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Akiyama S, Sakamoto T, Kobayashi M, Matsubara D, Tsuchiya K. Clinical usefulness of hypoxia imaging colonoscopy for the objective measurement of ulcerative colitis disease activity. Gastrointest Endosc 2024; 99:1006-1016.e4. [PMID: 38184118 DOI: 10.1016/j.gie.2023.12.035] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND AIMS Colonic mucosal hypoxia is associated with mucosal inflammation in ulcerative colitis (UC). We aimed to assess the clinical usefulness of hypoxia imaging colonoscopy for the evaluation of clinical, endoscopic, and histologic disease activities of UC. METHODS This retrospective cohort study comprised 100 consecutive patients with UC who underwent hypoxia imaging colonoscopy between September 2022 and September 2023 at the University of Tsukuba Hospital. Colonic tissue oxygen saturation (StO2) was measured at the biopsy sites, and StO2 values between different disease activities were compared. Receiver-operating characteristic (ROC) analysis was used to calculate the area under the ROC curve (AUROC). RESULTS A significant correlation was identified between rectal StO2 and the Simple Clinical Colitis Activity Index, with moderate accuracy to predict bowel urgency at a 40.5% cutoff (AUROC, .74; 95% confidence interval [CI], .62-.87). Our analysis of 490 images showed median StO2 values for Mayo endoscopic subscores 0, 1, 2, and 3 as 52% (interquartile range [IQR], 48%-56%), 47% (IQR, 43%-52%), 42% (IQR, 38.8%-47%), and 39.5% (IQR, 37.3%-41.8%), respectively. Differences for all pairs were significant. Median StO2 was 49% (IQR, 44%-54%) for Geboes scores 0 to 2, significantly higher than histologically active disease (Geboes score ≥3). At a colonic StO2 cutoff of 45.5%, AUROCs for endoscopically and histologically active diseases were .79 (95% CI, .74-.84) and .72 (95% CI, .66-.77). CONCLUSIONS StO2 obtained by hypoxia imaging colonoscopy is useful for assessing clinical, endoscopic, and histologic activities of UC, suggesting that StO2 may be a novel and objective endoscopic measurement.
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Affiliation(s)
- Shintaro Akiyama
- Department of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Taku Sakamoto
- Department of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Mariko Kobayashi
- Department of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Daisuke Matsubara
- Department of Pathology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kiichiro Tsuchiya
- Department of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Pantel AR, Bae SW, Li EJ, O'Brien SR, Manning HC. PET Imaging of Metabolism, Perfusion, and Hypoxia: FDG and Beyond. Cancer J 2024; 30:159-169. [PMID: 38753750 PMCID: PMC11101148 DOI: 10.1097/ppo.0000000000000716] [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] [Indexed: 05/18/2024]
Abstract
ABSTRACT Imaging glucose metabolism with [18F]fluorodeoxyglucose positron emission tomography has transformed the diagnostic and treatment algorithms of numerous malignancies in clinical practice. The cancer phenotype, though, extends beyond dysregulation of this single pathway. Reprogramming of other pathways of metabolism, as well as altered perfusion and hypoxia, also typifies malignancy. These features provide other opportunities for imaging that have been developed and advanced into humans. In this review, we discuss imaging metabolism, perfusion, and hypoxia in cancer, focusing on the underlying biology to provide context. We conclude by highlighting the ability to image multiple facets of biology to better characterize cancer and guide targeted treatment.
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Affiliation(s)
- Austin R Pantel
- From the Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Seong-Woo Bae
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth J Li
- From the Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Sophia R O'Brien
- From the Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - H Charles Manning
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
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Noble RMN, Kirschenman R, Wiedemeyer A, Patel V, Rachid JJ, Zemp RJ, Davidge ST, Bourque SL. Use of Photoacoustic Imaging to Study the Effects of Anemia on Placental Oxygen Saturation in Normoxic and Hypoxic Conditions. Reprod Sci 2024; 31:966-974. [PMID: 38012522 DOI: 10.1007/s43032-023-01395-6] [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: 07/07/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
We aimed to evaluate fetal and placental oxygen saturation (sO2) in anemic and non-anemic pregnant rats throughout gestation using photoacoustic imaging (PAI). Female Sprague-Dawley rats were fed an iron-restricted or iron-replete diet before and during pregnancy. On gestational days 13, 18, and 21, PAI was coupled with high resolution ultrasound to measure oxygenation of the fetus, whole placenta, mesometrial triangle, as well as the maternal and fetal faces of the placenta. PAI was performed in 3D, which allowed sO2 to be measured within an entire region, as well as in 2D, which enabled sO2 measurements in response to a hypoxic event in real time. Both 3D and 2D PAI were performed at varying levels of FiO2 (fraction of inspired oxygen). Iron restriction caused anemia in dams and fetuses, a reduction in fetal body weight, and an increase in placental weight, but overall had minimal effects on sO2. Reductions in FiO2 caused corresponding reductions in sO2 which correlated to the severity of the hypoxic challenge. Regional differences in sO2 were evident within the placenta and between the placenta and fetus. In conclusion, PAI enables non-invasive measurement of sO2 both rapidly and with a high degree of sensitivity. The lack of overt changes in sO2 levels between control and anemic fetuses may suggest reduced oxygen extraction and utilization in the latter group, which could be attributed to compensatory changes in growth and developmental trajectories.
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Affiliation(s)
- Ronan M N Noble
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Raven Kirschenman
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - Alyssa Wiedemeyer
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Vaishvi Patel
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Jad-Julian Rachid
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Roger J Zemp
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
| | - Sandra T Davidge
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
- Department of Physiology, University of Alberta, Edmonton, AB, Canada
| | - Stephane L Bourque
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada.
