 2024; 59:1807-1808. [PMID: 37534877 DOI: 10.1002/jmri.28939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
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Stovell MG, Ruetten PPR, Tozer DJ, Launey Y, Zimphango C, Thelin EP, Lupson VC, Giorgi-Coll S, Carpenter TA, Mada MO, Jalloh I, Helmy A, Wilson MH, Graves MJ, Menon D, Carpenter KLH, Hutchinson PJ. Characterizing diffusion from microdialysis catheters in the human brain: a magnetic resonance imaging study with gadobutrol. J Neurotrauma 2024. [PMID: 38468502 DOI: 10.1089/neu.2023.0560] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Cerebral microdialysis (CMD) catheters allow continuous monitoring of patients' cerebral metabolism in severe traumatic brain injury (TBI). The catheters consist of a terminal semi-permeable membrane that is inserted into the brain's interstitium to allow perfusion fluid to equalize with the surrounding cerebral extracellular environment before being recovered through a central non-porous channel. However, it is unclear how far recovered fluid and suspended metabolites have diffused from within the brain, and therefore what volume or region of brain tissue the analyses of metabolism represent. We assessed diffusion of the small magnetic resonance (MR)-detectible molecule gadobutrol from microdialysis catheters in six subjects (complete data five subjects, incomplete data one subject) who had sustained a severe TBI. Diffusion pattern and distance in cerebral white matter were assessed using T1 (time for MR spin-lattice relaxation) maps at 1 mm isotropic resolution in a 3 Tesla MR scanner. Gadobutrol at 10 mmol/L diffused from cerebral microdialysis catheters in a uniform spheroidal (ellipsoid of revolution) pattern around the catheters' semipermeable membranes, and across grey matter-white matter boundaries. Evidence of gadobutrol diffusion was found up to a mean of 13.4 ± 0.5 mm (mean ± s.d.) from catheters, but with a steep concentration drop off so that ≤ 50 % of maximum concentration was achieved at ≈ 4 mm, and ≤ 10 % of maximum was found beyond ≈ 7 mm from the catheters. There was little variation between subjects. The relaxivity of gadobutrol in human cerebral white matter was estimated to be 1.61 ± 0.38 L.mmol-1s-1 (mean ± s.d.); assuming gadobutrol remained extracellular thereby occupying 20 % of total tissue volume (interstitium), and concentration equilibrium with perfusion fluid was achieved immediately adjacent to catheters after 24 hours of perfusion. No statistically significant change was found in the concentration of the extracellular metabolites glucose, lactate, pyruvate, nor the lactate/pyruvate ratio during gadobutrol perfusion when compared to microdialysis period of baseline microdialysis perfusion. Cerebral microdialysis allows continuous monitoring of regional cerebral metabolism - the volume of which is now clearer from this study. It also has the potential to deliver small molecule therapies to focal pathologies of the human brain. This study provides a platform for future development of new catheters optimally designed to treat such conditions.
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Affiliation(s)
- Matthew George Stovell
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland
- The Walton Centre NHS Foundation Trust, 195157, Department of Neurosurgery, Liverpool, United Kingdom of Great Britain and Northern Ireland;
| | - Pascal P R Ruetten
- University of Cambridge, 2152, Department of Radiology, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Daniel J Tozer
- University of Cambridge, 2152, Stroke Research Group, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Yoann Launey
- University of Cambridge, 2152, Division of Anaesthesia, Department of Medicine, Cambridge, United Kingdom of Great Britain and Northern Ireland
- Centre Hospitalier Universitaire de Rennes, 36684, Réanimation chirurgicale, Rennes, France;
| | - Chisomo Zimphango
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Eric Peter Thelin
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland
- Karolinska Institutet, 27106, Department of Clinical Neuroscience, Stockholm, Sweden;
| | - Victoria C Lupson
- University of Cambridge, 2152, Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Susan Giorgi-Coll
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Thomas Adrian Carpenter
- University of Cambridge, 2152, Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Marius O Mada
- University of Cambridge, 2152, Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Ibrahim Jalloh
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Adel Helmy
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Mark H Wilson
- Imperial College London, 4615, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Martin J Graves
- University of Cambridge, 2152, Department of Radiology, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - David Menon
- University of Cambridge, 2152, Division of Anaesthesia, Department of Medicine, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Keri L H Carpenter
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Peter John Hutchinson
- University of Cambridge, 2152, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge, United Kingdom of Great Britain and Northern Ireland;
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Carmona-Bozo JC, Manavaki R, Miller JL, Brodie C, Caracò C, Woitek R, Baxter GC, Graves MJ, Fryer TD, Provenzano E, Gilbert FJ. PET/MRI of hypoxia and vascular function in ER-positive breast cancer: correlations with immunohistochemistry. Eur Radiol 2023; 33:6168-6178. [PMID: 37166494 PMCID: PMC10415421 DOI: 10.1007/s00330-023-09572-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/16/2022] [Accepted: 02/08/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To explore the relationship between indices of hypoxia and vascular function from 18F-fluoromisonidazole ([18F]-FMISO)-PET/MRI with immunohistochemical markers of hypoxia and vascularity in oestrogen receptor-positive (ER +) breast cancer. METHODS Women aged > 18 years with biopsy-confirmed, treatment-naïve primary ER + breast cancer underwent [18F]-FMISO-PET/MRI prior to surgery. Parameters of vascular function were derived from DCE-MRI using the extended Tofts model, whilst hypoxia was assessed using the [18F]-FMISO influx rate constant, Ki. Histological tumour sections were stained with CD31, hypoxia-inducible factor (HIF)-1α, and carbonic anhydrase IX (CAIX). The number of tumour microvessels, median vessel diameter, and microvessel density (MVD) were obtained from CD31 immunohistochemistry. HIF-1α and CAIX expression were assessed using histoscores obtained by multiplying the percentage of positive cells stained by the staining intensity. Regression analysis was used to study associations between imaging and immunohistochemistry variables. RESULTS Of the lesions examined, 14/22 (64%) were ductal cancers, grade 2 or 3 (19/22; 86%), with 17/22 (77%) HER2-negative. [18F]-FMISO Ki associated negatively with vessel diameter (p = 0.03), MVD (p = 0.02), and CAIX expression (p = 0.002), whilst no significant relationships were found between DCE-MRI pharmacokinetic parameters and immunohistochemical variables. HIF-1α did not significantly associate with any PET/MR imaging indices. CONCLUSION Hypoxia measured by [18F]-FMISO-PET was associated with increased CAIX expression, low MVD, and smaller vessel diameters in ER + breast cancer, further corroborating the link between inadequate vascularity and hypoxia in ER + breast cancer. KEY POINTS • Hypoxia, measured by [18F]-FMISO-PET, was associated with low microvessel density and small vessel diameters, corroborating the link between inadequate vascularity and hypoxia in ER + breast cancer. • Increased CAIX expression was associated with higher levels of hypoxia measured by [18F]-FMISO-PET. • Morphologic and functional abnormalities of the tumour microvasculature are the major determinants of hypoxia in cancers and support the previously reported perfusion-driven character of hypoxia in breast carcinomas.
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Affiliation(s)
- Julia C Carmona-Bozo
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Roido Manavaki
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jodi L Miller
- Cancer Research UK - Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Cara Brodie
- Cancer Research UK - Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Corradina Caracò
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Ramona Woitek
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Gabrielle C Baxter
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tim D Fryer
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Box 65 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Elena Provenzano
- Cancer Research UK - Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Box 97 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Fiona J Gilbert
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218 - Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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Lee KL, Kessler DA, Dezonie S, Chishaya W, Shepherd C, Carmo B, Graves MJ, Barrett T. Assessment of deep learning-based reconstruction on T2-weighted and diffusion-weighted prostate MRI image quality. Eur J Radiol 2023; 166:111017. [PMID: 37541181 DOI: 10.1016/j.ejrad.2023.111017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 04/29/2023] [Revised: 07/22/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
PURPOSE To evaluate the impact of a commercially available deep learning-based reconstruction (DLR) algorithm with varying combinations of DLR noise reduction settings and imaging parameters on quantitative and qualitative image quality, PI-RADS classification and examination time in prostate T2-weighted (T2WI) and diffusion-weighted (DWI) imaging. METHOD Forty patients were included. Standard-of-care (SoC) prostate MRI sequences including T2WI and DWI were reconstructed without and with different DLR de-noising levels (low, medium, high). In addition, faster T2WI(Fast) and DWI(Fast) sequences, and a higher resolution T2WI(HR) sequence were evaluated. Quantitative analysis included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and apparent diffusion coefficient (ADC) values. Two radiologists performed qualitative analysis, independently evaluating imaging datasets using 5-point scoring scales for image quality and artifacts. PI-RADS category assignment was also performed by the more experienced radiologist. RESULTS All DLR levels resulted in significantly higher SNR and CNR compared to the DLR(off) acquisitions. DLR allowed the acquisition time to be reduced by 33% for T2WI(Fast) and 49% for DWI(Fast) compared to SoC, without affecting image quality, whilst T2WI(HR) with DLR allowed for a 73% increase in spatial resolution in the phase encode direction compared to SoC. The inter-reader agreement for image quality and artifact scores was substantial for all subjective measurements on T2WI and DWI. The T2WI(Fast) protocol with DLR(medium) and DWI(Fast) with DLR(low) received the highest qualitative quality score. CONCLUSION DLR can reduce T2WI and DWI acquisition time and increase SNR and CNR without compromising image quality or altering PI-RADS classification.
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Affiliation(s)
- Kang-Lung Lee
- Department of Radiology, University of Cambridge, United Kingdom; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | | | - Wellington Chishaya
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Christopher Shepherd
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Bruno Carmo
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, United Kingdom; Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Tristan Barrett
- Department of Radiology, University of Cambridge, United Kingdom.
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5
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Escudero Sanchez L, Buddenkotte T, Al Sa’d M, McCague C, Darcy J, Rundo L, Samoshkin A, Graves MJ, Hollamby V, Browne P, Crispin-Ortuzar M, Woitek R, Sala E, Schönlieb CB, Doran SJ, Öktem O. Integrating Artificial Intelligence Tools in the Clinical Research Setting: The Ovarian Cancer Use Case. Diagnostics (Basel) 2023; 13:2813. [PMID: 37685352 PMCID: PMC10486639 DOI: 10.3390/diagnostics13172813] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/31/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Artificial intelligence (AI) methods applied to healthcare problems have shown enormous potential to alleviate the burden of health services worldwide and to improve the accuracy and reproducibility of predictions. In particular, developments in computer vision are creating a paradigm shift in the analysis of radiological images, where AI tools are already capable of automatically detecting and precisely delineating tumours. However, such tools are generally developed in technical departments that continue to be siloed from where the real benefit would be achieved with their usage. Significant effort still needs to be made to make these advancements available, first in academic clinical research and ultimately in the clinical setting. In this paper, we demonstrate a prototype pipeline based entirely on open-source software and free of cost to bridge this gap, simplifying the integration of tools and models developed within the AI community into the clinical research setting, ensuring an accessible platform with visualisation applications that allow end-users such as radiologists to view and interact with the outcome of these AI tools.
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Affiliation(s)
- Lorena Escudero Sanchez
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- National Cancer Imaging Translational Accelerator (NCITA) Consortium, UK
| | - Thomas Buddenkotte
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, UK
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Jung Diagnostics GmbH, 22335 Hamburg, Germany
| | - Mohammad Al Sa’d
- National Cancer Imaging Translational Accelerator (NCITA) Consortium, UK
- Cancer Imaging Centre, Department of Surgery & Cancer, Imperial College, London SW7 2AZ, UK
| | - Cathal McCague
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - James Darcy
- National Cancer Imaging Translational Accelerator (NCITA) Consortium, UK
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London SW7 3RP, UK
| | - Leonardo Rundo
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- Department of Information and Electrical Engineering and Applied Mathematics (DIEM), University of Salerno, 84084 Fisciano, Italy
| | - Alex Samoshkin
- Office for Translational Research, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK
| | - Martin J. Graves
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Victoria Hollamby
- Research and Information Governance, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK
| | - Paul Browne
- High Performance Computing Department, University of Cambridge, Cambridge CB3 0RB, UK
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- Department of Oncology, University of Cambridge, Cambridge CB2 0XZ, UK
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- Research Centre for Medical Image Analysis and Artificial Intelligence (MIAAI), Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500 Krems, Austria
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, Li Ka Shing Centre, Cambridge CB2 0RE, UK
- National Cancer Imaging Translational Accelerator (NCITA) Consortium, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Dipartimento di Scienze Radiologiche ed Ematologiche, Universita Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Carola-Bibiane Schönlieb
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, UK
| | - Simon J. Doran
- National Cancer Imaging Translational Accelerator (NCITA) Consortium, UK
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London SW7 3RP, UK
| | - Ozan Öktem
- Department of Mathematics, KTH-Royal Institute of Technology, SE-100 44 Stockholm, Sweden
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Gill AB, Gallagher FA, Graves MJ. Open source code for the generation of digital reference objects for dynamic contrast-enhanced MRI analysis software validation. Br J Radiol 2023; 96:20220976. [PMID: 37191274 PMCID: PMC10321261 DOI: 10.1259/bjr.20220976] [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: 10/18/2022] [Revised: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES Dynamic contrast-enhanced MR images can be analyzed through the application of a wide range of kinetic models. This process is prone to variability and a lack of standardization that can affect the measured metrics. There is a need for customized digital reference objects (DROs) for the validation of DCE-MRI software packages that undertake kinetic model analysis. DROs are currently available only for a small subset of the kinetic models commonly applied to DCE-MRI data. This work aimed to address this gap. METHODS Code was written in the MATLAB programming environment to generate customizable DROs. This modular code allows the insertion of a plug-in to describe the kinetic model to be tested. We input our generated DROs into three commercial and open-source analysis packages and assessed the agreement of kinetic model parameter values output with the 'ground-truth' values used in the DRO generation. RESULTS For the five kinetic models tested, the concordance correlation coefficient values were >98%, indicating excellent agreement of the results with 'ground-truth'. CONCLUSIONS Testing our DROs on three independent software packages produced concordant results, strongly suggesting our DRO generation code is correct. This implies that our DROs can be used to validate other third party software for the kinetic model analysis of DCE-MRI data. ADVANCES IN KNOWLEDGE This work extends published work of others to allow customized generation of test objects for any applied kinetic model and allows the incorporation of B1 mapping into the DRO for application at higher field strengths.
