Disposable point-of-care portable perfusion phantom for quantitative DCE-MRI

PURPOSE

To develop a disposable point-of-care portable perfusion phantom (DP4) and validate its clinical utility in a multi-institutional setting for quantitative dynamic contrast-enhanced magnetic resonance imaging (qDCE-MRI).

METHODS

The DP4 phantom was designed for single-use and imaged concurrently with a human subject so that the phantom data can be utilized as the reference to detect errors in qDCE-MRI measurement of human tissues. The change of contrast-agent concentration in the phantom was measured using liquid chromatography-mass spectrometry. The repeatability of the contrast enhancement curve (CEC) was assessed with five phantoms in a single MRI scanner. Five healthy human subjects were recruited to evaluate the reproducibility of qDCE-MRI measurements. Each subject was imaged concurrently with the DP4 phantom at two institutes using three 3T MRI scanners from three different vendors. Pharmacokinetic (PK) parameters in the regions of liver, spleen, pancreas, and paravertebral muscle were calculated based on the Tofts model (TM), extended Tofts model (ETM), and shutter speed model (SSM). The reproducibility of each PK parameter over three measurements was evaluated with the intraclass correlation coefficient (ICC) and compared before and after DP4-based error correction.

RESULTS

The contrast-agent concentration in the DP4 phantom was linearly increased over 10 min (0.17 mM/min, measurement accuracy: 96%) after injecting gadoteridol (100 mM) at a constant rate (0.24 ml/s, 4 ml). The repeatability of the CEC within the phantom was 0.997 when assessed by the ICC. The reproducibility of the volume transfer constant, K^trans , was the highest of the PK parameters regardless of the PK models. The ICCs of K^trans in the TM, ETM, and SSM before DP4-based error correction were 0.34, 0.39, and 0.72, respectively, while those increased to 0.93, 0.98, and 0.86, respectively, after correction.

CONCLUSIONS

The DP4 phantom is reliable, portable, and capable of significantly improving the reproducibility of qDCE-MRI measurements.

Abstract 1711: Mechanical strain induces phenotypic changes in breast cancer cells and promotes immunosuppression in the tumor microenvironment

Introduction: Breast cancer (BCa) occurs with a complex, three-dimensional microenvironment that involves heterogeneous biochemical and biophysical cues. Understanding how mechanical properties within the tumor microenvironment (TME) regulate breast cancer phenotype and immunosuppression is of great interest.

Materials and Methods: BCa cells (MCF-7, MDA-MB-231 or 4T1.2) cultured to confluence on collagen coated FlexCell culture plates were subjected to 10% uniaxial cyclic/oscillatory strain at 0.3 Hz, or 10% constant strain, or no strain for 48 hours. They were isolated for analysis of proliferation (MTT assay and cell count by trypan blue), and migration (transwell and wound healing assay). Exosomes from conditioned media were isolated by differential centrifugation or using the Total Exosome Isolation kit. The purified exosomes were quantified by NanoSight and characterized by ImageStream. 5 × 105 4T1.2 cells or PKH67-labeled strained or control cells were injected into the mammary fat pad of BALB/c mice. Tumor volume was measured at the indicated time points after injection. Tumor-infiltrating immune cells and the internalization of exosomes were analyzed by flow cytometry on day 14 post implantation. In some experiments, on day 6 after tumor injection, 7.5 × 108 PHK67-labeled tumor cell-derived exosomes or PBS were injected into the tumor nodule. Tumor tissues were harvested for analysis of the internalization of exosomes by immune cells and tumor cells on days 2 and 8 after exosome injection.

Results: We show that mechanical strain enhanced the proliferation and migration of BCa cells in vitro. Exosome concentrations produced by triple negative breast cancer (TNBC) cells were increased following exposure to oscillatory strain. Phenotyping exosomes by ImageStream showed that the percentages of CD81+PD-L1+ and CD63+PD-L1+ exosomes were increased after exposure to oscillatory strain. Using a syngeneic orthotopic mouse model of TNBC, we showed that preconditioning with mechanical strain increased tumor growth. The percentages of tumor-infiltrating monocytic myeloid-derived suppressor cells (M-MDSC) and recruited macrophages were increased while CD8+ T cells decreased in the TME of mice implanted with 4T1.2 cells preconditioned with oscillatory strain. Further, exosome internalizations by M-MDSC and recruited macrophages were elevated when tumor cells were preconditioned with oscillatory strain. Moreover, exosomes internalization by immune cells and tumor cells in TME were identified by PKH67 positive signals on days 2 and 8 after injection of PKH67-labeled exosomes into tumor nodules by flow cytometry analyses and confocal microscope imaging.

Conclusions: Our data indicate that exposure to mechanical strain promotes invasive and pro-tumorigenic phenotypes in BCa, alters exosome production by BCa and induces immunosuppression in the TME.

Citation Format: Yong Wang, Kayla F. Goliwas, Paige E. Severino, Kenneth Hough, Derek Van Vessem, Hong Wang, Sultan Tousif, Roy P. Koomullil, Andra R. Frost, Selvarangan Ponnazhagen, Joel L. Berry, Jessy S. Deshane. Mechanical strain induces phenotypic changes in breast cancer cells and promotes immunosuppression in the tumor microenvironment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1711.

Assessment of Surgical Effects on Patients with Obstructive Sleep Apnea Syndrome Using Computational Fluid Dynamics Simulations

Obstructive sleep apnea syndrome is one of the most common sleep disorders. To treat patients with this health problem, it is important to detect the severity of this syndrome and occlusion sites in each patient. The goal of this study is to test the hypothesis that the cure of obstructive sleep apnea syndrome by maxillomandibular advancement surgery can be predicted by analyzing the effect of anatomical airway changes on the pressure effort required for normal breathing using a high-fidelity, 3-D numerical model. The employed numerical model consists of: 1) 3-D upper airway geometry construction from patient-specific computed tomographic scans using an image segmentation technique, 2) mixed-element mesh generation of the numerically constructed airway geometry for discretizing the domain of interest, and 3) computational fluid dynamics simulations for predicting the flow field within the airway and the degree of severity of breathing obstruction. In the present study, both laminar and turbulent flow simulations were performed to predict the flow field in the upper airway of the selected patients before and after maxillomandibular advancement surgery. Patients of different body mass indices were also studied to assess their effects. The numerical results were analyzed to evaluate the pressure gradient along the upper airway. The magnitude of the pressure gradient is regarded as the pressure effort required for breathing, and the extent of reduction of the pressure effort is taken to measure the success of the surgery. The description of the employed numerical model, numerical results from simulations of various patients, and suggestion for future work are detailed in this paper.

Patient-Specific Geometry Modeling and Mesh Generation for Simulating Obstructive Sleep Apnea Syndrome Cases by Maxillomandibular Advancement

The objective of this paper is the reconstruction of upper airway geometric models as hybrid meshes from clinically used Computed Tomography (CT) data sets in order to understand the dynamics and behaviors of the pre- and postoperative upper airway systems of Obstructive Sleep Apnea Syndrome (OSAS) patients by viscous Computational Fluid Dynamics (CFD) simulations. The selection criteria for OSAS cases studied are discussed because two reasonable pre- and postoperative upper airway models for CFD simulations may not be created for every case without a special protocol for CT scanning. The geometry extraction and manipulation methods are presented with technical barriers that must be overcome so that they can be used along with computational simulation software as a daily clinical evaluation tool. Eight cases are presented in this paper, and each case consists of pre- and postoperative configurations. The results of computational simulations of two cases are included in this paper as demonstration.