- Cardiovascular Research Institute, University of Alberta, Edmonton, AB, Canada.
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
- Department of Physiology, University of Alberta, Edmonton, AB, Canada.
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada.
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Kepes Z, Hegedus E, Sass T, Csikos C, Szabo JP, Szugyiczki V, Hajdu I, Kertesz I, Opposits G, Imrek J, Balkay L, Kalman FK, Trencsenyi G. Concomitant [ 18F]F-FAZA and [ 18F]F-FDG Imaging of Gynecological Cancer Xenografts: Insight into Tumor Hypoxia. In Vivo 2024; 38:574-586. [PMID: 38418132 PMCID: PMC10905447 DOI: 10.21873/invivo.13476] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Herein we assessed the feasibility of imaging protocols using both hypoxia-specific [18F]F-FAZA and [18F]F-FDG in bypassing the limitations derived from the non-specific findings of [18F]F-FDG PET imaging of tumor-related hypoxia. MATERIALS AND METHODS CoCl2-generated hypoxia was induced in multidrug resistant (Pgp+) or sensitive (Pgp-) human ovarian (Pgp- A2780, Pgp+ A2780AD), and cervix carcinoma (Pgp- KB-3-1, Pgp+ KB-V-1) cell lines to establish corresponding tumor-bearing mouse models. Prior to [18F]F-FDG/[18F]F-FAZA-based MiniPET imaging, in vitro [18F]F-FDG uptake measurements and western blotting were used to verify the presence of hypoxia. RESULTS Elevated GLUT-1, and hexokinase enzyme-II expression driven by CoCl2-induced activation of hypoxia-inducible factor-1α explains enhanced cellular [18F]F-FDG accumulation. No difference was observed in the [18F]F-FAZA accretion of Pgp+ and Pgp- tumors. Tumor-to-muscle ratios for [18F]F-FAZA measured at 110-120 min postinjection (6.2±0.1) provided the best contrasted images for the delineation of PET-oxic and PET-hypoxic intratumor regions. Although all tumors exhibited heterogenous uptake of both radiopharmaceuticals, greater differences for [18F]F-FAZA between the tracer avid and non-accumulating regions indicate its superiority over [18F]F-FDG. Spatial correlation between [18F]F-FGD and [18F]F-FAZA scans confirms that hypoxia mostly occurs in regions with highly active glucose metabolism. CONCLUSION The addition of [18F]F-FAZA PET to [18F]F-FGD imaging may add clinical value in determining hypoxic sub-regions.
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Affiliation(s)
- Zita Kepes
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary;
| | - Eva Hegedus
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamas Sass
- Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csaba Csikos
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Gyula Petrányi Doctoral School of Clinical Immunology and Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit P Szabo
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Viktoria Szugyiczki
- Department of Nuclear Medicine, Békés County Pándy Kálmán Hospital, Semmelweis, Hungary
| | - István Hajdu
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Istvan Kertesz
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabor Opposits
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Jozsef Imrek
- Institute of Physics, University of Debrecen, Debrecen, Hungary
| | - Laszlo Balkay
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Gyorgy Trencsenyi
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Sakamoto DM, Tamura I, Yi B, Hasegawa S, Saito Y, Yamada N, Takakusagi Y, Kubota SI, Kobayashi M, Harada H, Hanaoka K, Taki M, Nangaku M, Tainaka K, Sando S. Whole-Body and Whole-Organ 3D Imaging of Hypoxia Using an Activatable Covalent Fluorescent Probe Compatible with Tissue Clearing. ACS Nano 2024; 18:5167-5179. [PMID: 38301048 DOI: 10.1021/acsnano.3c12716] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Elucidation of biological phenomena requires imaging of microenvironments in vivo. Although the seamless visualization of in vivo hypoxia from the level of whole-body to single-cell has great potential to discover unknown phenomena in biological and medical fields, no methodology for achieving it has been established thus far. Here, we report the whole-body and whole-organ imaging of hypoxia, an important microenvironment, at single-cell resolution using activatable covalent fluorescent probes compatible with tissue clearing. We initially focused on overcoming the incompatibility of fluorescent dyes and refractive index matching solutions (RIMSs), which has greatly hindered the development of fluorescent molecular probes in the field of tissue clearing. The fluorescent dyes compatible with RIMS were then incorporated into the development of activatable covalent fluorescent probes for hypoxia. We combined the probes with tissue clearing, achieving comprehensive single-cell-resolution imaging of hypoxia in a whole mouse body and whole organs.