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Affiliation(s)
- Andrew B. Gill
- Department of Radiology, University of Cambridge, Cambridge, UK
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7
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Ćorović A, Wall C, Nus M, Gopalan D, Huang Y, Imaz M, Zulcinski M, Peverelli M, Uryga A, Lambert J, Bressan D, Maughan RT, Pericleous C, Dubash S, Jordan N, Jayne DR, Hoole SP, Calvert PA, Dean AF, Rassl D, Barwick T, Iles M, Frontini M, Hannon G, Manavaki R, Fryer TD, Aloj L, Graves MJ, Gilbert FJ, Dweck MR, Newby DE, Fayad ZA, Reynolds G, Morgan AW, Aboagye EO, Davenport AP, Jørgensen HF, Mallat Z, Bennett MR, Peters JE, Rudd JHF, Mason JC, Tarkin JM. Somatostatin Receptor PET/MR Imaging of Inflammation in Patients With Large Vessel Vasculitis and Atherosclerosis. J Am Coll Cardiol 2023; 81:336-354. [PMID: 36697134 PMCID: PMC9883634 DOI: 10.1016/j.jacc.2022.10.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/03/2022] [Accepted: 10/24/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Assessing inflammatory disease activity in large vessel vasculitis (LVV) can be challenging by conventional measures. OBJECTIVES We aimed to investigate somatostatin receptor 2 (SST2) as a novel inflammation-specific molecular imaging target in LVV. METHODS In a prospective, observational cohort study, in vivo arterial SST2 expression was assessed by positron emission tomography/magnetic resonance imaging (PET/MRI) using 68Ga-DOTATATE and 18F-FET-βAG-TOCA. Ex vivo mapping of the imaging target was performed using immunofluorescence microscopy; imaging mass cytometry; and bulk, single-cell, and single-nucleus RNA sequencing. RESULTS Sixty-one participants (LVV: n = 27; recent atherosclerotic myocardial infarction of ≤2 weeks: n = 25; control subjects with an oncologic indication for imaging: n = 9) were included. Index vessel SST2 maximum tissue-to-blood ratio was 61.8% (P < 0.0001) higher in active/grumbling LVV than inactive LVV and 34.6% (P = 0.0002) higher than myocardial infarction, with good diagnostic accuracy (area under the curve: ≥0.86; P < 0.001 for both). Arterial SST2 signal was not elevated in any of the control subjects. SST2 PET/MRI was generally consistent with 18F-fluorodeoxyglucose PET/computed tomography imaging in LVV patients with contemporaneous clinical scans but with very low background signal in the brain and heart, allowing for unimpeded assessment of nearby coronary, myocardial, and intracranial artery involvement. Clinically effective treatment for LVV was associated with a 0.49 ± 0.24 (standard error of the mean [SEM]) (P = 0.04; 22.3%) reduction in the SST2 maximum tissue-to-blood ratio after 9.3 ± 3.2 months. SST2 expression was localized to macrophages, pericytes, and perivascular adipocytes in vasculitis specimens, with specific receptor binding confirmed by autoradiography. SSTR2-expressing macrophages coexpressed proinflammatory markers. CONCLUSIONS SST2 PET/MRI holds major promise for diagnosis and therapeutic monitoring in LVV. (PET Imaging of Giant Cell and Takayasu Arteritis [PITA], NCT04071691; Residual Inflammation and Plaque Progression Long-Term Evaluation [RIPPLE], NCT04073810).
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Affiliation(s)
- Andrej Ćorović
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Christopher Wall
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Meritxell Nus
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Deepa Gopalan
- Department of Radiology, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom; Department of Radiology, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Yuan Huang
- Engineering and Physical Sciences Research Council Centre for Mathematical Imaging in Healthcare, University of Cambridge, Cambridge, United Kingdom
| | - Maria Imaz
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Michal Zulcinski
- Leeds Institute of Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Marta Peverelli
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom; Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Anna Uryga
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jordi Lambert
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Dario Bressan
- Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Robert T Maughan
- Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Charis Pericleous
- Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Suraiya Dubash
- Department of Oncology, University College London NHS Trust, London, United Kingdom; Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Natasha Jordan
- Department of Rheumatology, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - David R Jayne
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Stephen P Hoole
- Department of Cardiology, Royal Papworth Hospital NHS Trust, Cambridge, United Kingdom
| | - Patrick A Calvert
- Department of Cardiology, Royal Papworth Hospital NHS Trust, Cambridge, United Kingdom
| | - Andrew F Dean
- Department of Histopathology, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Doris Rassl
- Department of Histopathology, Royal Papworth Hospital NHS Trust, Cambridge, United Kingdom
| | - Tara Barwick
- Department of Radiology, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom; Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Mark Iles
- Leeds Institute of Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Mattia Frontini
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Greg Hannon
- Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Luigi Aloj
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - David E Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Zahi A Fayad
- BioMedical Engineering & Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gary Reynolds
- Department of Rheumatology, University of Newcastle, Newcastle, United Kingdom
| | - Ann W Morgan
- Leeds Institute of Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Eric O Aboagye
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Anthony P Davenport
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Helle F Jørgensen
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Ziad Mallat
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Martin R Bennett
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - James E Peters
- Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
| | - James H F Rudd
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Justin C Mason
- Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Jason M Tarkin
- Section of Cardiorespiratory Medicine, University of Cambridge, Cambridge, United Kingdom; Vascular Sciences, National Heart & Lung Institute, Imperial College London, London, United Kingdom.
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8
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Ćorović A, Gopalan D, Wall C, Peverelli M, Hoole SP, Calvert PA, Manavaki R, Fryer TD, Aloj L, Graves MJ, Bennett MR, Rudd JH, Tarkin JM. Novel Approach for Assessing Postinfarct Myocardial Injury and Inflammation Using Hybrid Somatostatin Receptor Positron Emission Tomography/Magnetic Resonance Imaging. Circ Cardiovasc Imaging 2023; 16:e014538. [PMID: 36649455 PMCID: PMC9848209 DOI: 10.1161/circimaging.122.014538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Andrej Ćorović
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
| | - Deepa Gopalan
- Department of Radiology, Cambridge University Hospitals NHS Trust, United Kingdom (D.G.)
| | - Christopher Wall
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
| | - Marta Peverelli
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
| | - Stephen P. Hoole
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
- Department of Cardiology, Royal Papworth Hospital NHS Trust, United Kingdom (S.P.H., P.A.C.)
| | - Patrick A. Calvert
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
- Department of Cardiology, Royal Papworth Hospital NHS Trust, United Kingdom (S.P.H., P.A.C.)
| | - Roido Manavaki
- Department of Radiology (R.M., L.A., M.J.G.), University of Cambridge, United Kingdom
| | - Tim D. Fryer
- Department of Clinical Neurosciences (T.D.F.), University of Cambridge, United Kingdom
| | - Luigi Aloj
- Department of Radiology (R.M., L.A., M.J.G.), University of Cambridge, United Kingdom
| | - Martin J. Graves
- Department of Radiology (R.M., L.A., M.J.G.), University of Cambridge, United Kingdom
| | - Martin R. Bennett
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
| | - James H.F. Rudd
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
| | - Jason M. Tarkin
- Section of CardioRespiratory Medicine (A.C., C.W., M.P., S.P.H., P.A.C., M.R.B., J.H.F.R., J.M.T.), University of Cambridge, United Kingdom
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9
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Corovic A, Nus M, Peverelli M, Gopalan D, Calvert PA, Hoole SP, Manavaki R, Fryer T, Aloj L, Graves MJ, Dweck MR, Newby DE, Mallat Z, Rudd JHF, Tarkin JM. Imaging of post-infarct myocardial inflammation with 68Ga-DOTATATE PET/MRI. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
After myocardial infarction (MI), inflammation and its resolution modulate the extent of myocardial damage. 68Ga-DOTATATE is a PET tracer that binds to somatostatin receptor 2 (SST2), which is up-regulated in pro-inflammatory macrophages [1].
Purpose
We investigated 68Ga-DOTATATE PET/MRI for quantifying post-infarct myocardial inflammation.
Methods
In this prospective observational cohort study, participants with MI underwent 68Ga-DOTATATE PET/MRI at baseline (t0: <2 weeks post-MI) and 3 months (t3M). Patients with prior MI, heart failure, coronary revascularisation, or contraindication to PET/MRI, were excluded. Blood samples were taken at the time of imaging for high sensitivity CRP (hsCRP), high sensitivity troponin I (hsTnI), NTproBNP and peripheral blood monocyte subset counts measured by mass cytometry. 68Ga-DOTATATE maximum Standardised Uptake Values (SUV) and Tissue-to-Background Ratios (TBR) adjusted for blood pool activity were compared in the infarct defined by late gadolinium enhancement (LGE) MRI to remote myocardium at t0 and t3M.
Results
Thirty-two patients (mean age 59 [SD 9] years; 26 [81%] male and 6 [19%] female), comprised of 18 (56%) patients with ST elevation MI and 14 (44%) with non-ST elevation MI, were enrolled. Mean peak troponin was 16,953ng/L (range 408 to >25,000ng/L), and 16 (52%) patients had left ventricular impairment (ejection fraction <50%).
68Ga-DOTATATE PET signal co-localised with myocardial LGE and focal oedema (arrows) on T2-weighted MRI (Fig. 1; asterisk: culprit artery) and had excellent ability to discriminate infarct from remote regions (t0: infarct SUV 2.41 vs. remote 1.58, p<0.0001; t0: infarct TBR 5.08 vs. 3.35, p<0.0001; Fig. 2a).
At 100 (SD 13) days after MI (n=23 patients), residual 68Ga-DOTATATE uptake in the infarct remained higher than remote myocardium (t3M: infarct SUV 1.88 vs. remote 1.27, p<0.0001; t3M: infarct TBR 3.96 vs. remote 2.73, p<0.0001), but was reduced compared to baseline (SUV −22%, p<0.0001; TBR −22%, p=0.002; Fig. 2b).
Reduction in infarct 68Ga-DOTATATE uptake was consistent with overall decreases in hsCRP (2.16 vs. 8.76 mg/L), hsTnI (19 vs. 1365 ng/L) and NTproBNP (372 vs. 959 pg/mL) at t3M vs. t0 (n=23, all p<0.05). Focal oedema on MRI was resolved in 17 (74%) patients at t3M. Infarct-to-remote TBR ratio at t0 was correlated with hsTnI (r=0.35, p<0.05). At t3M (n=9 samples) vs t0 (n=20 samples), there was a reduction in % classical-to-non-classical ratio of peripheral monocytes (mean 6.5 [SD 3.8] vs. 14.4 [SD 11.2], p=0.005).
Conclusions
This is the first prospective study of serial 68Ga-DOTATATE PET/MRI in patients after MI. Here we show that 68Ga-DOTATATE tracks resolving myocardial inflammation. Ongoing work as part of this study seeks to confirm the cellular origin of infarct-related 68Ga-DOTATATE PET signal and SST2 expression within inflamed myocardial tissue, and test its longer-term association with ischaemic myocardial remodelling.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Wellcome TrustBritish Heart Foundation
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Affiliation(s)
- A Corovic
- University of Cambridge , Cambridge , United Kingdom
| | - M Nus
- University of Cambridge , Cambridge , United Kingdom
| | - M Peverelli
- University of Cambridge , Cambridge , United Kingdom
| | - D Gopalan
- Cambridge University Hospitals NHS Foundation Trust , Cambridge , United Kingdom
| | - P A Calvert
- Royal Papworth Hospital NHS Foundation Trust , Cambridge , United Kingdom
| | - S P Hoole
- Royal Papworth Hospital NHS Foundation Trust , Cambridge , United Kingdom
| | - R Manavaki
- University of Cambridge , Cambridge , United Kingdom
| | - T Fryer
- University of Cambridge , Cambridge , United Kingdom
| | - L Aloj
- University of Cambridge , Cambridge , United Kingdom
| | - M J Graves
- University of Cambridge , Cambridge , United Kingdom
| | - M R Dweck
- University of Edinburgh , Edinburgh , United Kingdom
| | - D E Newby
- University of Edinburgh , Edinburgh , United Kingdom
| | - Z Mallat
- University of Cambridge , Cambridge , United Kingdom
| | - J H F Rudd
- University of Cambridge , Cambridge , United Kingdom
| | - J M Tarkin
- University of Cambridge , Cambridge , United Kingdom
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Kaggie JD, Khan AS, Matys T, Schulte RF, Locke MJ, Grimmer A, Frary A, Menih IH, Latimer E, Graves MJ, McLean MA, Gallagher FA. Deuterium metabolic imaging and hyperpolarized 13C-MRI of the normal human brain at clinical field strength reveals differential cerebral metabolism. Neuroimage 2022; 257:119284. [PMID: 35533826 DOI: 10.1016/j.neuroimage.2022.119284] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 01/26/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022] Open
Abstract
Deuterium metabolic imaging (DMI) and hyperpolarized 13C-pyruvate MRI (13C-HPMRI) are two emerging methods for non-invasive and non-ionizing imaging of tissue metabolism. Imaging cerebral metabolism has potential applications in cancer, neurodegeneration, multiple sclerosis, traumatic brain injury, stroke, and inborn errors of metabolism. Here we directly compare these two non-invasive methods at 3 T for the first time in humans and show how they simultaneously probe both oxidative and non-oxidative metabolism. DMI was undertaken 1-2 h after oral administration of [6,6'-2H2]glucose, and 13C-MRI was performed immediately following intravenous injection of hyperpolarized [1-13C]pyruvate in ten and nine normal volunteers within each arm respectively. DMI was used to generate maps of deuterium-labelled water, glucose, lactate, and glutamate/glutamine (Glx) and the spectral separation demonstrated that DMI is feasible at 3 T. 13C-HPMRI generated maps of hyperpolarized carbon-13 labelled pyruvate, lactate, and bicarbonate. The ratio of 13C-lactate/13C-bicarbonate (mean 3.7 ± 1.2) acquired with 13C-HPMRI was higher than the equivalent 2H-lactate/2H-Glx ratio (mean 0.18 ± 0.09) acquired using DMI. These differences can be explained by the route of administering each probe, the timing of imaging after ingestion or injection, as well as the biological differences in cerebral uptake and cellular physiology between the two molecules. The results demonstrate these two metabolic imaging methods provide different yet complementary readouts of oxidative and reductive metabolism within a clinically feasible timescale. Furthermore, as DMI was undertaken at a clinical field strength within a ten-minute scan time, it demonstrates its potential as a routine clinical tool in the future.
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Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.
| | - Alixander S Khan
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Tomasz Matys
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
| | | | - Matthew J Locke
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Ashley Grimmer
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Amy Frary
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Ines Horvat Menih
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Elizabeth Latimer
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge UK
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
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11
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Zaccagna F, McLean MA, Grist JT, Kaggie J, Mair R, Riemer F, Woitek R, Gill AB, Deen S, Daniels CJ, Ursprung S, Schulte RF, Allinson K, Chhabra A, Laurent MC, Locke M, Frary A, Hilborne S, Patterson I, Carmo BD, Slough R, Wilkinson I, Basu B, Wason J, Gillard JH, Matys T, Watts C, Price SJ, Santarius T, Graves MJ, Jefferies S, Brindle KM, Gallagher FA. Imaging Glioblastoma Metabolism by Using Hyperpolarized [1- 13C]Pyruvate Demonstrates Heterogeneity in Lactate Labeling: A Proof of Principle Study. Radiol Imaging Cancer 2022; 4:e210076. [PMID: 35838532 PMCID: PMC9360994 DOI: 10.1148/rycan.210076] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 01/20/2023]
Abstract
Purpose To evaluate glioblastoma (GBM) metabolism by using hyperpolarized carbon 13 (13C) MRI to monitor the exchange of the hyperpolarized 13C label between injected [1-13C]pyruvate and tumor lactate and bicarbonate. Materials and Methods In this prospective study, seven treatment-naive patients (age [mean ± SD], 60 years ± 11; five men) with GBM were imaged at 3 T by using a dual-tuned 13C-hydrogen 1 head coil. Hyperpolarized [1-13C]pyruvate was injected, and signal was acquired by using a dynamic MRI spiral sequence. Metabolism was assessed within the tumor, in the normal-appearing brain parenchyma (NABP), and in healthy volunteers by using paired or unpaired t tests and a Wilcoxon signed rank test. The Spearman ρ correlation coefficient was used to correlate metabolite labeling with lactate dehydrogenase A (LDH-A) expression and some immunohistochemical markers. The Benjamini-Hochberg procedure was used to correct for multiple comparisons. Results The bicarbonate-to-pyruvate (BP) ratio was lower in the tumor than in the contralateral NABP (P < .01). The tumor lactate-to-pyruvate (LP) ratio was not different from that in the NABP (P = .38). The LP and BP ratios in the NABP were higher than those observed previously in healthy volunteers (P < .05). Tumor lactate and bicarbonate signal intensities were strongly correlated with the pyruvate signal intensity (ρ = 0.92, P < .001, and ρ = 0.66, P < .001, respectively), and the LP ratio was weakly correlated with LDH-A expression in biopsy samples (ρ = 0.43, P = .04). Conclusion Hyperpolarized 13C MRI demonstrated variation in lactate labeling in GBM, both within and between tumors. In contrast, bicarbonate labeling was consistently lower in tumors than in the surrounding NABP. Keywords: Hyperpolarized 13C MRI, Glioblastoma, Metabolism, Cancer, MRI, Neuro-oncology Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Fulvio Zaccagna
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Mary A. McLean
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - James T. Grist
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Joshua Kaggie
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Richard Mair
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Frank Riemer
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ramona Woitek
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Andrew B. Gill
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Surrin Deen
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Charlie J. Daniels
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Stephan Ursprung
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Rolf F. Schulte
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Kieren Allinson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Anita Chhabra
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Marie-Christine Laurent
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Matthew Locke
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Amy Frary
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Sarah Hilborne
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ilse Patterson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Bruno D. Carmo
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Rhys Slough
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ian Wilkinson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Bristi Basu
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - James Wason
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Jonathan H. Gillard
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Tomasz Matys
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Colin Watts
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Stephen J. Price
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Thomas Santarius
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Martin J. Graves
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Sarah Jefferies
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Kevin M. Brindle
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ferdia A. Gallagher
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
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12
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Brown RB, Tozer DJ, Loubière L, Hong YT, Fryer TD, Williams GB, Graves MJ, Aigbirhio FI, O’Brien JT, Markus HS. MINocyclinE to Reduce inflammation and blood brain barrier leakage in small Vessel diseAse (MINERVA) trial study protocol. Eur Stroke J 2022; 7:323-330. [PMID: 36082255 PMCID: PMC9445404 DOI: 10.1177/23969873221100338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cerebral small vessel disease (SVD) is a common cause of stroke and cognitive impairment. Recent data has implicated neuroinflammation and increased blood-brain barrier (BBB) permeability in its pathogenesis, but whether such processes are causal and can be therapeutically modified is uncertain. In a rodent model of SVD, minocycline was associated with reduced white matter lesions, inflammation and BBB permeability. Aims: To determine whether blood-brain barrier permeability (measured using dynamic contrast-enhanced MRI) and microglial activation (measured by positron emission tomography using the radioligand 11C-PK11195) can be modified in SVD. Design: Phase II randomised double blind, placebo-controlled trial of minocycline 100 mg twice daily for 3 months in 44 participants with moderate to severe SVD defined as a clinical lacunar stroke and confluent white matter hyperintensities. Outcomes: Primary outcome measures are volume and intensity of focal increases of blood-brain barrier permeability and microglial activation determined using PET-MRI imaging. Secondary outcome measures include inflammatory biomarkers in serum, and change in conventional MRI markers and cognitive performance over 1 year follow up. Discussion: The MINERVA trial aims to test whether minocycline can influence novel pathological processes thought to be involved in SVD progression, and will provide insights into whether central nervous system inflammation in SVD can be therapeutically modulated.
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Affiliation(s)
- Robin B Brown
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Daniel J Tozer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Laurence Loubière
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Young T Hong
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Franklin I Aigbirhio
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Hugh S Markus
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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13
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Deen SS, McLean MA, Gill AB, Crawford RAF, Latimer J, Baldwin P, Earl HM, Parkinson CA, Smith S, Hodgkin C, Jimenez-Linan M, Brodie CR, Patterson I, Addley HC, Freeman SJ, Moyle PM, Graves MJ, Sala E, Brenton JD, Gallagher FA. Magnetization transfer imaging of ovarian cancer: initial experiences of correlation with tissue cellularity and changes following neoadjuvant chemotherapy. BJR Open 2022; 4:20210078. [PMID: 36105417 PMCID: PMC9459873 DOI: 10.1259/bjro.20210078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives To investigate the relationship between magnetization transfer (MT) imaging and tissue macromolecules in high-grade serous ovarian cancer (HGSOC) and whether MT ratio (MTR) changes following neoadjuvant chemotherapy (NACT). Methods This was a prospective observational study. 12 HGSOC patients were imaged before treatment. MTR was compared to quantified tissue histology and immunohistochemistry. For a subset of patients (n = 5), MT imaging was repeated after NACT. The Shapiro-Wilk test was used to assess for normality of data and Spearman's rank-order or Pearson's correlation tests were then used to compare MTR with tissue quantifications. The Wilcoxon signed-rank test was used to assess for changes in MTR after treatment. Results Treatment-naïve tumour MTR was 21.9 ± 3.1% (mean ± S.D.). MTR had a positive correlation with cellularity, rho = 0.56 (p < 0.05) and a negative correlation with tumour volume, ρ = -0.72 (p = 0.01). MTR did not correlate with the extracellular proteins, collagen IV or laminin (p = 0.40 and p = 0.90). For those patients imaged before and after NACT, an increase in MTR was observed in each case with mean MTR 20.6 ± 3.1% (median 21.1) pre-treatment and 25.6 ± 3.4% (median 26.5) post-treatment (p = 0.06). Conclusion In treatment-naïve HGSOC, MTR is associated with cellularity, possibly reflecting intracellular macromolecular concentration. MT may also detect the HGSOC response to NACT, however larger studies are required to validate this finding. Advances in knowledge MTR in HGSOC is influenced by cellularity. This may be applied to assess for cell changes following treatment.
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Affiliation(s)
| | | | - Andrew B Gill
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom, CB2 0QQ
| | - Robin A F Crawford
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - John Latimer
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Peter Baldwin
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | | | - Christine A Parkinson
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Sarah Smith
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | | | - Mercedes Jimenez-Linan
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Cara R Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom, CB2 0RE
| | - Ilse Patterson
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Helen C Addley
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Susan J Freeman
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Penelope M Moyle
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom, CB2 0QQ
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14
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Cheriyan J, Roberts A, Roberts C, Graves MJ, Patterson I, Slough RA, Schroyer R, Fernando D, Kumar S, Lee S, Parker GJM, Sarov-Blat L, McEniery C, Middlemiss J, Sprecher D, Janiczek RL. Evaluation of Dynamic Contrast-Enhanced MRI Measures of Lung Congestion and Endothelial Permeability in Heart Failure: A Prospective Method Validation Study. J Magn Reson Imaging 2022; 56:450-461. [PMID: 35343008 PMCID: PMC9544235 DOI: 10.1002/jmri.28174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/12/2020] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
Abstract
Background Methods for accurate quantification of lung fluid in heart failure (HF) are needed. Dynamic contrast‐enhanced (DCE)‐MRI may be an appropriate modality. Purpose DCE‐MRI evaluation of fraction of fluid volume in the interstitial lung space (ve) and vascular permeability (Ktrans). Study Type Prospective, single‐center method validation. Population Seventeen evaluable healthy volunteers (HVs), 12 participants with HF, and 3 with acute decompensated HF (ADHF). Field Strength/Sequence T1 mapping (spoiled gradient echo variable flip angle acquisition) followed by dynamic series (three‐dimensional spoiled gradient‐recalled echo acquisitions [constant echo time, repetition time, and flip angle at 1.5 T]). Assessment Three whole‐chest scans were acquired: baseline (Session 1), 1‐week later (Session 2), following exercise (Session 3). Extended Tofts model quantified ve and Ktrans (voxel‐wise basis); total lung median measures were extracted and fitted via repeat measure analysis of variance (ANOVA) model. Patient tolerability of the scanning protocol was assessed. Statistical Tests This was constructed as an experimental medicine study. Primary endpoints: Ktrans and ve at baseline (HV vs. HF), change in Ktrans and ve following exercise, and following lung congestion resolution (ADHF). Ktrans and ve were fitted separately using ANOVA. Secondary endpoint: repeatability, that is, within‐participant variability in ve and Ktrans between sessions (coefficient of variation estimated via mixed effects model). Results There was no significant difference in mean Ktrans between HF and HV (P ≤ 0.17): 0.2216 minutes−1 and 0.2353 minutes−1 (Session 1), 0.2044 minutes−1 and 0.2567 minutes−1 (Session 2), 0.1841 minutes−1 and 0.2108 minutes−1 (Session 3), respectively. ve was greater in the HF group (all scans, P ≤ 0.02). Results were repeatable between Sessions 1 and 2; mean values for HF and HV were 0.4946 and 0.3346 (Session 1), 0.4353 and 0.3205 (Session 2), respectively. There was minimal difference in Ktrans or ve between scans for participants with ADHF (small population precluded significance testing). Scanning was well tolerated. Data Conclusion While no differences were detected in Ktrans, ve was greater in chronic HF patients vs. HV, augmented beyond plasma and intracellular volume. DCE‐MRI is a valuable diagnostic and physiologic tool to evaluate changes in fluid volume in the interstitial lung space associated with symptomatic HF. Level of Evidence 2 Technical Efficacy Stage 2
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Affiliation(s)
- Joseph Cheriyan
- Research, GSK Clinical Unit Cambridge, Cambridge, UK.,Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.,Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Martin J Graves
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ilse Patterson
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rhys A Slough
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | - Sarah Lee
- Consulting, Amallis Consulting Ltd, London, UK
| | - Geoffrey J M Parker
- Imaging Services, Bioxydyn Ltd, Manchester, UK.,Centre for Medical Imaging Computing, Department of Computer Science, University College London, London, UK
| | - Lea Sarov-Blat
- Research and Development, GSK, Crescent Drive, Philadelphia, Pennsylvania, USA
| | - Carmel McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Jessica Middlemiss
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Dennis Sprecher
- Consulting, BioView Consulting LLC, Blue Bell, Pennsylvania, USA
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15
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Sushentsev N, McLean MA, Warren AY, Benjamin AJV, Brodie C, Frary A, Gill AB, Jones J, Kaggie JD, Lamb BW, Locke MJ, Miller JL, Mills IG, Priest AN, Robb FJL, Shah N, Schulte RF, Graves MJ, Gnanapragasam VJ, Brindle KM, Barrett T, Gallagher FA. Author Correction: Hyperpolarised 13C-MRI identifies the emergence of a glycolytic cell population within intermediate-risk human prostate cancer. Nat Commun 2022; 13:1274. [PMID: 35256616 PMCID: PMC8901739 DOI: 10.1038/s41467-022-28979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Anne Y Warren
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Arnold J V Benjamin
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Cara Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Amy Frary
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Andrew B Gill
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Julia Jones
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Benjamin W Lamb
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- School of Allied Health, Anglia Ruskin University, Cambridge, UK
| | - Matthew J Locke
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Jodi L Miller
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ian G Mills
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | | | - Nimish Shah
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Vincent J Gnanapragasam
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Urology, Department of Surgery, University of Cambridge, Cambridge, UK
- Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
| | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
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16
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Tadimalla S, Wilson DJ, Shelley D, Bainbridge G, Saysell M, Mendichovszky IA, Graves MJ, Guthrie JA, Waterton JC, Parker GJM, Sourbron SP. Bias, Repeatability and Reproducibility of Liver T 1 Mapping With Variable Flip Angles. J Magn Reson Imaging 2022; 56:1042-1052. [PMID: 35224803 PMCID: PMC9545852 DOI: 10.1002/jmri.28127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/24/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/16/2022] Open
Abstract
Background Three‐dimensional variable flip angle (VFA) methods are commonly used for T1 mapping of the liver, but there is no data on the accuracy, repeatability, and reproducibility of this technique in this organ in a multivendor setting. Purpose To measure bias, repeatability, and reproducibility of VFA T1 mapping in the liver. Study Type Prospective observational. Population Eight healthy volunteers, four women, with no known liver disease. Field Strength/Sequence 1.5‐T and 3.0‐T; three‐dimensional steady‐state spoiled gradient echo with VFAs; Look‐Locker. Assessment Traveling volunteers were scanned twice each (30 minutes to 3 months apart) on six MRI scanners from three vendors (GE Healthcare, Philips Medical Systems, and Siemens Healthineers) at two field strengths. The maximum period between the first and last scans among all volunteers was 9 months. Volunteers were instructed to abstain from alcohol intake for at least 72 hours prior to each scan and avoid high cholesterol foods on the day of the scan. Statistical Tests Repeated measures ANOVA, Student t‐test, Levene's test of variances, and 95% significance level. The percent error relative to literature liver T1 in healthy volunteers was used to assess bias. The relative error (RE) due to intrascanner and interscanner variation in T1 measurements was used to assess repeatability and reproducibility. Results The 95% confidence interval (CI) on the mean bias and mean repeatability RE of VFA T1 in the healthy liver was 34 ± 6% and 10 ± 3%, respectively. The 95% CI on the mean reproducibility RE at 1.5 T and 3.0 T was 29 ± 7% and 25 ± 4%, respectively. Data Conclusion Bias, repeatability, and reproducibility of VFA T1 mapping in the liver in a multivendor setting are similar to those reported for breast, prostate, and brain. Level of Evidence 1 Technical Efficacy Stage 1
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Affiliation(s)
- Sirisha Tadimalla
- Institute of Medical Physics, University of Sydney, Sydney, Australia.,Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | | | | | | | | | | | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - John C Waterton
- Bioxydyn Ltd, Manchester, UK.,Centre for Imaging Sciences, Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Geoffrey J M Parker
- Bioxydyn Ltd, Manchester, UK.,Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Steven P Sourbron
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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17
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Sushentsev N, McLean MA, Warren AY, Benjamin AJV, Brodie C, Frary A, Gill AB, Jones J, Kaggie JD, Lamb BW, Locke MJ, Miller JL, Mills IG, Priest AN, Robb FJL, Shah N, Schulte RF, Graves MJ, Gnanapragasam VJ, Brindle KM, Barrett T, Gallagher FA. Hyperpolarised 13C-MRI identifies the emergence of a glycolytic cell population within intermediate-risk human prostate cancer. Nat Commun 2022; 13:466. [PMID: 35075123 PMCID: PMC8786834 DOI: 10.1038/s41467-022-28069-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [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: 07/02/2021] [Accepted: 12/02/2021] [Indexed: 02/08/2023] Open
Abstract
Hyperpolarised magnetic resonance imaging (HP 13C-MRI) is an emerging clinical technique to detect [1-13C]lactate production in prostate cancer (PCa) following intravenous injection of hyperpolarised [1-13C]pyruvate. Here we differentiate clinically significant PCa from indolent disease in a low/intermediate-risk population by correlating [1-13C]lactate labelling on MRI with the percentage of Gleason pattern 4 (%GP4) disease. Using immunohistochemistry and spatial transcriptomics, we show that HP 13C-MRI predominantly measures metabolism in the epithelial compartment of the tumour, rather than the stroma. MRI-derived tumour [1-13C]lactate labelling correlated with epithelial mRNA expression of the enzyme lactate dehydrogenase (LDHA and LDHB combined), and the ratio of lactate transporter expression between the epithelial and stromal compartments (epithelium-to-stroma MCT4). We observe similar changes in MCT4, LDHA, and LDHB between tumours with primary Gleason patterns 3 and 4 in an independent TCGA cohort. Therefore, HP 13C-MRI can metabolically phenotype clinically significant disease based on underlying metabolic differences in the epithelial and stromal tumour compartments.