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Affiliation(s)
- Daichi M Sakamoto
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Iori Tamura
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Bo Yi
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Sho Hasegawa
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
| | - Yutaro Saito
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Naoki Yamada
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Yoichi Takakusagi
- Quantum Hyperpolarized MRI Team, Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage, Chiba-city 263-8555, Japan
- Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage, Chiba-city 263-8555, Japan
| | - Shimpei I Kubota
- Division of Molecular Psychoimmunology, Institute for Genetic Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Minoru Kobayashi
- Laboratory of Cancer Cell Biology, Graduate School of Biostudies, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
- Department of Genome Dynamics, Radiation Biology Center, Graduate School of Biostudies, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hiroshi Harada
- Laboratory of Cancer Cell Biology, Graduate School of Biostudies, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
- Department of Genome Dynamics, Radiation Biology Center, Graduate School of Biostudies, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Kenjiro Hanaoka
- Division of Analytical Chemistry for Drug Discovery, Graduate School of Pharmaceutical Sciences, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Masayasu Taki
- Institute of Transformative Bio-Molecules, Nagoya University, Furo, Chikusa, Nagoya 464-8601, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
| | - Kazuki Tainaka
- Department of System Pathology for Neurological Disorders, Brain Research Institute, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata 951-8585, Japan
- Gftd DeSci, Gftd DAO, Nishikawa Building, 20 Kikuicho, Shinjuku-ku, Tokyo 162-0044, Japan
| | - Shinsuke Sando
- Department of Chemistry and Biotechnology, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
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Busana M, Rau A, Lazzari S, Gattarello S, Cressoni M, Biggemann L, Harnisch LO, Giosa L, Vogt A, Saager L, Lotz J, Meller B, Meissner K, Gattinoni L, Moerer O. Causes of Hypoxemia in COVID-19 Acute Respiratory Distress Syndrome: A Combined Multiple Inert Gas Elimination Technique and Dual-energy Computed Tomography Study. Anesthesiology 2024; 140:251-260. [PMID: 37656772 DOI: 10.1097/aln.0000000000004757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
BACKGROUND Despite the fervent scientific effort, a state-of-the art assessment of the different causes of hypoxemia (shunt, ventilation-perfusion mismatch, and diffusion limitation) in COVID-19 acute respiratory distress syndrome (ARDS) is currently lacking. In this study, the authors hypothesized a multifactorial genesis of hypoxemia and aimed to measure the relative contribution of each of the different mechanism and their relationship with the distribution of tissue and blood within the lung. METHODS In this cross-sectional study, the authors prospectively enrolled 10 patients with COVID-19 ARDS who had been intubated for less than 7 days. The multiple inert gas elimination technique (MIGET) and a dual-energy computed tomography (DECT) were performed and quantitatively analyzed for both tissue and blood volume. Variables related to the respiratory mechanics and invasive hemodynamics (PiCCO [Getinge, Sweden]) were also recorded. RESULTS The sample (51 ± 15 yr; Pao2/Fio2, 172 ± 86 mmHg) had a mortality of 50%. The MIGET showed a shunt of 25 ± 16% and a dead space of 53 ± 11%. Ventilation and perfusion were mismatched (LogSD, Q, 0.86 ± 0.33). Unexpectedly, evidence of diffusion limitation or postpulmonary shunting was also found. In the well aerated regions, the blood volume was in excess compared to the tissue, while the opposite happened in the atelectasis. Shunt was proportional to the blood volume of the atelectasis (R2 = 0.70, P = 0.003). V˙A/Q˙T mismatch was correlated with the blood volume of the poorly aerated tissue (R2 = 0.54, P = 0.016). The overperfusion coefficient was related to Pao2/Fio2 (R2 = 0.66, P = 0.002), excess tissue mass (R2 = 0.84, P < 0.001), and Etco2/Paco2 (R2 = 0.63, P = 0.004). CONCLUSIONS These data support the hypothesis of a highly multifactorial genesis of hypoxemia. Moreover, recent evidence from post-mortem studies (i.e., opening of intrapulmonary bronchopulmonary anastomosis) may explain the findings regarding the postpulmonary shunting. The hyperperfusion might be related to the disease severity. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Mattia Busana
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Anna Rau
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Stefano Lazzari
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany; and Institute for Treatment and Research San Raffaele Scientific Institute, Department of Anesthesia and Intensive Care, Milan, Italy
| | - Simone Gattarello
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany; and Institute for Treatment and Research San Raffaele Scientific Institute, Department of Anesthesia and Intensive Care, Milan, Italy
| | - Massimo Cressoni
- Unit of Radiology, Institute for Treatment and Research Policlinico San Donato, Milan, Italy
| | - Lorenz Biggemann
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Lars-Olav Harnisch
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Lorenzo Giosa
- Centre for Human and Applied Physiological Sciences, King's College London, London, United Kingdom
| | - Andreas Vogt
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Leif Saager
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany; and Outcomes Research Consortium, Cleveland, Ohio
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Birgit Meller
- Clinic of Nuclear Medicine, University Medical Center of Göttingen, Göttingen, Germany
| | - Konrad Meissner
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Luciano Gattinoni
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
| | - Onnen Moerer
- Department of Anesthesiology, University Medical Center of Göttingen, Göttingen, Germany
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Okawa KS, Hirasawa T, Okawa S, Fujita M, Ishihara M. Real-time fetal monitoring using photoacoustic measurement of placental oxygen saturation in a rabbit hypoxia model. Placenta 2024; 146:110-119. [PMID: 38241840 DOI: 10.1016/j.placenta.2024.01.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/28/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
INTRODUCTION Ensuring adequate fetal oxygenation is an essential aim of fetal monitoring. The purpose of this study was to establish a basic technique for real-time measurement of blood oxygen saturation of the placenta by photoacoustic (PA) technique as a new fetal monitoring method. METHODS The hypoxia model established in our previous study was applied to 7 pregnant rabbits. Three phases were induced: normal phase, hypoxia phase, and recovery phase. Three methods were simultaneously used for real-time fetal monitoring: fetal heat rate (FHR) monitoring, oxygen saturation (SO2) measurement by near-infrared spectroscopy (SNO2), and placenta SO2 measured by PA technique (SplO2). The maternal hypoxia was assessed by skin SO2 measured by PA technique (SsO2), and arterial blood SO2 by blood gas analysis (SaO2). RESULTS The average of SplO2 in normal phase was 52.6 ± 13.9 %. The averages of SNO2, SSO2, and SplO2 in the seven rabbits changed in parallel from the normal phase to hypoxia phase. In the recovery phase, the SplO2 rose in parallel with recovery of SaO2. There was lag in increase of the FHR compared to the change in the other values. In the detailed analysis of PA signals from the labyrinth and decidua, a unique change in oxygen saturation was seen in one case. DISCUSSION Results of this study showed that sensitivity of our novel PA technique in detecting tissue hypoxia was similar to near-infrared spectroscopy (NIRS). As an advantage, unlike NIRS, monitoring with PA technique was unaffected by ischemia and surface changes in oxygen saturation because of its higher spatial resolution. We conclude that PA technique provides more accurate information about fetal blood placenta than NIRS. Ultrasound imaging, combined with oxygen saturation monitoring by PA technique, would improve fetal monitoring and fetal diagnosis in the future.