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Affiliation(s)
- Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Anne Y Warren
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Arnold J V Benjamin
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Cara Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Amy Frary
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Andrew B Gill
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Julia Jones
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Benjamin W Lamb
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- School of Allied Health, Anglia Ruskin University, Cambridge, UK
| | - Matthew J Locke
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Jodi L Miller
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ian G Mills
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | | | - Nimish Shah
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Vincent J Gnanapragasam
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Urology, Department of Surgery, University of Cambridge, Cambridge, UK
- Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
| | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
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18
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Ursprung S, Woitek R, McLean MA, Priest AN, Crispin-Ortuzar M, Brodie CR, Gill AB, Gehrung M, Beer L, Riddick ACP, Field-Rayner J, Grist JT, Deen SS, Riemer F, Kaggie JD, Zaccagna F, Duarte JAG, Locke MJ, Frary A, Aho TF, Armitage JN, Casey R, Mendichovszky IA, Welsh SJ, Barrett T, Graves MJ, Eisen T, Mitchell TJ, Warren AY, Brindle KM, Sala E, Stewart GD, Gallagher FA. Hyperpolarized 13C-Pyruvate Metabolism as a Surrogate for Tumor Grade and Poor Outcome in Renal Cell Carcinoma-A Proof of Principle Study. Cancers (Basel) 2022; 14:335. [PMID: 35053497 PMCID: PMC8773685 DOI: 10.3390/cancers14020335] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Differentiating aggressive clear cell renal cell carcinoma (ccRCC) from indolent lesions is challenging using conventional imaging. This work prospectively compared the metabolic imaging phenotype of renal tumors using carbon-13 MRI following injection of hyperpolarized [1-13C]pyruvate (HP-13C-MRI) and validated these findings with histopathology. Nine patients with treatment-naïve renal tumors (6 ccRCCs, 1 liposarcoma, 1 pheochromocytoma, 1 oncocytoma) underwent pre-operative HP-13C-MRI and conventional proton (1H) MRI. Multi-regional tissue samples were collected using patient-specific 3D-printed tumor molds for spatial registration between imaging and molecular analysis. The apparent exchange rate constant (kPL) between 13C-pyruvate and 13C-lactate was calculated. Immunohistochemistry for the pyruvate transporter (MCT1) from 44 multi-regional samples, as well as associations between MCT1 expression and outcome in the TCGA-KIRC dataset, were investigated. Increasing kPL in ccRCC was correlated with increasing overall tumor grade (ρ = 0.92, p = 0.009) and MCT1 expression (r = 0.89, p = 0.016), with similar results acquired from the multi-regional analysis. Conventional 1H-MRI parameters did not discriminate tumor grades. The correlation between MCT1 and ccRCC grade was confirmed within a TCGA dataset (p < 0.001), where MCT1 expression was a predictor of overall and disease-free survival. In conclusion, metabolic imaging using HP-13C-MRI differentiates tumor aggressiveness in ccRCC and correlates with the expression of MCT1, a predictor of survival. HP-13C-MRI may non-invasively characterize metabolic phenotypes within renal cancer.
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Affiliation(s)
- Stephan Ursprung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Ramona Woitek
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Mary A. McLean
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Andrew N. Priest
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Cara R. Brodie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Andrew B. Gill
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Marcel Gehrung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Lucian Beer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Antony C. P. Riddick
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Johanna Field-Rayner
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - James T. Grist
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Surrin S. Deen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Frank Riemer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joshua D. Kaggie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Fulvio Zaccagna
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joao A. G. Duarte
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Matthew J. Locke
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Amy Frary
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Tevita F. Aho
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - James N. Armitage
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Ruth Casey
- Department of Endocrinology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Iosif A. Mendichovszky
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Sarah J. Welsh
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Tristan Barrett
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Martin J. Graves
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Tim Eisen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Thomas J. Mitchell
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
- Wellcome Sanger Institute, Hinxton CB10 1RQ, UK
| | - Anne Y. Warren
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Pathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Kevin M. Brindle
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Evis Sala
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Grant D. Stewart
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Ferdia A. Gallagher
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
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19
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Woitek R, McLean MA, Ursprung S, Rueda OM, Manzano Garcia R, Locke MJ, Beer L, Baxter G, Rundo L, Provenzano E, Kaggie J, Patterson A, Frary A, Field-Rayner J, Papalouka V, Kane J, Benjamin AJV, Gill AB, Priest AN, Lewis DY, Russell R, Grimmer A, White B, Latimer-Bowman B, Patterson I, Schiller A, Carmo B, Slough R, Lanz T, Wason J, Schulte RF, Chin SF, Graves MJ, Gilbert FJ, Abraham JE, Caldas C, Brindle KM, Sala E, Gallagher FA. Hyperpolarized Carbon-13 MRI for Early Response Assessment of Neoadjuvant Chemotherapy in Breast Cancer Patients. Cancer Res 2021; 81:6004-6017. [PMID: 34625424 PMCID: PMC7612070 DOI: 10.1158/0008-5472.can-21-1499] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 05/13/2021] [Revised: 07/14/2021] [Accepted: 10/06/2021] [Indexed: 01/09/2023]
Abstract
Hyperpolarized 13C-MRI is an emerging tool for probing tissue metabolism by measuring 13C-label exchange between intravenously injected hyperpolarized [1-13C]pyruvate and endogenous tissue lactate. Here, we demonstrate that hyperpolarized 13C-MRI can be used to detect early response to neoadjuvant therapy in breast cancer. Seven patients underwent multiparametric 1H-MRI and hyperpolarized 13C-MRI before and 7-11 days after commencing treatment. An increase in the lactate-to-pyruvate ratio of approximately 20% identified three patients who, following 5-6 cycles of treatment, showed pathological complete response. This ratio correlated with gene expression of the pyruvate transporter MCT1 and lactate dehydrogenase A (LDHA), the enzyme catalyzing label exchange between pyruvate and lactate. Analysis of approximately 2,000 breast tumors showed that overexpression of LDHA and the hypoxia marker CAIX was associated with reduced relapse-free and overall survival. Hyperpolarized 13C-MRI represents a promising method for monitoring very early treatment response in breast cancer and has demonstrated prognostic potential. SIGNIFICANCE: Hyperpolarized carbon-13 MRI allows response assessment in patients with breast cancer after 7-11 days of neoadjuvant chemotherapy and outperformed state-of-the-art and research quantitative proton MRI techniques.
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Affiliation(s)
- Ramona Woitek
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Stephan Ursprung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Oscar M Rueda
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
| | - Raquel Manzano Garcia
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Matthew J Locke
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Lucian Beer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gabrielle Baxter
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Leonardo Rundo
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Elena Provenzano
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Joshua Kaggie
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Amy Frary
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Johanna Field-Rayner
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Vasiliki Papalouka
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Justine Kane
- Department of Oncology, Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Arnold J V Benjamin
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew B Gill
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew N Priest
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - David Y Lewis
- Molecular Imaging Laboratory Cancer Research UK Beatson Institute, Glasgow, United Kingdom
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Roslin Russell
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Ashley Grimmer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Brian White
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Beth Latimer-Bowman
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Ilse Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Amy Schiller
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Bruno Carmo
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Rhys Slough
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - James Wason
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | | | - Suet-Feung Chin
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Fiona J Gilbert
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jean E Abraham
- Department of Oncology, Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Carlos Caldas
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
- Department of Oncology, Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Evis Sala
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ferdia A Gallagher
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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20
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Evans NR, Tarkin JM, Walsh J, Chowdhury MM, Patterson AJ, Graves MJ, Rudd JHF, Warburton EA. Carotid Atheroinflammation Is Associated With Cerebral Small Vessel Disease Severity. Front Neurol 2021; 12:690935. [PMID: 34531813 PMCID: PMC8438317 DOI: 10.3389/fneur.2021.690935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/04/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Atherosclerosis is a systemic inflammatory disease, with common inflammatory processes implicated in both atheroma vulnerability and blood-brain barrier disruption. This prospective multimodal imaging study aimed to measure directly the association between systemic atheroma inflammation (“atheroinflammation”) and downstream chronic cerebral small vessel disease severity. Methods: Twenty-six individuals with ischemic stroke with ipsilateral carotid artery stenosis of >50% underwent 18fluoride-fluorodeoxyglucose-positron emission tomography within 2 weeks of stroke. Small vessel disease severity and white matter hyperintensity volume were assessed using 3-tesla magnetic resonance imaging also within 2 weeks of stroke. Results: Fluorodeoxyglucose uptake was independently associated with more severe small vessel disease (odds ratio 6.18, 95% confidence interval 2.1–18.2, P < 0.01 for the non-culprit carotid artery) and larger white matter hyperintensity volumes (coefficient = 14.33 mL, P < 0.01 for the non-culprit carotid artery). Conclusion: These proof-of-concept results have important implications for our understanding of the neurovascular interface and potential therapeutic exploitation in the management of systemic atherosclerosis, particularly non-stenotic disease previously considered asymptomatic, in order to reduce the burden of chronic cerebrovascular disease.
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Affiliation(s)
- Nicholas R Evans
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Jason M Tarkin
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jessica Walsh
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Andrew J Patterson
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - James H F Rudd
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth A Warburton
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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21
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Kaggie JD, Lanz T, McLean MA, Riemer F, Schulte RF, Benjamin AJV, Kessler DA, Sun C, Gilbert FJ, Graves MJ, Gallagher FA. Combined 23 Na and 13 C imaging at 3.0 Tesla using a single-tuned large FOV birdcage coil. Magn Reson Med 2021; 86:1734-1745. [PMID: 33934383 DOI: 10.1002/mrm.28772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 11/27/2020] [Revised: 02/07/2021] [Accepted: 02/24/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE An unmet need in carbon-13 (13 C)-MRI is a transmit system that provides uniform excitation across a large FOV and can accommodate patients of wide-ranging body habitus. Due to the small difference between the resonant frequencies, sodium-23 (23 Na) coil developments can inform 13 C coil design while being simpler to assess due to the higher naturally abundant 23 Na signal. Here we present a removable 23 Na birdcage, which also allows operation as a 13 C abdominal coil. METHODS We demonstrate a quadrature-driven 4-rung 23 Na birdcage coil of 50 cm in length for both 23 Na and 13 C abdominal imaging. The coil transmit efficiencies and B 1 + maps were compared to a linearly driven 13 C Helmholtz-based (clamshell) coil. SNR was investigated with 23 Na and 13 C data using an 8-channel 13 C receive array within the 23 Na birdcage. RESULTS The 23 Na birdcage longitudinal FOV was > 40 cm, whereas the 13 C clamshell was < 32 cm. The transmit efficiency of the birdcage at the 23 Na frequency was 0.65 µT/sqrt(W), similar to the clamshell for 13 C. However, the coefficient of variation of 23 Na- B 1 + was 16%, nearly half that with the 13 C clamshell. The 8-channel 13 C receive array combined with the 23 Na birdcage coil generated a greater than twofold increase in 23 Na-SNR from the central abdomen compared with the birdcage alone. DISCUSSION This 23 Na birdcage coil has a larger FOV and improved B 1 + uniformity when compared to the widely used clamshell coil design while also providing similar transmit efficiency. The coil has the potential to be used for both 23 Na and 13 C imaging.
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Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | | | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Frank Riemer
- Mohn Medical Imaging and Visualisation Centre (MMIV), Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | | | - Arnold J V Benjamin
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Dimitri A Kessler
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Chang Sun
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
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22
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Wall C, Huang Y, Le EPV, Ćorović A, Uy CP, Gopalan D, Ma C, Manavaki R, Fryer TD, Aloj L, Graves MJ, Tombetti E, Ariff B, Bambrough P, Hoole SP, Rusk RA, Jayne DR, Dweck MR, Newby D, Fayad ZA, Bennett MR, Peters JE, Slomka P, Dey D, Mason JC, Rudd JHF, Tarkin JM. Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis. Eur Heart J Open 2021; 1:oeab019. [PMID: 34661196 PMCID: PMC8508012 DOI: 10.1093/ehjopen/oeab019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022]
Abstract
AIMS To examine pericoronary adipose tissue (PCAT) and periaortic adipose tissue (PAAT) density on coronary computed tomography angiography for assessing arterial inflammation in Takayasu arteritis (TAK) and atherosclerosis. METHODS AND RESULTS PCAT and PAAT density was measured in coronary (n = 1016) and aortic (n = 108) segments from 108 subjects [TAK + coronary artery disease (CAD), n = 36; TAK, n = 18; atherosclerotic CAD, n = 32; matched controls, n = 22]. Median PCAT and PAAT densities varied between groups (mPCAT: P < 0.0001; PAAT: P = 0.0002). PCAT density was 7.01 ± standard error of the mean (SEM) 1.78 Hounsfield Unit (HU) higher in coronary segments from TAK + CAD patients than stable CAD patients (P = 0.0002), and 8.20 ± SEM 2.04 HU higher in TAK patients without CAD than controls (P = 0.0001). mPCAT density was correlated with Indian Takayasu Clinical Activity Score (r = 0.43, P = 0.001) and C-reactive protein (r = 0.41, P < 0.0001) and was higher in active vs. inactive TAK (P = 0.002). mPCAT density above -74 HU had 100% sensitivity and 95% specificity for differentiating active TAK from controls [area under the curve = 0.99 (95% confidence interval 0.97-1)]. The association of PCAT density and coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography (PET) equated to an increase of 2.44 ± SEM 0.77 HU in PCAT density for each unit increase in 68Ga-DOTATATE maximum tissue-to-blood ratio (P = 0.002). These findings remained in multivariable sensitivity analyses adjusted for potential confounders. CONCLUSIONS PCAT and PAAT density are higher in TAK than atherosclerotic CAD or controls and are associated with clinical, biochemical, and PET markers of inflammation. Owing to excellent diagnostic accuracy, PCAT density could be useful as a clinical adjunct for assessing disease activity in TAK.
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Affiliation(s)
- Christopher Wall
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Yuan Huang
- EPSRC Centre for Mathematical Imaging in Healthcare, University of Cambridge, Cambridge, UK
| | - Elizabeth P V Le
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Andrej Ćorović
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Christopher P Uy
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
| | - Deepa Gopalan
- Department of Radiology, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge, CB2 2QQ, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK
| | - Chuoxin Ma
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Luigi Aloj
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Enrico Tombetti
- Department of biomedical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Ben Ariff
- Department of Radiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK
| | - Paul Bambrough
- Department of Cardiology, Royal Papworth Hospital, Cambridge, UK CB2 0AY, UK
| | - Stephen P Hoole
- Department of Cardiology, Royal Papworth Hospital, Cambridge, UK CB2 0AY, UK
| | - Rosemary A Rusk
- Department of Cardiology, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge, CB2 2QQ, UK
| | - David R Jayne
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - David Newby
- Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Zahi A Fayad
- BioMedical Engineering & Imaging Institute, Icahn School of Medicine at Mt Sinai, Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Martin R Bennett
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - James E Peters
- Centre for Inflammatory Diseases, Imperial College London, London, UK
| | - Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N Robertson Blvd, Los Angeles, CA, 90048, USA
| | - Justin C Mason
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
| | - James H F Rudd
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Jason M Tarkin
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
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23
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Lau D, McLean MA, Priest AN, Gill AB, Scott F, Patterson I, Carmo B, Riemer F, Kaggie JD, Frary A, Milne D, Booth C, Lewis A, Sulikowski M, Brown L, Lapointe JM, Aloj L, Graves MJ, Brindle KM, Corrie PG, Gallagher FA. Multiparametric MRI of early tumor response to immune checkpoint blockade in metastatic melanoma. J Immunother Cancer 2021; 9:e003125. [PMID: 34561275 PMCID: PMC8475139 DOI: 10.1136/jitc-2021-003125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Accepted: 08/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors are now standard of care treatment for many cancers. Treatment failure in metastatic melanoma is often due to tumor heterogeneity, which is not easily captured by conventional CT or tumor biopsy. The aim of this prospective study was to investigate early microstructural and functional changes within melanoma metastases following immune checkpoint blockade using multiparametric MRI. METHODS Fifteen treatment-naïve metastatic melanoma patients (total 27 measurable target lesions) were imaged at baseline and following 3 and 12 weeks of treatment on immune checkpoint inhibitors using: T2-weighted imaging, diffusion kurtosis imaging, and dynamic contrast-enhanced MRI. Treatment timepoint changes in tumor cellularity, vascularity, and heterogeneity within individual metastases were evaluated and correlated to the clinical outcome in each patient based on Response Evaluation Criteria in Solid Tumors V.1.1 at 1 year. RESULTS Differential tumor growth kinetics in response to immune checkpoint blockade were measured in individual metastases within the same patient, demonstrating significant intertumoral heterogeneity in some patients. Early detection of tumor cell death or cell loss measured by a significant increase in the apparent diffusivity (Dapp) (p<0.05) was observed in both responding and pseudoprogressive lesions after 3 weeks of treatment. Tumor heterogeneity, as measured by apparent diffusional kurtosis (Kapp), was consistently higher in the pseudoprogressive and true progressive lesions, compared with the responding lesions throughout the first 12 weeks of treatment. These preceded tumor regression and significant tumor vascularity changes (Ktrans, ve, and vp) detected after 12 weeks of immunotherapy (p<0.05). CONCLUSIONS Multiparametric MRI demonstrated potential for early detection of successful response to immune checkpoint inhibitors in metastatic melanoma.
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Affiliation(s)
- Doreen Lau
- Department of Radiology, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Andrew N Priest
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Andrew B Gill
- Department of Radiology, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Francis Scott
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ilse Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Bruno Carmo
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Amy Frary
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Doreen Milne
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Catherine Booth
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Arthur Lewis
- Clinical Pharmacology & Safety Sciences, AstraZeneca PLC, Cambridge, Cambridgeshire, UK
| | - Michal Sulikowski
- Clinical Pharmacology & Safety Sciences, AstraZeneca PLC, Cambridge, Cambridgeshire, UK
| | - Lee Brown
- Clinical Pharmacology & Safety Sciences, AstraZeneca PLC, Cambridge, Cambridgeshire, UK
| | - Jean-Martin Lapointe
- Clinical Pharmacology & Safety Sciences, AstraZeneca PLC, Cambridge, Cambridgeshire, UK
| | - Luigi Aloj
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Research Institute, Cambridge, UK
| | - Pippa G Corrie
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
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24
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McLean MA, Hinks RS, Kaggie JD, Woitek R, Riemer F, Graves MJ, McIntyre DJO, Gallagher FA, Schulte RF. Characterization and correction of center-frequency effects in X-nuclear eddy current compensations on a clinical MR system. Magn Reson Med 2021; 85:2370-2376. [PMID: 33274790 PMCID: PMC7898706 DOI: 10.1002/mrm.28607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/27/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of the study was to investigate whether incorrectly compensated eddy currents are the source of persistent X-nuclear spectroscopy and imaging artifacts, as well as methods to correct this. METHODS Pulse-acquire spectra were collected for 1 H and X-nuclei (23 Na or 31 P) using the minimum TR permitted on a 3T clinical MRI system. Data were collected in 3 orientations (axial, sagittal, and coronal) with the spoiler gradient at the end of the TR applied along the slice direction for each. Modifications to system calibration files to tailor eddy current compensation for each X-nucleus were developed and applied, and data were compared with and without these corrections for: slice-selective MRS (for 23 Na and 31 P), 2D spiral trajectories (for 13 C), and 3D cones trajectories (for 23 Na). RESULTS Line-shape distortions characteristic of eddy currents were demonstrated for X-nuclei, which were not seen for 1 H. The severity of these correlated with the amplitude of the eddy current frequency compensation term applied by the system along the axis of the applied spoiler gradient. A proposed correction to eddy current compensation, taking account of the gyromagnetic ratio, was shown to dramatically reduce these distortions. The same correction was also shown to improve data quality of non-Cartesian imaging (2D spiral and 3D cones trajectories). CONCLUSION A simple adaptation of the default compensation for eddy currents was shown to eliminate a range of artifacts detected on X-nuclear spectroscopy and imaging.
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Affiliation(s)
- Mary A. McLean
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUnited Kingdom
| | | | - Joshua D. Kaggie
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Ramona Woitek
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Frank Riemer
- MMIV, Department of RadiologyHaukeland University HospitalBergenNorway
| | - Martin J. Graves
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
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25
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Maiter A, Riemer F, Allinson K, Zaccagna F, Crispin-Ortuzar M, Gehrung M, McLean MA, Priest AN, Grist J, Matys T, Graves MJ, Gallagher FA. Investigating the relationship between diffusion kurtosis tensor imaging (DKTI) and histology within the normal human brain. Sci Rep 2021; 11:8857. [PMID: 33893338 PMCID: PMC8065051 DOI: 10.1038/s41598-021-87857-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/07/2020] [Accepted: 03/26/2021] [Indexed: 01/13/2023] Open
Abstract
Measurements of water diffusion with MRI have been used as a biomarker of tissue microstructure and heterogeneity. In this study, diffusion kurtosis tensor imaging (DKTI) of the brain was undertaken in 10 healthy volunteers at a clinical field strength of 3 T. Diffusion and kurtosis metrics were measured in regions-of-interest on the resulting maps and compared with quantitative analysis of normal post-mortem tissue histology from separate age-matched donors. White matter regions showed low diffusion (0.60 ± 0.04 × 10-3 mm2/s) and high kurtosis (1.17 ± 0.06), consistent with a structured heterogeneous environment comprising parallel neuronal fibres. Grey matter showed intermediate diffusion (0.80 ± 0.02 × 10-3 mm2/s) and kurtosis (0.82 ± 0.05) values. An important finding is that the subcortical regions investigated (thalamus, caudate and putamen) showed similar diffusion and kurtosis properties to white matter. Histological staining of the subcortical nuclei demonstrated that the predominant grey matter was permeated by small white matter bundles, which could account for the similar kurtosis to white matter. Quantitative histological analysis demonstrated higher mean tissue kurtosis and vector standard deviation values for white matter (1.08 and 0.81) compared to the subcortical regions (0.34 and 0.59). Mean diffusion on DKTI was positively correlated with tissue kurtosis (r = 0.82, p < 0.05) and negatively correlated with vector standard deviation (r = -0.69, p < 0.05). This study demonstrates how DKTI can be used to study regional structural variations in the cerebral tissue microenvironment and could be used to probe microstructural changes within diseased tissue in the future.
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Affiliation(s)
- Ahmed Maiter
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- MMIV, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Kieren Allinson
- Department of Pathology, Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK
| | - Fulvio Zaccagna
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | | | - Marcel Gehrung
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James Grist
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Tomasz Matys
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
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26
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Li H, Graves MJ, Shaida N, Prashar A, Lomas DJ, Priest AN. Highly accelerated subtractive femoral non-contrast-enhanced MRA using compressed sensing with k-space subtraction, phase and intensity correction. Magn Reson Med 2021; 86:320-334. [PMID: 33645815 DOI: 10.1002/mrm.28736] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE To develop an improved reconstruction method, k-space subtraction with phase and intensity correction (KSPIC), for highly accelerated, subtractive, non-contrast-enhanced MRA. METHODS The KSPIC method is based on k-space subtraction of complex raw data. It applies a phase-correction procedure to restore the polarity of negative signals caused by subtraction and an intensity-correction procedure to improve background suppression and thereby sparsity. Ten retrospectively undersampled data sets and 10 groups of prospectively undersampled data sets were acquired in 12 healthy volunteers. The performance of KSPIC was compared with another improved reconstruction based on combined magnitude subtraction, as well as with conventional k-space subtraction reconstruction and magnitude subtraction reconstruction, both using quantitative metrics and using subjective quality scoring. RESULTS In the quantitative evaluation, KSPIC had the best performance in terms of peak SNR, structural similarity index measure, contrast-to-noise ratio of artery-to-background and sharpness, especially at high acceleration factors. The KSPIC method also had the highest subjective scores for all acceleration factors in terms of vessel delineation, image noise and artifact, and background contamination. The acquisition can be accelerated by a factor of 20 without significant decreases of subjective scores. The optimal size of the phase-correction region was found to be 12-20 pixels in this study. CONCLUSION Compared with combined magnitude subtraction and conventional reconstructions, KSPIC has the best performance in all of the quantitative and qualitative measurements, permitting good image quality to be maintained up to higher accelerations. The KSPIC method has the potential to further reduce the acquisition time of subtractive MRA for clinical examinations.
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Affiliation(s)
- Hao Li
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom.,Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Nadeem Shaida
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Akash Prashar
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - David J Lomas
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom.,Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Andrew N Priest
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom.,Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
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27
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Baxter GC, Patterson AJ, Woitek R, Allajbeu I, Graves MJ, Gilbert F. Improving the image quality of DWI in breast cancer: comparison of multi-shot DWI using multiplexed sensitivity encoding to conventional single-shot echo-planar imaging DWI. Br J Radiol 2021; 94:20200427. [PMID: 32903028 PMCID: PMC8011253 DOI: 10.1259/bjr.20200427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: To compare diffusion-weighted images (DWI) acquired using single-shot echo-planar imaging (ss-EPI) and multiplexed sensitivity encoding (MUSE) in breast cancer. Methods 20 females with pathologically confirmed breast cancer (age 51 ± 12 years) were imaged with ss-EPI-DWI and MUSE-DWI. ADC, normalised ADC (nADC), blur and distortion metrics and qualitative image quality scores were compared. The Crété-Roffet and Mattes mutual information metrics were used to evaluate blurring and distortion, respectively. In a breast phantom, six permutations of MUSE-DWI with varying parallel acceleration factor and number of shots were compared. Differences in ADC and nADC were compared using the coefficient of variation in the phantom and a paired t-test in patients. Differences in blur, distortion and qualitative metrics were analysed using a Wilcoxon signed-rank test. Results: There was a low coefficient of variation (<2%) in ADC between ss-EPI-DWI and all MUSE-DWI permutations acquired using the phantom. 22 malignant and three benign lesions were identified in 20 patients. ADC values measured using MUSE were significantly lower compared to ss-EPI for malignant but not benign lesions (p < 0.001, p = 0.21). nADC values were not significantly different (p = 0.62, p = 0.28). Blurring and distortion improved with number of shots and acceleration factor, and significantly improved with MUSE in patients (p < 0.001, p = 0.002). Qualitatively, image quality improved using MUSE. Conclusion: MUSE improves the image quality of breast DWI compared to ss-EPI. Advances in knowledge: MUSE-DWI has superior image quality and reduced blurring and distortion compared to ss-EPI-DWI in breast cancer.
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Affiliation(s)
- Gabrielle C Baxter
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew J Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Iris Allajbeu
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
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MacKay JW, Nezhad FS, Rifai T, Kaggie JD, Naish JH, Roberts C, Graves MJ, Waterton JC, Janiczek RL, Roberts AR, McCaskie A, Gilbert FJ, Parker GJM. Dynamic contrast-enhanced MRI of synovitis in knee osteoarthritis: repeatability, discrimination and sensitivity to change in a prospective experimental study. Eur Radiol 2021; 31:5746-5758. [PMID: 33591383 PMCID: PMC8270862 DOI: 10.1007/s00330-021-07698-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/30/2020] [Revised: 11/07/2020] [Accepted: 01/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Evaluate test-retest repeatability, ability to discriminate between osteoarthritic and healthy participants, and sensitivity to change over 6 months, of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) biomarkers in knee OA. METHODS Fourteen individuals aged 40-60 with mild-moderate knee OA and 6 age-matched healthy volunteers (HV) underwent DCE-MRI at 3 T at baseline, 1 month and 6 months. Voxelwise pharmacokinetic modelling of dynamic data was used to calculate DCE-MRI biomarkers including Ktrans and IAUC60. Median DCE-MRI biomarker values were extracted for each participant at each study visit. Synovial segmentation was performed using both manual and semiautomatic methods with calculation of an additional biomarker, the volume of enhancing pannus (VEP). Test-retest repeatability was assessed using intraclass correlation coefficients (ICC). Smallest detectable differences (SDDs) were calculated from test-retest data. Discrimination between OA and HV was assessed via calculation of between-group standardised mean differences (SMD). Responsiveness was assessed via the number of OA participants with changes greater than the SDD at 6 months. RESULTS Ktrans demonstrated the best test-retest repeatability (Ktrans/IAUC60/VEP ICCs 0.90/0.84/0.40, SDDs as % of OA mean 33/71/76%), discrimination between OA and HV (SMDs 0.94/0.54/0.50) and responsiveness (5/1/1 out of 12 OA participants with 6-month change > SDD) when compared to IAUC60 and VEP. Biomarkers derived from semiautomatic segmentation outperformed those derived from manual segmentation across all domains. CONCLUSIONS Ktrans demonstrated the best repeatability, discrimination and sensitivity to change suggesting that it is the optimal DCE-MRI biomarker for use in experimental medicine studies. KEY POINTS • Dynamic contrast-enhanced MRI (DCE-MRI) provides quantitative measures of synovitis in knee osteoarthritis which may permit early assessment of efficacy in experimental medicine studies. • This prospective observational study compared DCE-MRI biomarkers across domains relevant to experimental medicine: test-retest repeatability, discriminative validity and sensitivity to change. • The DCE-MRI biomarker Ktrans demonstrated the best performance across all three domains, suggesting that it is the optimal biomarker for use in future interventional studies.
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Affiliation(s)
- James W MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK. .,Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UY, UK.
| | | | - Tamam Rifai
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | | | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - John C Waterton
- Bioxydyn Limited, Manchester, UK.,Centre for Imaging Sciences, Division of Informatics Imaging & Data Sciences, School of Health Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | | | - Alexandra R Roberts
- Clinical Imaging, GlaxoSmithKline, London, UK.,Antaros Medical, Uppsala, Sweden
| | - Andrew McCaskie
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Geoff J M Parker
- Bioxydyn Limited, Manchester, UK.,Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
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Teng Z, Wang S, Tokgoz A, Taviani V, Bird J, Sadat U, Huang Y, Patterson AJ, Figg N, Graves MJ, Gillard JH. Study on the association of wall shear stress and vessel structural stress with atherosclerosis: An experimental animal study. Atherosclerosis 2021; 320:38-46. [PMID: 33524908 DOI: 10.1016/j.atherosclerosis.2021.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Artery is subject to wall shear stress (WSS) and vessel structural stress (VSS) simultaneously. This study is designed to explore the role of VSS in development of atherosclerosis. METHODS Silastic collars were deployed on the carotid to create two constrictions on 13 rabbits for a distinct mechanical environment at the constriction. MRI was performed to visualize arteries' configuration. Animals with high fat (n = 9; Model-group) and normal diet (n = 4; Control-group) were sacrificed after 16 weeks. 3D fluid-structure interaction analysis was performed to quantify WSS and VSS simultaneously. RESULTS Twenty plaques were found in Model-group and 3 in Control-group. In Model-group, 8 plaques located proximally to the first constriction (Region-1, close to the heart) and 7 distally to the second (Region-2, close to the head) and 5 plaques were found on the contralateral side of 3 rabbits. Plaques at Region-1 tended to be bigger than those at Region-2 and the macrophage density at these locations was comparable. Minimum time-averaged WSS (TAWSS) in Region-1 was significantly higher than that in Region-2, and both maximum oscillatory shear index (OSI) and particle relative residence time (RRT) were significantly lower. Peak and mean VSS in Region-1 were significantly higher than those in Region-2. Correlation analyses indicated that low TAWSS, high OSI and RRT were only associated with plaque in Region-2, while lesions in Region-1 were only associated with high VSS. Moreover, only VSS was associated with wall thickness of plaque-free regions in both regions. CONCLUSIONS VSS might contribute to the initialization and development of atherosclerosis solely or in combination with WSS.