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Affiliation(s)
- Kiguna Sei Okawa
- Department of Obstetrics and Gynecology, Seirei Hamamatsu Hospital, 2-12-12 Sumiyoshi, Chuuou-ku, Hamamatsu, Shizuoka, Japan.
| | - Takeshi Hirasawa
- Department of Medical Engineering, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, Japan
| | - Shinpei Okawa
- Institute for Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan
| | - Masanori Fujita
- Division of Environmental Medicine, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa, Saitama, Japan
| | - Miya Ishihara
- Department of Medical Engineering, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, Japan
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Han HJ, Lee J, Kim Y. An unusual cause of positional hypoxaemia: platypnoea-orthodeoxia syndrome associated with patent foramen ovale and ascending aortic dilatation. Eur Heart J Cardiovasc Imaging 2024; 25:e96. [PMID: 37852090 DOI: 10.1093/ehjci/jead267] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Hyo Jin Han
- Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Republic of Korea
| | - Jayeon Lee
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Republic of Korea
| | - Yisik Kim
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Republic of Korea
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9
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Hirata K, Watanabe S, Kitagawa Y, Kudo K. A Review of Hypoxia Imaging Using 18F-Fluoromisonidazole Positron Emission Tomography. Methods Mol Biol 2024; 2755:133-140. [PMID: 38319574 DOI: 10.1007/978-1-0716-3633-6_9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Tumor hypoxia is an essential factor related to malignancy, prognosis, and resistance to treatment. Positron emission tomography (PET) is a modality that visualizes the distribution of radiopharmaceuticals administered into the body. PET imaging with [18F]fluoromisonidazole ([18F]FMISO) identifies hypoxic tissues. Unlike [18F]fluorodeoxyglucose ([18F]FDG)-PET, fasting is not necessary for [18F]FMISO-PET, but the waiting time from injection to image acquisition needs to be relatively long (e.g., 2-4 h). [18F]FMISO-PET images can be displayed on an ordinary commercial viewer on a personal computer (PC). While visual assessment is fundamental, various quantitative indices such as tumor-to-muscle ratio have also been proposed. Several novel hypoxia tracers have been invented to compensate for the limitations of [18F]FMISO.
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Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
- Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan.
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
| | - Shiro Watanabe
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshimasa Kitagawa
- Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
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10
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Salvas JP, Leyba KA, Schepers LE, Paiyabhroma N, Goergen CJ, Sicard P. Neurovascular Hypoxia Trajectories Assessed by Photoacoustic Imaging in a Murine Model of Cardiac Arrest and Resuscitation. IEEE Trans Ultrason Ferroelectr Freq Control 2023; 70:1661-1670. [PMID: 37043326 DOI: 10.1109/tuffc.2023.3265800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Cardiac arrest is a common cause of death annually mainly due to postcardiac arrest syndrome that leads to multiple organ global hypoxia and dysfunction after resuscitation. The ability to quantify vasculature changes and tissue oxygenation is crucial to adapt patient treatment in order to minimize major outcomes after resuscitation. For the first time, we applied high-resolution ultrasound associated with photoacoustic imaging (PAI) to track neurovascular oxygenation and cardiac function trajectories in a murine model of cardiac arrest and resuscitation. We report the preservation of brain oxygenation is greater compared to that in peripheral tissues during the arrest. Furthermore, distinct patterns of cerebral oxygen decay may relate to the support of vital brain functions. In addition, we followed trajectories of cerebral perfusion and cardiac function longitudinally after induced cardiac arrest and resuscitation. Volumetric cerebral oxygen saturation (sO2) decreased 24 h postarrest, but these levels rebounded at one week. However, systolic and diastolic cardiac dysfunction persisted throughout and correlated with cerebral hypoxia. Pathophysiologic biomarker trends, identified via cerebral PAI in preclinical models, could provide new insights into understanding the pathophysiology of cardiac arrest and resuscitation.
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11
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Karan S, Cho MY, Lee H, Kim HM, Park HS, Han EH, Sessler JL, Hong KS. Hypoxia-Directed and Self-Immolative Theranostic Agent: Imaging and Treatment of Cancer and Bacterial Infections. J Med Chem 2023; 66:14175-14187. [PMID: 37823731 PMCID: PMC10614179 DOI: 10.1021/acs.jmedchem.3c01274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/13/2023] [Indexed: 10/13/2023]
Abstract
The impact of bacteria on cancer progression and treatment is becoming increasingly recognized. Cancer-associated bacteria are linked to metastases, reduced efficacy, and survival challenges. In this study, we present a sensitive hypoxia-activated prodrug, NR-NO2, which comprises an antibiotic combined with a chemotherapeutic. This prodrug demonstrates rapid and robust fluorescence enhancement and exhibits potent antibacterial activity against both Gram-positive and Gram-negative bacteria as well as tumor cells. Upon activation, NR-NO2 produces a distinct "fluorescence-on" signal, enabling real-time drug release monitoring. By leveraging elevated nitroreductase in cancer cells, NR-NO2 gives rise to heightened bacterial cytotoxicity while sparing normal cells. In A549 solid tumor-bearing mice, NR-NO2 selectively accumulated at tumor sites, displaying fluorescence signals under hypoxia superior to those of a corresponding prodrug-like control. These findings highlight the potential of NR-NO2 as a promising cancer therapy prodrug that benefits from targeted release, antibacterial impact, and imaging-based guidance.
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Affiliation(s)
- Sanu Karan
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Mi Young Cho
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Hyunseung Lee
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Hyun Min Kim
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Hye Sun Park
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Eun Hee Han
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
| | - Jonathan L. Sessler
- Department
of Chemistry, The University of Texas at
Austin, Austin, Texas 78712-1224, United States
| | - Kwan Soo Hong
- Research
Center for Bioconvergence Analysis, Korea
Basic Science Institute, Cheongju 28119, Republic
of Korea
- Graduate
School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Republic of Korea
- Department
of Chemistry, Chung-Ang University, Seoul 06974, Republic of Korea
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12
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Campos JH. Hypoxemia May Occur After Endobronchial Valve Deployment-The Mechanism Is Speculative at Present. J Cardiothorac Vasc Anesth 2023; 37:2116-2118. [PMID: 37633740 DOI: 10.1053/j.jvca.2023.05.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 08/28/2023]
Affiliation(s)
- Javier H Campos
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa.
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13
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Mittal S, Mallia MB. Molecular imaging of tumor hypoxia: Evolution of nitroimidazole radiopharmaceuticals and insights for future development. Bioorg Chem 2023; 139:106687. [PMID: 37406518 DOI: 10.1016/j.bioorg.2023.106687] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
Though growing evidence has been collected in support of the concept of dose escalation based on the molecular level images indicating hypoxic tumor sub-volumes that could be radio-resistant, validation of the concept is still a work in progress. Molecular imaging of tumor hypoxia using radiopharmaceuticals is expected to provide the required input to plan dose escalation through Image Guided Radiation Therapy (IGRT) to kill/control the radio-resistant hypoxic tumor cells. The success of the IGRT, therefore, is heavily dependent on the quality of images obtained using the radiopharmaceutical and the extent to which the image represents the true hypoxic status of the tumor in spite of the heterogeneous nature of tumor hypoxia. Available literature on radiopharmaceuticals for imaging hypoxia is highly skewed in favor of nitroimidazole as the pharmacophore given their ability to undergo oxygen dependent reduction in hypoxic cells. In this context, present review on nitroimidazole radiopharmaceuticals would be immensely helpful to the researchers to obtain a birds-eye view on what has been achieved so far and what can be tried differently to obtain a better hypoxia imaging agent. The review also covers various methods of radiolabeling that could be utilized for developing radiotracers for hypoxia targeting applications.
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Affiliation(s)
- Sweety Mittal
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai 400085, India.
| | - Madhava B Mallia
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India.
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14
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Minakawa M, Wares MA, Nakano K, Haneishi H, Aizu Y, Hayasaki Y, Ikeda T, Nagahara H, Nishidate I. Measuring and imaging of transcutaneous bilirubin, hemoglobin, and melanin based on diffuse reflectance spectroscopy. J Biomed Opt 2023; 28:107001. [PMID: 37915398 PMCID: PMC10616887 DOI: 10.1117/1.jbo.28.10.107001] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/19/2023] [Accepted: 10/13/2023] [Indexed: 11/03/2023]
Abstract
Significance Evaluation of biological chromophore levels is useful for detection of various skin diseases, including cancer, monitoring of health status and tissue metabolism, and assessment of clinical and physiological vascular functions. Clinically, it is useful to assess multiple different chromophores in vivo with a single technique or instrument. Aim To investigate the possibility of estimating the concentration of four chromophores, bilirubin, oxygenated hemoglobin, deoxygenated hemoglobin, and melanin from diffuse reflectance spectra in the visible region. Approach A new diffuse reflectance spectroscopic method based on the multiple regression analysis aided by Monte Carlo simulations for light transport was developed to quantify bilirubin, oxygenated hemoglobin, deoxygenated hemoglobin, and melanin. Three different experimental animal models were used to induce hyperbilirubinemia, hypoxemia, and melanogenesis in rats. Results The estimated bilirubin concentration increased after ligation of the bile duct and reached around 18 mg / dl at 50 h after the onset of ligation, which corresponds to the reference value of bilirubin measured by a commercially available transcutaneous bilirubin meter. The concentration of oxygenated hemoglobin and that of deoxygenated hemoglobin decreased and increased, respectively, as the fraction of inspired oxygen decreased. Consequently, the tissue oxygen saturation dramatically decreased. The time course of melanin concentration after depilation of skin on the back of rats was indicative of the supply of melanosomes produced by melanocytes of hair follicles to the growing hair shaft. Conclusions The results of our study showed that the proposed method is capable of the in vivo evaluation of percutaneous bilirubin level, skin hemodynamics, and melanogenesis in rats, and that it has potential as a tool for the diagnosis and management of hyperbilirubinemia, hypoxemia, and pigmented skin lesions.