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Affiliation(s)
- Zhongzhao Teng
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom; Department of Engineering, University of Cambridge, Cambridge, United Kingdom.
| | - Shuo Wang
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Aziz Tokgoz
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Valentina Taviani
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Joseph Bird
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Umar Sadat
- Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Yuan Huang
- EPSRC Centre for Mathematical and Statistical Analysis of Multimodal Clinical Imaging, University of Cambridge, Cambridge, United Kingdom
| | - Andrew J Patterson
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Nichola Figg
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan H Gillard
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
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30
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Carmona-Bozo JC, Manavaki R, Woitek R, Torheim T, Baxter GC, Caracò C, Provenzano E, Graves MJ, Fryer TD, Patterson AJ, Gilbert FJ. Hypoxia and perfusion in breast cancer: simultaneous assessment using PET/MR imaging. Eur Radiol 2021; 31:333-344. [PMID: 32725330 PMCID: PMC7755870 DOI: 10.1007/s00330-020-07067-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 02/26/2020] [Revised: 05/12/2020] [Accepted: 07/03/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Hypoxia is associated with poor prognosis and treatment resistance in breast cancer. However, the temporally variant nature of hypoxia can complicate interpretation of imaging findings. We explored the relationship between hypoxia and vascular function in breast tumours through combined 18F-fluoromisonidazole (18 F-FMISO) PET/MRI, with simultaneous assessment circumventing the effect of temporal variation in hypoxia and perfusion. METHODS Women with histologically confirmed, primary breast cancer underwent a simultaneous 18F-FMISO-PET/MR examination. Tumour hypoxia was assessed using influx rate constant Ki and hypoxic fractions (%HF), while parameters of vascular function (Ktrans, kep, ve, vp) and cellularity (ADC) were derived from dynamic contrast-enhanced (DCE) and diffusion-weighted (DW)-MRI, respectively. Additional correlates included histological subtype, grade and size. Relationships between imaging variables were assessed using Pearson correlation (r). RESULTS Twenty-nine women with 32 lesions were assessed. Hypoxic fractions > 1% were observed in 6/32 (19%) cancers, while 18/32 (56%) tumours showed a %HF of zero. The presence of hypoxia in lesions was independent of histological subtype or grade. Mean tumour Ktrans correlated negatively with Ki (r = - 0.38, p = 0.04) and %HF (r = - 0.33, p = 0.04), though parametric maps exhibited intratumoural heterogeneity with hypoxic regions colocalising with both hypo- and hyperperfused areas. No correlation was observed between ADC and DCE-MRI or PET parameters. %HF correlated positively with lesion size (r = 0.63, p = 0.001). CONCLUSION Hypoxia measured by 18F-FMISO-PET correlated negatively with Ktrans from DCE-MRI, supporting the hypothesis of perfusion-driven hypoxia in breast cancer. Intratumoural hypoxia-perfusion relationships were heterogeneous, suggesting that combined assessment may be needed for disease characterisation, which could be achieved using simultaneous multimodality imaging. KEY POINTS • At the tumour level, hypoxia measured by 18F-FMISO-PET was negatively correlated with perfusion measured by DCE-MRI, which supports the hypothesis of perfusion-driven hypoxia in breast cancer. • No associations were observed between 18F-FMISO-PET parameters and tumour histology or grade, but tumour hypoxic fractions increased with lesion size. • Intratumoural hypoxia-perfusion relationships were heterogeneous, suggesting that the combined hypoxia-perfusion status of tumours may need to be considered for disease characterisation, which can be achieved via simultaneous multimodality imaging as reported here.
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Affiliation(s)
- Julia C Carmona-Bozo
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Roido Manavaki
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Ramona Woitek
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Turid Torheim
- Cancer Research UK - Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - Gabrielle C Baxter
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Corradina Caracò
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Elena Provenzano
- Cancer Research UK - Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Box 97, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- MRIS Unit, Cambridge University Hospitals NHS Foundation Trust, Box 162, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tim D Fryer
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Box 65, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- MRIS Unit, Cambridge University Hospitals NHS Foundation Trust, Box 162, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Fiona J Gilbert
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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31
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Aviles-Rivero AI, Debroux N, Williams G, Graves MJ, Schönlieb CB. Compressed sensing plus motion (CS + M): A new perspective for improving undersampled MR image reconstruction. Med Image Anal 2020; 68:101933. [PMID: 33341495 DOI: 10.1016/j.media.2020.101933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/11/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
We address the problem of reconstructing high quality images from undersampled MRI data. This is a challenging task due to the highly ill-posed nature of the problem. In particular, in dynamic MRI scans, the interaction between the target structure and the physical motion affects the acquired measurements leading to blurring artefacts and loss of fine details. In this work, we propose a framework for dynamic MRI reconstruction framed under a new multi-task optimisation model called Compressed Sensing Plus Motion (CS + M). Firstly, we propose a single optimisation problem that simultaneously computes the MRI reconstruction and the physical motion. Secondly, we show our model can be efficiently solved by breaking it up into two computationally tractable problems. The potentials and generalisation capabilities of our approach are demonstrated in different clinical applications including cardiac cine, cardiac perfusion and brain perfusion imaging. We show, through numerical experiments, that the proposed scheme reduces blurring artefacts, and preserves the target shape and fine details in the reconstruction. We also report the highest quality reconstruction under high undersampling rates in comparison to several state of the art techniques.
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Affiliation(s)
| | - Noémie Debroux
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, France
| | - Guy Williams
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Martin J Graves
- Department of Radiology, Cambridge University Hospitals, University of Cambridge, UK
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32
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Sherry F, Benning M, De Los Reyes JC, Graves MJ, Maierhofer G, Williams G, Schonlieb CB, Ehrhardt MJ. Learning the Sampling Pattern for MRI. IEEE Trans Med Imaging 2020; 39:4310-4321. [PMID: 32804647 DOI: 10.1109/tmi.2020.3017353] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The discovery of the theory of compressed sensing brought the realisation that many inverse problems can be solved even when measurements are "incomplete". This is particularly interesting in magnetic resonance imaging (MRI), where long acquisition times can limit its use. In this work, we consider the problem of learning a sparse sampling pattern that can be used to optimally balance acquisition time versus quality of the reconstructed image. We use a supervised learning approach, making the assumption that our training data is representative enough of new data acquisitions. We demonstrate that this is indeed the case, even if the training data consists of just 7 training pairs of measurements and ground-truth images; with a training set of brain images of size 192 by 192, for instance, one of the learned patterns samples only 35% of k-space, however results in reconstructions with mean SSIM 0.914 on a test set of similar images. The proposed framework is general enough to learn arbitrary sampling patterns, including common patterns such as Cartesian, spiral and radial sampling.
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Sushentsev N, Kaggie JD, Buonincontri G, Schulte RF, Graves MJ, Gnanapragasam VJ, Barrett T. The effect of gadolinium-based contrast agent administration on magnetic resonance fingerprinting-based T 1 relaxometry in patients with prostate cancer. Sci Rep 2020; 10:20475. [PMID: 33235229 PMCID: PMC7686305 DOI: 10.1038/s41598-020-77331-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 07/13/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022] Open
Abstract
Magnetic resonance fingerprinting (MRF) is a rapidly developing fast quantitative mapping technique able to produce multiple property maps with reduced sensitivity to motion. MRF has shown promise in improving the diagnosis of clinically significant prostate cancer but requires further validation as part of a prostate multiparametric (mp) MRI protocol. mpMRI protocol mandates the inclusion of dynamic contrast enhanced (DCE) imaging, known for its significant T1 shortening effect. MRF could be used to measure both pre- and post-contrast T1 values, but its utility must be assessed. In this proof-of-concept study, we sought to evaluate the variation in MRF T1 measurements post gadolinium-based contrast agent (GBCA) injection and the utility of such T1 measurements to differentiate peripheral and transition zone tumours from normal prostatic tissue. We found that the T1 variation in all tissues increased considerably post-GBCA following the expected significant T1 shortening effect, compromising the ability of MRF T1 to identify transition zone lesions. We, therefore, recommend performing MRF T1 prior to DCE imaging to maintain its benefit for improving detection of both peripheral and transition zone lesions while reducing additional scanning time. Demonstrating the effect of GBCA on MRF T1 relaxometry in patients also paves the way for future clinical studies investigating the added value of post-GBCA MRF in PCa, including its dynamic analysis as in DCE-MRF.
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Affiliation(s)
- Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | | | | | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Vincent J Gnanapragasam
- Department of Urology, Addenbrooke's Hospital, Cambridge, UK
- Academic Urology Group, Department of Surgery and Oncology, University of Cambridge, Cambridge, UK
- Cambridge Urology Translational Research and Clinical Trials Office, University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
- CamPARI Prostate Cancer Group, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
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Grist JT, Riemer F, Hansen ESS, Tougaard RS, McLean MA, Kaggie J, Bøgh N, Graves MJ, Gallagher FA, Laustsen C. Visualization of sodium dynamics in the kidney by magnetic resonance imaging in a multi-site study. Kidney Int 2020; 98:1174-1178. [PMID: 32585166 PMCID: PMC7652549 DOI: 10.1016/j.kint.2020.04.056] [Citation(s) in RCA: 16] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
Sodium magnetic resonance imaging (MRI) is a powerful, non-invasive technique to assess sodium distribution within the kidney. Here we undertook pre-clinical and clinical studies to quantify the corticomedullary sodium gradient in healthy individuals and in a porcine model of diuresis. The results demonstrated that sodium MRI could detect spatial differences in sodium biodistribution across the kidney. The sodium gradient of the kidney changed significantly after diuresis in the pig model and was independent of blood electrolyte measurements. Thus, rapid sodium MRI can be used to dynamically quantify sodium biodistribution in the porcine and human kidney.
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Affiliation(s)
- James T Grist
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Esben S S Hansen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rasmus S Tougaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge, UK; Cancer Research UK, Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Joshua Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Nikolaj Bøgh
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Martin J Graves
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Serrao EM, Kessler DA, Carmo B, Beer L, Brindle KM, Buonincontri G, Gallagher FA, Gilbert FJ, Godfrey E, Graves MJ, McLean MA, Sala E, Schulte RF, Kaggie JD. Magnetic resonance fingerprinting of the pancreas at 1.5 T and 3.0 T. Sci Rep 2020; 10:17563. [PMID: 33067515 PMCID: PMC7567885 DOI: 10.1038/s41598-020-74462-6] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Magnetic resonance imaging of the pancreas is increasingly used as an important diagnostic modality for characterisation of pancreatic lesions. Pancreatic MRI protocols are mostly qualitative due to time constraints and motion sensitivity. MR Fingerprinting is an innovative acquisition technique that provides qualitative data and quantitative parameter maps from a single free-breathing acquisition with the potential to reduce exam times. This work investigates the feasibility of MRF parameter mapping for pancreatic imaging in the presence of free-breathing exam. Sixteen healthy participants were prospectively imaged using MRF framework. Regions-of-interest were drawn in multiple solid organs including the pancreas and T1 and T2 values determined. MRF T1 and T2 mapping was performed successfully in all participants (acquisition time:2.4-3.6 min). Mean pancreatic T1 values were 37-43% lower than those of the muscle, spleen, and kidney at both 1.5 and 3.0 T. For these organs, the mean pancreatic T2 values were nearly 40% at 1.5 T and < 12% at 3.0 T. The feasibility of MRF at 1.5 T and 3 T was demonstrated in the pancreas. By enabling fast and free-breathing quantitation, MRF has the potential to add value during the clinical characterisation and grading of pathological conditions, such as pancreatitis or cancer.
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Affiliation(s)
- Eva M Serrao
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Dimitri A Kessler
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Bruno Carmo
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Lucian Beer
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Edmund Godfrey
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | | | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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MacKay JW, Kaggie JD, Treece GM, McDonnell SM, Khan W, Roberts AR, Janiczek RL, Graves MJ, Turmezei TD, McCaskie AW, Gilbert FJ. Three-Dimensional Surface-Based Analysis of Cartilage MRI Data in Knee Osteoarthritis: Validation and Initial Clinical Application. J Magn Reson Imaging 2020; 52:1139-1151. [PMID: 32447815 DOI: 10.1002/jmri.27193] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/20/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Traditional quantitative analysis of cartilage with MRI averages measurements (eg, thickness) across regions-of-interest (ROIs) which may reduce responsiveness. PURPOSE To validate and describe clinical application of a semiautomated surface-based method for analyzing cartilage relaxation times ("composition") and morphology on MRI, 3D cartilage surface mapping (3D-CaSM). STUDY TYPE Validation study in cadaveric knees and prospective observational (cohort) study in human participants. POPULATION Four cadaveric knees and 14 participants aged 40-60 with mild-moderate knee osteoarthritis (OA) and 6 age-matched healthy volunteers, imaged at baseline, 1, and 6 months. FIELD STRENGTH/SEQUENCE 3D spoiled gradient echo, T1 rho/T2 magnetization-prepared 3D fast spin echo for mapping of T1 rho/T2 relaxation times and delayed gadolinium enhanced MRI of cartilage (dGEMRIC) using variable flip angle T1 relaxation time mapping at 3T. ASSESSMENT 3D-CaSM was validated against high-resolution peripheral quantitative computed tomography (HRpQCT) in cadaveric knees, with comparison to expert manual segmentation. The clinical study assessed test-retest repeatability and sensitivity to change over 6 months for cartilage thickness and relaxation times. STATISTICAL TESTS Bland-Altman analysis was performed for the validation study and evaluation of test-retest repeatability. Six-month changes were assessed via calculation of the percentage of each cartilage surface affected by areas of significant change (%SC), defined using thresholds based on area and smallest detectable difference (SDD). RESULTS Bias and precision (0.06 ± 0.25 mm) of 3D-CaSM against reference HRpQCT data were comparable to expert manual segmentation (-0.13 ± 0.26 mm). 3D-CaSM demonstrated significant (>SDD) 6-month changes in cartilage thickness and relaxation times in both OA participants and healthy controls. The parameter demonstrating the greatest 6-month change was T2 relaxation time (OA median %SC [IQR] = 8.8% [5.5 to 12.6]). DATA CONCLUSION This study demonstrates the construct validity and potential clinical utility of 3D-CaSM, which may offer advantages to conventional ROI-based methods. LEVEL OF EVIDENCE 2. TECHNICAL EFFICACY STAGE 2. J. Magn. Reson. Imaging 2020;52:1139-1151.
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Affiliation(s)
- James W MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Graham M Treece
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - Stephen M McDonnell
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Wasim Khan
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Alexandra R Roberts
- Clinical Imaging, GlaxoSmithKline, London, UK
- Antaros Medical, Uppsala, Sweden
| | | | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Tom D Turmezei
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK
| | - Andrew W McCaskie
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK
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Li H, Wang S, Graves MJ, Lomas DJ, Priest AN. Subtractive NCE-MRA: Improved background suppression using robust regression-based weighted subtraction. Magn Reson Med 2020; 85:694-708. [PMID: 32754954 DOI: 10.1002/mrm.28443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/19/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE To correct the intensity difference of static background signal between bright blood images and dark blood images in subtractive non-contrast-enhanced MR angiography using robust regression, thereby improving static background signal suppression on subtracted angiograms. METHODS Robust regression (RR), using iteratively reweighted least squares, is used to calculate the regression coefficient of background tissues from a scatter plot showing the voxel intensity of bright blood images versus dark blood images. The weighting function is based on either the Euclidean distance from the estimated regression line or the deviation angle. Results from RR using the deviation angle (RRDA), conventional RR using the Euclidean distance, and ordinary leastsquares regression were compared with reference values determined manually by two observers. Performance was evaluated over studies using different sequences, including 36 thoracic flow-sensitive dephasing data sets, 13 iliac flow-sensitive dephasing data sets, and 26 femoral fresh blood imaging data sets. RESULTS RR deviation angle achieved robust and accurate performance in all types of images, with small bias, small mean absolute error, and high-correlation coefficients with reference values. Background tissues, such as muscle, veins, and bladder, were suppressed while the vascular signal was preserved. Euclidean distance gave good performance for thoracic and iliac flow-sensitive dephasing, but could not suppress background tissues in femoral fresh blood imaging. Ordinary least squares regression was sensitive to outliers and overestimated regression coefficients in thoracic flow-sensitive dephasing. CONCLUSION Weighted subtraction using RR was able to acquire the regression coefficients of background signal and improve background suppression of subtractive non-contrast-enhanced MR angiography techniques. RR deviation angle has the most robust and accurate overall performance among three regression methods.