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Affiliation(s)
- Masafumi Minakawa
- Tokyo University of Agriculture and Technology, Graduate School of Bio-Applications and Systems Engineering, Tokyo, Japan
| | - Md. Abdul Wares
- Government of Bangladesh, Ministry of Fisheries and Livestock, Department of Livestock Services, Dhaka, Bangladesh
| | - Kazuya Nakano
- Seikei University, Department of Science and Technology, Faculty of Science and Technology, Tokyo, Japan
| | - Hideaki Haneishi
- Chiba University, Center for Frontier Medical Engineering, Chiba, Japan
| | - Yoshihisa Aizu
- Muroran Institute of Technology, College of Design and Manufacturing Technology, Hokkaido, Japan
| | - Yoshio Hayasaki
- Utsunomiya University, Center for Optical Research and Education, Tochigi, Japan
| | - Tetsuo Ikeda
- Fukuoka Dental College, Section of General Surgery, Division of Oral and Medical Management, Department of Medicine, Fukuoka, Japan
| | - Hajime Nagahara
- Osaka University, Institute for Datability Science, Osaka, Japan
| | - Izumi Nishidate
- Tokyo University of Agriculture and Technology, Graduate School of Bio-Applications and Systems Engineering, Tokyo, Japan
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15
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Banerjee R, Wang V, Huang CY, Pandita D, Leonard MK, LaRue S, Ahmadi M, Kaplan L, Ai WZ, Fakhri B, Spinner M, Seshadri MR, Pampaloni MH, Andreadis CB. Hypoxia-specific imaging in patients with lymphoma undergoing CAR-T therapy. Eur J Nucl Med Mol Imaging 2023; 50:3349-3353. [PMID: 37300573 PMCID: PMC10853015 DOI: 10.1007/s00259-023-06296-z] [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: 03/24/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Intratumoral hypoxia in non-Hodgkin's Lymphoma (NHL) may interfere with chimeric antigen receptor T-cell (CAR-T) function. We conducted a single-center pilot study (clinicaltrials.gov ID NCT04409314) of [18F]fluoroazomycin arabinoside, a hypoxia-specific radiotracer abbreviated as [18F]FAZA, to assess the feasibility of this positron emission tomography (PET) imaging modality in this population. METHODS Patients with relapsed NHL being evaluated for CAR-T therapy received a one-time [18F]FAZA PET scan before pre-CAR-T lymphodepletion. A tumor to mediastinum (T/M) ratio of 1.2 or higher with regard to [18F]FAZA uptake was defined as positive for intratumoral hypoxia. We planned to enroll 30 patients with an interim futility analysis after 16 scans. RESULTS Of 16 scanned patients, 3 had no evidence of disease by standard [18F]fluorodeoxyglucose PET imaging before CAR-T therapy. Six patients (38%) had any [18F]FAZA uptake above background. Using a T/M cutoff of 1.20, only one patient (a 68-year-old male with relapsed diffuse large B-cell lymphoma) demonstrated intratumoral hypoxia in an extranodal chest wall lesion (T/M 1.35). Interestingly, of all 16 scanned patients, he was the only patient with progressive disease within 1 month of CAR-T therapy. However, because of our low overall proportion of positive scans, our study was stopped for futility. CONCLUSIONS Our pilot study identified low-level [18F]FAZA uptake in a small number of patients with NHL receiving CAR-T therapy. The only patient who met our pre-specified threshold for intratumoral hypoxia was also the only patient with early CAR-T failure. Future plans include exploration of [18F]FAZA in a more selected patient population.
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Affiliation(s)
- Rahul Banerjee
- Division of Medical Oncology, Department of Medicine, University of Washington, 825 Eastlake Ave E, LG-650, Seattle, WA, 98109, USA.
| | - Victoria Wang
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Divita Pandita
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michelle K Leonard
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Siobhan LaRue
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michael Ahmadi
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Lawrence Kaplan
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Weiyun Z Ai
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Bita Fakhri
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michael Spinner
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Madhav Rao Seshadri
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Miguel Hernandez Pampaloni
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Charalambos Babis Andreadis
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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16
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Uchiyama Y, Yamagishi S, Yamaura T, Kanazawa K, Maruyama H. In Vivo Imaging of Tumor Hypoxia by Maintaining Green Fluorescence of 9-Aminoanthracene Under Hypoxic Conditions. Bioorg Med Chem 2023; 91:117407. [PMID: 37421710 DOI: 10.1016/j.bmc.2023.117407] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
In this study, 9-aminoanthracene (9AA) was used as a new fluorescence reagent for the in vivo imaging of tumor hypoxia by taking advantage of the maintenance of its green fluorescence under hypoxic conditions. As 9AA is insoluble in water, polyethylene glycol (PEG)-400 was used to dissolve 9AA in saline. Each organ was successfully stained with 9AA, as observed by green fluorescence using in vivo imaging, following intragastric administration of a 9AA PEG-saline solution in mice. Therefore, the intragastric administration of 9AA can be used for in vivo imaging of normal mice. Tumor hypoxia staining using the 9AA fluorescence method was evaluated by in vivo imaging of mice subcutaneously transplanted with Ehrlich ascites carcinoma cells and compared with conventional pimonidazole (PIMO) staining under hypoxic conditions. The tumor sections were stained with green fluorescence derived from 9AA and the same sections corresponded to hypoxic areas upon immunohistochemical staining with PIMO.
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Affiliation(s)
- Yosuke Uchiyama
- Department of Chemistry, School of Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan.
| | - Shotaro Yamagishi
- Department of Chemistry, School of Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Takahisa Yamaura
- Department of Chemistry, School of Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Kazutoshi Kanazawa
- Department of Chemistry, School of Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Hiroko Maruyama
- Department of Cytopathology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
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17
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Srivastava I, Moitra P, Brent KM, Wang K, Pandit S, Altun E, Pan D. Biodegradable and switchable near-infrared fluorescent probes for hypoxia detection. Nanomedicine (Lond) 2023; 18:1061-1073. [PMID: 37610080 DOI: 10.2217/nnm-2023-0095] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Aims: Among solid tumors, hypoxia is a common characteristic and responsible for chemotherapeutic resistance. Hypoxia-sensitive imaging probes are therefore essential for early tumor detection, growth monitoring and drug-response evaluation. Despite significant efforts, detecting hypoxic oxygen levels remains challenging. Materials & methods: This paper demonstrates the use of an amine-rich carbon dot probe functionalized with an imidazole group that exhibits reversible fluorescence switching in normoxic and hypoxic environments. Results & conclusion: We demonstrate the ability to emit near-infrared light only under hypoxic conditions. The probes are found to be biodegradable in the presence of human digestive enzymes such as lipase. Ex vivo tissue imaging experiments revealed promising near-infrared signals even at a depth of 5 mm for the probe under ex vivo imaging conditions.
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Affiliation(s)
- Indrajit Srivastava
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
| | - Parikshit Moitra
- Department of Nuclear Engineering, The Pennsylvania State University, University Park, PA 16802, USA
| | - Kurtis M Brent
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
| | - Kevin Wang
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
| | - Subhendu Pandit
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
| | - Esra Altun
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
| | - Dipanjan Pan
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Mills Breast Cancer Institute, Carle Foundation Hospital, Urbana, IL 61801, USA
- Department of Nuclear Engineering, The Pennsylvania State University, University Park, PA 16802, USA
- Department of Materials Science and Engineering, The Pennsylvania State University, University Park, PA 16802, USA
- Huck Institutes of the Life Sciences, University Park, PA 16802, USA
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Chen M, Zhou X, Cai H, Li D, Song C, You H, Ma R, Dong Z, Peng Z, Feng ST. Evaluation of Hypoxia in Hepatocellular Carcinoma Using Quantitative MRI: Significances, Challenges, and Advances. J Magn Reson Imaging 2023; 58:12-25. [PMID: 36971442 DOI: 10.1002/jmri.28694] [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: 10/11/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
This review aimed to perform a scoping review of promising MRI methods in assessing tumor hypoxia in hepatocellular carcinoma (HCC). The hypoxic microenvironment and upregulated hypoxic metabolism in HCC are determining factors of poor prognosis, increased metastatic potential, and resistance to chemotherapy and radiotherapy. Assessing hypoxia in HCC is essential for personalized therapy and predicting prognoses. Oxygen electrodes, protein markers, optical imaging, and positron emission tomography can evaluate tumor hypoxia. These methods lack clinical applicability because of invasiveness, tissue depth, and radiation exposure. MRI methods, including blood oxygenation level-dependent, dynamic contrast-enhanced MRI, diffusion-weighted imaging, MRI spectroscopy, chemical exchange saturation transfer MRI, and multinuclear MRI, are promising noninvasive methods that evaluate the hypoxic microenvironment by observing biochemical processes in vivo, which may inform on therapeutic options. This review summarizes the recent challenges and advances in MRI techniques for assessing hypoxia in HCC and highlights the potential of MRI methods for examining the hypoxic microenvironment via specific metabolic substrates and pathways. Although the utilization of MRI methods for evaluating hypoxia in patients with HCC is increasing, rigorous validation is needed in order to translate these MRI methods into clinical use. Due to the limited sensitivity and specificity of current quantitative MRI methods, their acquisition and analysis protocols require further improvement. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Meicheng Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Xiaoqi Zhou
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Huasong Cai
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Di Li
- Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Chenyu Song
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Huayu You
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Ruixia Ma
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Zhi Dong
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Zhenpeng Peng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
| | - Shi-Ting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Province Guangdong, People's Republic of China
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19
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Nabawanuka E, Ameda F, Erem G, Bugeza S, Opoka RO, Kiguli S, Amorut D, Aloroker F, Olupot-Olupot P, Mnjalla H, Mpoya A, Maitland K. Cardiovascular abnormalities in chest radiographs of children with pneumonia, Uganda. Bull World Health Organ 2023; 101:202-210. [PMID: 36865598 PMCID: PMC9948502 DOI: 10.2471/blt.22.288801] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 03/04/2023] Open
Abstract
Objective To describe chest radiograph findings among children hospitalized with clinically diagnosed severe pneumonia and hypoxaemia at three tertiary facilities in Uganda. Methods The study involved clinical and radiograph data on a random sample of 375 children aged 28 days to 12 years enrolled in the Children's Oxygen Administration Strategies Trial in 2017. Children were hospitalized with a history of respiratory illness and respiratory distress complicated by hypoxaemia, defined as a peripheral oxygen saturation (SpO2) < 92%. Radiologists blinded to clinical findings interpreted chest radiographs using standardized World Health Organization method for paediatric chest radiograph reporting. We report clinical and chest radiograph findings using descriptive statistics. Findings Overall, 45.9% (172/375) of children had radiological pneumonia, 36.3% (136/375) had a normal chest radiograph and 32.8% (123/375) had other radiograph abnormalities, with or without pneumonia. In addition, 28.3% (106/375) had a cardiovascular abnormality, including 14.9% (56/375) with both pneumonia and another abnormality. There was no significant difference in the prevalence of radiological pneumonia or of cardiovascular abnormalities or in 28-day mortality between children with severe hypoxaemia (SpO2: < 80%) and those with mild hypoxaemia (SpO2: 80 to < 92%). Conclusion Cardiovascular abnormalities were relatively common among children hospitalized with severe pneumonia in Uganda. The standard clinical criteria used to identify pneumonia among children in resource-poor settings were sensitive but lacked specificity. Chest radiographs should be performed routinely for all children with clinical signs of severe pneumonia because it provides useful information on both cardiovascular and respiratory systems.