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Affiliation(s)
- Hao Li
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Shuo Wang
- Department of Radiology, University of Cambridge, Cambridge, UK.,Data Science Institute, Imperial College London, London, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK.,Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - David J Lomas
- Department of Radiology, University of Cambridge, Cambridge, UK.,Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Andrew N Priest
- Department of Radiology, University of Cambridge, Cambridge, UK.,Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
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38
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Woitek R, McLean MA, Gill AB, Grist JT, Provenzano E, Patterson AJ, Ursprung S, Torheim T, Zaccagna F, Locke M, Laurent MC, Hilborne S, Frary A, Beer L, Rundo L, Patterson I, Slough R, Kane J, Biggs H, Harrison E, Lanz T, Basu B, Baird R, Sala E, Graves MJ, Gilbert FJ, Abraham JE, Caldas C, Brindle KM, Gallagher FA. Hyperpolarized 13C MRI of Tumor Metabolism Demonstrates Early Metabolic Response to Neoadjuvant Chemotherapy in Breast Cancer. Radiol Imaging Cancer 2020; 2:e200017. [PMID: 32803167 PMCID: PMC7398116 DOI: 10.1148/rycan.2020200017] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 02/28/2020] [Revised: 03/24/2020] [Accepted: 04/15/2020] [Indexed: 04/12/2023]
Abstract
Purpose To compare hyperpolarized carbon 13 (13C) MRI with dynamic contrast material-enhanced (DCE) MRI in the detection of early treatment response in breast cancer. Materials and Methods In this institutional review board-approved prospective study, a woman with triple-negative breast cancer (age, 49 years) underwent 13C MRI after injection of hyperpolarized [1-carbon 13 {13C}]-pyruvate and DCE MRI at 3 T at baseline and after one cycle of neoadjuvant therapy. The 13C-labeled lactate-to-pyruvate ratio derived from hyperpolarized 13C MRI and the pharmacokinetic parameters transfer constant (K trans) and washout parameter (k ep) derived from DCE MRI were compared before and after treatment. Results Exchange of the 13C label between injected hyperpolarized [1-13C]-pyruvate and the endogenous lactate pool was observed, catalyzed by the enzyme lactate dehydrogenase. After one cycle of neoadjuvant chemotherapy, a 34% reduction in the 13C-labeled lactate-to-pyruvate ratio resulted in correct identification of the patient as a responder to therapy, which was subsequently confirmed via a complete pathologic response. However, DCE MRI showed an increase in mean K trans (132%) and mean k ep (31%), which could be incorrectly interpreted as a poor response to treatment. Conclusion Hyperpolarized 13C MRI enabled successful identification of breast cancer response after one cycle of neoadjuvant chemotherapy and may improve response prediction when used in conjunction with multiparametric proton MRI.Published under a CC BY 4.0 license.
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Affiliation(s)
- Ramona Woitek
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Mary A. McLean
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Andrew B. Gill
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - James T. Grist
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Elena Provenzano
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Andrew J. Patterson
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Stephan Ursprung
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Turid Torheim
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Fulvio Zaccagna
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Matthew Locke
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Marie-Christine Laurent
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Sarah Hilborne
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Amy Frary
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Lucian Beer
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Leonardo Rundo
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Ilse Patterson
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Rhys Slough
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Justine Kane
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Heather Biggs
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Emma Harrison
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Titus Lanz
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Bristi Basu
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Richard Baird
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Evis Sala
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Martin J. Graves
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Fiona J. Gilbert
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Jean E. Abraham
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Carlos Caldas
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Kevin M. Brindle
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
| | - Ferdia A. Gallagher
- From the Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.)
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Kessler DA, MacKay JW, McDonald S, McDonnell S, Grainger AJ, Roberts AR, Janiczek RL, Graves MJ, Kaggie JD, Gilbert FJ. Effectively Measuring Exercise-Related Variations in T1ρ and T2 Relaxation Times of Healthy Articular Cartilage. J Magn Reson Imaging 2020; 52:1753-1764. [PMID: 32677070 DOI: 10.1002/jmri.27278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/28/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Determining the compositional response of articular cartilage to dynamic joint-loading using MRI may be a more sensitive assessment of cartilage status than conventional static imaging. However, distinguishing the effects of joint-loading vs. inherent measurement variability remains difficult, as the repeatability of these quantitative methods is often not assessed or reported. PURPOSE To assess exercise-induced changes in femoral, tibial, and patellar articular cartilage composition and compare these against measurement repeatability. STUDY TYPE Prospective observational study. POPULATION Phantom and 19 healthy participants. FIELD STRENGTH/SEQUENCE 3T; 3D fat-saturated spoiled gradient recalled-echo; T1ρ - and T2 -prepared pseudosteady-state 3D fast spin echo. ASSESSMENT The intrasessional repeatability of T1ρ and T2 relaxation mapping, with and without knee repositioning between two successive measurements, was determined in 10 knees. T1ρ and T2 relaxation mapping of nine knees was performed before and at multiple timepoints after a 5-minute repeated, joint-loading stepping activity. 3D surface models were created from patellar, femoral, and tibial articular cartilage. STATISTICAL TESTS Repeatability was assessed using root-mean-squared-CV (RMS-CV). Using Bland-Altman analysis, thresholds defined as the smallest detectable difference (SDD) were determined from the repeatability data with knee repositioning. RESULTS Without knee repositioning, both surface-averaged T1ρ and T2 were very repeatable on all cartilage surfaces, with RMS-CV <1.1%. Repositioning of the knee had the greatest effect on T1ρ of patellar cartilage with the surface-averaged RMS-CV = 4.8%. While T1ρ showed the greatest response to exercise at the patellofemoral cartilage region, the largest changes in T2 were determined in the lateral femorotibial region. Following thresholding, significant (>SDD) average exercise-induced in T1ρ and T2 of femoral (-8.0% and -5.3%), lateral tibial (-6.9% and -5.9%), medial tibial (+5.8% and +2.9%), and patellar (-7.9% and +2.8%) cartilage were observed. DATA CONCLUSION Joint-loading with a stepping activity resulted in T1ρ and T2 changes above background measurement error. EVIDENCE LEVEL 2 TECHNICAL EFFICACY STAGE: 1 J. MAGN. RESON. IMAGING 2020;52:1753-1764.
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Affiliation(s)
| | - James W MacKay
- Department of Radiology, University of Cambridge, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Scott McDonald
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Stephen McDonnell
- Division of Trauma and Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Andrew J Grainger
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | | | - Martin J Graves
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
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40
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Kaggie JD, Markides H, Graves MJ, MacKay J, Houston G, El Haj A, Gilbert F, Henson F. Author Correction: Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model. Sci Rep 2020; 10:11171. [PMID: 32612189 PMCID: PMC7330032 DOI: 10.1038/s41598-020-68531-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK. .,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
| | - Hareklea Markides
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK.,Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, Birmingham, B15 2TT, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - James MacKay
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Alicia El Haj
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK.,Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, Birmingham, B15 2TT, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Frances Henson
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK.,Comparative Musculoskeletal Biology Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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41
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Kaggie JD, Markides H, Graves MJ, MacKay J, Houston G, El Haj A, Gilbert F, Henson F. Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model. Sci Rep 2020; 10:8451. [PMID: 32439838 PMCID: PMC7242461 DOI: 10.1038/s41598-020-64423-4] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 03/13/2020] [Indexed: 01/22/2023] Open
Abstract
Multipotent Mesenchymal Stem/Stromal Cells (MSCs) are widely used in cellular therapy for joint repair. However, the use of MSC therapies is complicated by a lack of understanding of the behaviour of cells and repair within the joint. Current methods of MSC tracking include labelling the cells with Super Paramagnetic Iron Oxide nanoparticles (SPIOs). However, standard acquisition sequences (T2 and T2*) give poor anatomical definition in the presence of SPIOs. To avoid anatomical compromise in the presence of SPIOs, we have investigated the use of Ultra-short Echo Time (UTE) MRI, using a 3D cones acquisition trajectory. This method was used to track SPIO labelled MSC injected into joints containing osteochondral defects in experimental sheep. This study demonstrates that multiple echo times from UTE with 3 T MRI can provide excellent anatomical detail of osteochondral defects and demonstrate similar features to histology. This work also monitors the location of SPIO-labelled cells for regenerative medicine of the knee with MRI, histology, and Prussian blue staining. With these methods, we show that the SPIOs do not hone to the site of defect but instead aggregate in the location of injection, which suggests that any repair mechanism with this disease model must trigger a secondary process.
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Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom.
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom.
| | - Hareklea Markides
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK
- Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, B15 2TT, Birmingham, UK
| | - Martin J Graves
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - James MacKay
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | - Alicia El Haj
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK
- Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, B15 2TT, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Frances Henson
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, United Kingdom
- Comparative Musculoskeletal Biology Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Usman A, Patterson AJ, Yuan J, Cluroe A, Patterson I, Graves MJ, Gillard JH, Sadat U. Ferumoxytol-enhanced three-dimensional magnetic resonance imaging of carotid atheroma- a feasibility and temporal dependence study. Sci Rep 2020; 10:1808. [PMID: 32020031 PMCID: PMC7000763 DOI: 10.1038/s41598-020-58708-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/01/2020] [Indexed: 12/25/2022] Open
Abstract
Ferumoxytol is an ultrasmall super paramagnetic particles of iron oxide (USPIO) agent recently used for magnetic resonance (MR) vascular imaging. Other USPIOs have been previously used for assessing inflammation within atheroma. We aim to assess feasibility of ferumoxytol in imaging carotid atheroma (with histological assessment); and the optimum MR imaging time to detect maximum quantitative signal change post-ferumoxytol infusion. Ten patients with carotid artery disease underwent high-resolution MR imaging of their carotid arteries on a 1.5 T MR system. MR imaging was performed before and at 24, 48, 72 and 96 hrs post ferumoxytol infusion. Optimal ferumoxytol uptake time was evaluated by quantitative relaxometry maps indicating the difference in T2* (ΔT2*) and T2 (ΔT2) between baseline and post-Ferumoxytol MR imaging using 3D DANTE MEFGRE qT2*w and iMSDE black-blood qT2w sequences respectively. 20 patients in total (10 symptomatic and 10 with asymptomatic carotid artery disease) had ferumoxytol-enhanced MR imaging at the optimal imaging window. 69 carotid MR imaging studies were completed. Ferumoxytol uptake (determined by a decrease in ΔT2* and ΔT2) was identified in all carotid plaques (symptomatic and asymptomatic). Maximum quantitative decrease in ΔT2* (10.4 [3.5-16.2] ms, p < 0.001) and ΔT2 (13.4 [6.2-18.9] ms; p = 0.001) was found on carotid MR imaging at 48 hrs following the ferumoxytol infusion. Ferumoxytol uptake by carotid plaques was assessed by histopathological analysis of excised atheroma. Ferumoxytol-enhanced MR imaging using quantitative 3D MR pulse sequences allows assessment of inflammation within carotid atheroma in symptomatic and asymptomatic patients. The optimum MR imaging time for carotid atheroma is 48 hrs after its administration.
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Affiliation(s)
- Ammara Usman
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Jianmin Yuan
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Alison Cluroe
- Department of Pathology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Ilse Patterson
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | - Umar Sadat
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
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Gallagher FA, Woitek R, McLean MA, Gill AB, Manzano Garcia R, Provenzano E, Riemer F, Kaggie J, Chhabra A, Ursprung S, Grist JT, Daniels CJ, Zaccagna F, Laurent MC, Locke M, Hilborne S, Frary A, Torheim T, Boursnell C, Schiller A, Patterson I, Slough R, Carmo B, Kane J, Biggs H, Harrison E, Deen SS, Patterson A, Lanz T, Kingsbury Z, Ross M, Basu B, Baird R, Lomas DJ, Sala E, Wason J, Rueda OM, Chin SF, Wilkinson IB, Graves MJ, Abraham JE, Gilbert FJ, Caldas C, Brindle KM. Imaging breast cancer using hyperpolarized carbon-13 MRI. Proc Natl Acad Sci U S A 2020; 117:2092-2098. [PMID: 31964840 PMCID: PMC6995024 DOI: 10.1073/pnas.1913841117] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [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] [Indexed: 01/08/2023] Open
Abstract
Our purpose is to investigate the feasibility of imaging tumor metabolism in breast cancer patients using 13C magnetic resonance spectroscopic imaging (MRSI) of hyperpolarized 13C label exchange between injected [1-13C]pyruvate and the endogenous tumor lactate pool. Treatment-naïve breast cancer patients were recruited: four triple-negative grade 3 cancers; two invasive ductal carcinomas that were estrogen and progesterone receptor-positive (ER/PR+) and HER2/neu-negative (HER2-), one grade 2 and one grade 3; and one grade 2 ER/PR+ HER2- invasive lobular carcinoma (ILC). Dynamic 13C MRSI was performed following injection of hyperpolarized [1-13C]pyruvate. Expression of lactate dehydrogenase A (LDHA), which catalyzes 13C label exchange between pyruvate and lactate, hypoxia-inducible factor-1 (HIF1α), and the monocarboxylate transporters MCT1 and MCT4 were quantified using immunohistochemistry and RNA sequencing. We have demonstrated the feasibility and safety of hyperpolarized 13C MRI in early breast cancer. Both intertumoral and intratumoral heterogeneity of the hyperpolarized pyruvate and lactate signals were observed. The lactate-to-pyruvate signal ratio (LAC/PYR) ranged from 0.021 to 0.473 across the tumor subtypes (mean ± SD: 0.145 ± 0.164), and a lactate signal was observed in all of the grade 3 tumors. The LAC/PYR was significantly correlated with tumor volume (R = 0.903, P = 0.005) and MCT 1 (R = 0.85, P = 0.032) and HIF1α expression (R = 0.83, P = 0.043). Imaging of hyperpolarized [1-13C]pyruvate metabolism in breast cancer is feasible and demonstrated significant intertumoral and intratumoral metabolic heterogeneity, where lactate labeling correlated with MCT1 expression and hypoxia.
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Affiliation(s)
- Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom;
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Andrew B Gill
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Raquel Manzano Garcia
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Elena Provenzano
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Department of Histopathology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Joshua Kaggie
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Anita Chhabra
- Pharmacy Department, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Stephan Ursprung
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - James T Grist
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Charlie J Daniels
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Fulvio Zaccagna
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | | | - Matthew Locke
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Sarah Hilborne
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Amy Frary
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Turid Torheim
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Chris Boursnell
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Amy Schiller
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Ilse Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Rhys Slough
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Bruno Carmo
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Justine Kane
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Heather Biggs
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Emma Harrison
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Surrin S Deen
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Andrew Patterson
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Titus Lanz
- RAPID Biomedical GmbH, 97222 Rimpar, Germany
| | - Zoya Kingsbury
- Medical Genomics Research, Illumina, Great Abington, Cambridge CB21 6DF, United Kingdom
| | - Mark Ross
- Medical Genomics Research, Illumina, Great Abington, Cambridge CB21 6DF, United Kingdom
| | - Bristi Basu
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Richard Baird
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - David J Lomas
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - James Wason
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne NE2 4AX, United Kingdom
| | - Oscar M Rueda
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Suet-Feung Chin
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Ian B Wilkinson
- Department of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
| | - Jean E Abraham
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Carlos Caldas
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cambridge Breast Cancer Research Unit, Addenbrooke's Hospital, Cambridge University Hospital National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom
- Department of Oncology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Kevin M Brindle
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
- Department of Biochemistry, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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Ruetten PPR, Cluroe AD, Usman A, Priest AN, Gillard JH, Graves MJ. Simultaneous MRI water‐fat separation and quantitative susceptibility mapping of carotid artery plaque pre‐ and post‐ultrasmall superparamagnetic iron oxide‐uptake. Magn Reson Med 2020; 84:686-697. [DOI: 10.1002/mrm.28151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/28/2019] [Accepted: 12/08/2019] [Indexed: 12/20/2022]
Affiliation(s)
| | - Alison D. Cluroe
- Department of Histopathology Addenbrooke’s Hospital Histopathology, Cambridge United Kingdom
| | - Ammara Usman
- Department of Radiology University of Cambridge Cambridge United Kingdom
| | - Andrew N. Priest
- Department of Medical Physics Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom
| | | | - Martin J. Graves
- Department of Radiology Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom
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Barrett T, Riemer F, McLean MA, Kaggie JD, Robb F, Warren AY, Graves MJ, Gallagher FA. Molecular imaging of the prostate: Comparing total sodium concentration quantification in prostate cancer and normal tissue using dedicated 13 C and 23 Na endorectal coils. J Magn Reson Imaging 2020; 51:90-97. [PMID: 31081564 DOI: 10.1002/jmri.26788] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/30/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND There has been recent interest in nonproton MRI including hyperpolarized carbon-13 (13 C) imaging. Prostate cancer has been shown to have a higher tissue sodium concentration (TSC) than normal tissue. Sodium (23 Na) and 13 C nuclei have a frequency difference of only 1.66 MHz at 3T, potentially enabling 23 Na imaging with a 13 C-tuned coil and maximizing the metabolic information obtained from a single study. PURPOSE To compare TSC measurements from a 13 C-tuned endorectal coil to those quantified with a dedicated 23 Na-tuned coil. STUDY TYPE Prospective. POPULATION Eight patients with biopsy-proven, intermediate/high risk prostate cancer imaged prior to prostatectomy. SEQUENCE 3T MRI with separate dual-tuned 1 H/23 Na and 1 H/13 C endorectal receive coils to quantify TSC. ASSESSMENT Regions-of-interest for TSC quantification were defined for normal peripheral zone (PZ), normal transition zone (TZ), and tumor, with reference to histopathology maps. STATISTICAL TESTS Two-sided Wilcoxon rank sum with additional measures of correlation, coefficient of variation, and Bland-Altman plots to assess for between-test differences. RESULTS Mean TSC for normal PZ and TZ were 39.2 and 33.9 mM, respectively, with the 23 Na coil and 40.1 and 36.3 mM, respectively, with the 13 C coil (P = 0.22 and P = 0.11 for the intercoil comparison, respectively). For tumor tissue, there was no statistical difference between the overall mean tumor TSC measured with the 23 Na coil (41.8 mM) and with the 13 C coil (46.6 mM; P = 0.38). Bland-Altman plots showed good repeatability for tumor TSC measurements between coils, with a reproducibility coefficient of 9 mM; the coefficient of variation between the coils was 12%. The Pearson correlation coefficient for TSC between coils for all measurements was r = 0.71 (r2 = 0.51), indicating a strong positive linear relationship. The mean TSC within PZ tumors was significantly higher compared with normal PZ for both the 23 Na coil (45.4 mM; P = 0.02) and the 13 C coil (49.4 mM; P = 0.002). DATA CONCLUSION We demonstrated the feasibility of using a carbon-tuned coil to quantify TSC, enabling dual metabolic information from a single coil. This approach could make the acquisition of both 23 Na-MRI and 13 C-MRI feasible in a single clinical imaging session. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:90-97.
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Affiliation(s)
- Tristan Barrett
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Anne Y Warren
- Department of Histopathology, Cambridge University Hospitals and University of Cambridge, Cambridge, UK
| | - Martin J Graves
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
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46
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de Groot M, Patel N, Manavaki R, Janiczek RL, Bergstrom M, Östör A, Gerlag D, Roberts A, Graves MJ, Karkera Y, Fernando D, Mistry P, Walker A, Wisniacki N, Fryer TD, Jimenez-Royo P. Quantifying disease activity in rheumatoid arthritis with the TSPO PET ligand 18F-GE-180 and comparison with 18F-FDG and DCE-MRI. EJNMMI Res 2019; 9:113. [PMID: 31858293 PMCID: PMC6923307 DOI: 10.1186/s13550-019-0576-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 07/22/2019] [Accepted: 11/15/2019] [Indexed: 02/14/2023] Open
Abstract
Purpose While the aetiology of rheumatoid arthritis (RA) remains unclear, many of the inflammatory components are well characterised. For diagnosis and therapy evaluation, in vivo insight into these processes would be valuable. Various imaging probes have shown value including dynamic contrast-enhanced (DCE) MRI and PET/CT using 18F-fluorodeoxyglucose (18F-FDG) or tracers targeting the translocator protein (TSPO). To evaluate 18F-GE-180, a novel TSPO PET tracer, for detecting and quantifying disease activity in RA, we compared 18F-GE-180 uptake with that of 18F-FDG and DCE-MRI measures of inflammation. Methods Eight RA patients with moderate-to-high, stable disease activity and active disease in at least one wrist were included in this study (NCT02350426). Participants underwent PET/CT examinations with 18F-GE-180 and 18F-FDG on separate visits, covering the shoulders and from the pelvis to the feet, including hands and wrists. DCE-MRI was performed on one affected hand. Uptake was compared visually between tracers as judged by an experienced radiologist and quantitatively using the maximum standardised uptake value (SUVmax). Uptake for both tracers was correlated with DCE-MRI parameters of inflammation, including the volume transfer coefficient Ktrans using Pearson correlation (r). Results PET/CT imaging with 18F-GE-180 in RA patients showed marked extra-synovial uptake around the affected joints. Overall sensitivity for detecting clinically affected joints was low (14%). 18F-GE-180 uptake did not or only weakly correlate with DCE-MRI parameters in the wrist (r = 0.09–0.31). 18F-FDG showed higher sensitivity for detecting symptomatic joints (34%), as well as strong positive correlation with DCE-MRI parameters (SUVmax vs. Ktrans: r = 0.92 for wrist; r = 0.68 for metacarpophalangeal joints). Conclusions The correlations between DCE-MRI parameters and 18F-FDG uptake support use of this PET tracer for quantification of inflammatory burden in RA. The TSPO tracer 18F-GE-180, however, has shown limited use for the investigation of RA due to its poor sensitivity and ability to quantify disease activity in RA.
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Affiliation(s)
- Marius de Groot
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK.,Department of Radiology, University of Cambridge, Cambridge, UK
| | - Neel Patel
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Robert L Janiczek
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Mats Bergstrom
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Andrew Östör
- Monash University, Cabrini Medical Centre, Melbourne, Australia
| | | | - Alexandra Roberts
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Disala Fernando
- Clinical Unit Cambridge (CUC), GlaxoSmithKline R&D, Addenbrooke's Hospital, Cambridge, UK
| | | | - Adam Walker
- Clinical Unit Cambridge (CUC), GlaxoSmithKline R&D, Addenbrooke's Hospital, Cambridge, UK
| | - Nicolas Wisniacki
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Tim D Fryer
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Pilar Jimenez-Royo
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK.
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Riemer F, McHugh D, Zaccagna F, Lewis D, McLean MA, Graves MJ, Gilbert FJ, Parker GJ, Gallagher FA. Measuring tissue sodium concentration: Cross-vendor repeatability and reproducibility of 23 Na-MRI across two sites. J Magn Reson Imaging 2019; 50:1278-1284. [PMID: 30859655 PMCID: PMC6767101 DOI: 10.1002/jmri.26705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 11/27/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sodium MRI (23 Na-MRI)-derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy. PURPOSE To evaluate the repeatability and reproducibility of TSC measurements in the brains of healthy volunteers, providing evidence for the technical validation of 23 Na-MRI-derived biomarkers. STUDY TYPE Prospective multicenter study. SUBJECTS Eleven volunteers (32 ± 6 years; eight males, three females) were scanned twice at each of two sites. FIELD STRENGTH/SEQUENCE Comparable 3D-cones 23 Na-MRI ultrashort echo time acquisitions at 3T. ASSESSMENT TSC values, quantified from calibration phantoms placed in the field of view, were obtained from white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), based on automated segmentation of coregistered 1 H T1 -weighted images and hand-drawn regions of interest by two readers. STATISTICAL TESTS Coefficients of variation (CoVs) from mean TSC values were used to assess intrasite repeatability and intersite reproducibility. RESULTS Mean GM TSC concentrations (52.1 ± 7.1 mM) were ∼20% higher than for WM (41.8 ± 6.7 mM). Measurements were highly repeatable at both sites with mean scan-rescan CoVs between volunteers and regions of 2% and 4%, respectively. Mean intersite reproducibility CoVs were 3%, 3%, and 6% for WM, GM, and CSF, respectively. DATA CONCLUSION These results demonstrate technical validation of sodium MRI-derived biomarkers in healthy volunteers. We also show that comparable 23 Na imaging of the brain can be implemented across different sites and scanners with excellent repeatability and reproducibility. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1278-1284.
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Affiliation(s)
- Frank Riemer
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Damien McHugh
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
- Division of Neuroscience & Experimental PsychologyThe University of ManchesterManchesterUK
| | - Fulvio Zaccagna
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Daniel Lewis
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Mary A. McLean
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUK
| | | | - Fiona J. Gilbert
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Geoff J.M. Parker
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
- Division of Neuroscience & Experimental PsychologyThe University of ManchesterManchesterUK
- Bioxydyn Ltd.ManchesterUK
| | - Ferdia A. Gallagher
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
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Zaccagna F, Riemer F, Priest AN, McLean MA, Allinson K, Grist JT, Dragos C, Matys T, Gillard JH, Watts C, Price SJ, Graves MJ, Gallagher FA. Non-invasive assessment of glioma microstructure using VERDICT MRI: correlation with histology. Eur Radiol 2019; 29:5559-5566. [PMID: 30888488 PMCID: PMC6719328 DOI: 10.1007/s00330-019-6011-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 07/27/2018] [Revised: 11/28/2018] [Accepted: 12/17/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE This prospective study evaluated the use of vascular, extracellular and restricted diffusion for cytometry in tumours (VERDICT) MRI to investigate the tissue microstructure in glioma. VERDICT-derived parameters were correlated with both histological features and tumour subtype and were also used to explore the peritumoural region. METHODS Fourteen consecutive treatment-naïve patients (43.5 years ± 15.1 years, six males, eight females) with suspected glioma underwent diffusion-weighted imaging including VERDICT modelling. Tumour cell radius and intracellular and combined extracellular/vascular volumes were estimated using a framework based on linearisation and convex optimisation. An experienced neuroradiologist outlined the peritumoural oedema, enhancing tumour and necrosis on T2-weighted imaging and contrast-enhanced T1-weighted imaging. The same regions of interest were applied to the co-registered VERDICT maps to calculate the microstructure parameters. Pathology sections were analysed with semi-automated software to measure cellularity and cell size. RESULTS VERDICT parameters were successfully calculated in all patients. The imaging-derived results showed a larger intracellular volume fraction in high-grade glioma compared to low-grade glioma (0.13 ± 0.07 vs. 0.08 ± 0.02, respectively; p = 0.05) and a trend towards a smaller extracellular/vascular volume fraction (0.88 ± 0.07 vs. 0.92 ± 0.04, respectively; p = 0.10). The conventional apparent diffusion coefficient was higher in low-grade gliomas compared to high-grade gliomas, but this difference was not statistically significant (1.22 ± 0.13 × 10-3 mm2/s vs. 0.98 ± 0.38 × 10-3 mm2/s, respectively; p = 0.18). CONCLUSION This feasibility study demonstrated that VERDICT MRI can be used to explore the tissue microstructure of glioma using an abbreviated protocol. The VERDICT parameters of tissue structure correlated with those derived on histology. The method shows promise as a potential test for diagnostic stratification and treatment response monitoring in the future. KEY POINTS • VERDICT MRI is an advanced diffusion technique which has been correlated with histopathological findings obtained at surgery from patients with glioma in this study. • The intracellular volume fraction measured with VERDICT was larger in high-grade tumours compared to that in low-grade tumours. • The results were complementary to measurements from conventional diffusion-weighted imaging, and the technique could be performed in a clinically feasible timescale.
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Affiliation(s)
- Fulvio Zaccagna
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Frank Riemer
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Andrew N Priest
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Kieren Allinson
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James T Grist
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Carmen Dragos
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Tomasz Matys
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jonathan H Gillard
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Colin Watts
- Institute of Cancer and Genomic Sciences, Birmingham Brain Cancer Program, University of Birmingham, Birmingham, UK
| | - Stephen J Price
- Neurosurgery Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Ferdia A Gallagher
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Abstract
Quantitative Susceptibility Mapping (QSM) and Susceptibility Weighted Imaging (SWI) are MRI techniques that measure and display differences in the magnetization that is induced in tissues, i.e. their magnetic susceptibility, when placed in the strong external magnetic field of an MRI system. SWI produces images in which the contrast is heavily weighted by the intrinsic tissue magnetic susceptibility. It has been applied in a wide range of clinical applications. QSM is a further advancement of this technique that requires sophisticated post-processing in order to provide quantitative maps of tissue susceptibility. This review explains the steps involved in both SWI and QSM as well as describing some of their uses in both clinical and research applications.
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Affiliation(s)
- Pascal P R Ruetten
- 1Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan H Gillard
- 1Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- 2Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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50
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Deen SS, Priest AN, McLean MA, Gill AB, Brodie C, Crawford R, Latimer J, Baldwin P, Earl HM, Parkinson C, Smith S, Hodgkin C, Patterson I, Addley H, Freeman S, Moyle P, Jimenez-Linan M, Graves MJ, Sala E, Brenton JD, Gallagher FA. Diffusion kurtosis MRI as a predictive biomarker of response to neoadjuvant chemotherapy in high grade serous ovarian cancer. Sci Rep 2019; 9:10742. [PMID: 31341212 PMCID: PMC6656714 DOI: 10.1038/s41598-019-47195-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/25/2019] [Accepted: 07/11/2019] [Indexed: 02/05/2023] Open
Abstract
This study assessed the feasibility of using diffusion kurtosis imaging (DKI) as a measure of tissue heterogeneity and proliferation to predict the response of high grade serous ovarian cancer (HGSOC) to neoadjuvant chemotherapy (NACT). Seventeen patients with HGSOC were imaged at 3 T and had biopsy samples taken prior to any treatment. The patients were divided into two groups: responders and non-responders based on Response Evaluation Criteria In Solid Tumours (RECIST) criteria. The following imaging metrics were calculated: apparent diffusion coefficient (ADC), apparent diffusion (Dapp) and apparent kurtosis (Kapp). Tumour cellularity and proliferation were quantified using histology and Ki-67 immunohistochemistry. Mean Kapp before therapy was higher in responders compared to non-responders: 0.69 ± 0.13 versus 0.51 ± 0.11 respectively, P = 0.02. Tumour cellularity correlated positively with Kapp (rho = 0.50, P = 0.04) and negatively with both ADC (rho = -0.72, P = 0.001) and Dapp (rho = -0.80, P < 0.001). Ki-67 expression correlated with Kapp (rho = 0.53, P = 0.03) but not with ADC or Dapp. In conclusion, Kapp was found to be a potential predictive biomarker of NACT response in HGSOC, which suggests that DKI is a promising clinical tool for use oncology and radiology that should be evaluated further in future larger studies.
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Affiliation(s)
- Surrin S Deen
- Department of Radiology, Box 218, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom.
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom.
| | - Andrew N Priest
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Andrew B Gill
- Department of Radiology, Box 218, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Cara Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Robin Crawford
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - John Latimer
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Peter Baldwin
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Helena M Earl
- Department of Radiology, Box 218, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Christine Parkinson
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Sarah Smith
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Charlotte Hodgkin
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Ilse Patterson
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Helen Addley
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Susan Freeman
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Penny Moyle
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Mercedes Jimenez-Linan
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Martin J Graves
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Evis Sala
- Department of Radiology, Box 218, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - James D Brenton
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Ferdia A Gallagher
- Department of Radiology, Box 218, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
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