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Affiliation(s)
- Eva Nabawanuka
- Department of Radiology, School of Medicine, Makerere University, PO Box 7051, Kampala, Uganda
| | - Faith Ameda
- Department of Radiology, School of Medicine, Makerere University, PO Box 7051, Kampala, Uganda
| | - Geoffrey Erem
- Department of Radiology, School of Medicine, Makerere University, PO Box 7051, Kampala, Uganda
| | - Samuel Bugeza
- Department of Radiology, School of Medicine, Makerere University, PO Box 7051, Kampala, Uganda
| | - RO Opoka
- Department of Paediatrics, School of Medicine, Makerere University, Kampala, Uganda
| | - Sarah Kiguli
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Denis Amorut
- Soroti Regional Referral Hospital, Soroti, Uganda
| | | | | | - Hellen Mnjalla
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ayub Mpoya
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Kathryn Maitland
- Department of Infectious Disease and Institute of Global Health and Innovation, Imperial College, London, England
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20
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Valable S, Toutain J, Divoux D, Chazalviel L, Corroyer-Dulmont A, Chakhoyan A, Guillouet S, Bernaudin M, Barbier EL, Touzani O. Magnetic resonance imaging of hypoxia in acute stroke compared with fluorine-18 fluoromisonidazole-positron emission tomography: A cross-validation study? NMR Biomed 2023; 36:e4858. [PMID: 36285719 DOI: 10.1002/nbm.4858] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 10/07/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
Acute ischemic stroke results in an ischemic core surrounded by a tissue at risk, named the penumbra, which is potentially salvageable. One way to differentiate the tissues is to measure the hypoxia status. The purpose of the current study is to correlate the abnormal brain tissue volume derived from magnetic resonance-based imaging of brain oxygen saturation (St O2 -MRI) to the fluorine-18 fluoromisonidazole ([18 F]FMISO) positron emission tomography (PET) volume for hypoxia imaging validation, and to analyze the ability of St O2 -MRI to depict the different hypoxic tissue types in the acute phase of stroke. In a pertinent model of stroke in the rat, the volume of tissue with decreased St O2 -MRI signal and that with increased uptake of [18 F]FMISO were equivalent and correlated (r = 0.706; p = 0.015). The values of St O2 in the tissue at risk were significantly greater than those quantified in the core of the lesion, and were less than those for healthy tissue (52.3% ± 2.0%; 43.3% ± 1.9%, and 67.9 ± 1.4%, respectively). A threshold value for St O2 of ≈60% as the cut-off for the identification of the tissue at risk was calculated. Tissue volumes with reduced St O2 -MRI correlated with the final lesion (r = 0.964, p < 0.0001). The findings show that the St O2 -MRI approach is sensitive for the detection of hypoxia and for the prediction of the final lesion after stroke. Once validated in acute clinical settings, this approach might be used to enhance the stratification of patients for potential therapeutic interventions.
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Affiliation(s)
- Samuel Valable
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | - Jérôme Toutain
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | - Didier Divoux
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | - Laurent Chazalviel
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | | | - Ararat Chakhoyan
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | - Stéphane Guillouet
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/LDM-TEP group, Caen, France
| | - Myriam Bernaudin
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
| | - Emmanuel L Barbier
- Univ. Grenoble Alpes, Grenoble Institut Neurosciences, Inserm, U1216, Grenoble, France
| | - Omar Touzani
- Normandie-Univ, UNICAEN, CEA, CNRS, GIP CYCERON, ISTCT/CERVOxy group, Caen, France
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21
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Cavuoto MG, Robinson SR, O'Donoghue FJ, Barnes M, Howard ME, Tolson J, Stevens B, Schembri R, Rosenzweig I, Rowe CC, Jackson ML. Associations Between Amyloid Burden, Hypoxemia, Sleep Architecture, and Cognition in Obstructive Sleep Apnea. J Alzheimers Dis 2023; 96:149-159. [PMID: 37742634 DOI: 10.3233/jad-221049] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with an increased risk of amyloid-β (Aβ) burden, the hallmark of Alzheimer's disease, and cognitive decline. OBJECTIVE To determine the differential impacts of hypoxemia and slow-wave sleep disruption on brain amyloid burden, and to explore the effects of hypoxemia, slow-wave sleep disruption, and amyloid burden on cognition in individuals with and without OSA. METHODS Thirty-four individuals with confirmed OSA (mean±SD age 57.5±4.1 years; 19 males) and 12 healthy controls (58.5±4.2 years; 6 males) underwent a clinical polysomnogram, a NAV4694 positron emission tomography (PET) scan for Aβ burden, assessment of APOEɛ status and cognitive assessments. Linear hierarchical regressions were conducted to determine the contributions of demographic and sleep variables on amyloid burden and cognition. RESULTS Aβ burden was associated with nocturnal hypoxemia, and impaired verbal episodic memory, autobiographical memory and set shifting. Hypoxemia was correlated with impaired autobiographical memory, and only set shifting performance remained significantly associated with Aβ burden when controlling for sleep variables. CONCLUSIONS Nocturnal hypoxemia was related to brain Aβ burden in this sample of OSA participants. Aβ burden and hypoxemia had differential impacts on cognition. This study reveals aspects of sleep disturbance in OSA that are most strongly associated with brain Aβ burden and poor cognition, which are markers of early Alzheimer's disease. These findings add weight to the possibility that hypoxemia may be causally related to the development of dementia; however, whether it may be a therapeutic target for dementia prevention in OSA is yet to be determined.
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Affiliation(s)
- Marina G Cavuoto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Stephen R Robinson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Fergal J O'Donoghue
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
- The University of Melbourne, Parkville, Australia
| | - Maree Barnes
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
- The University of Melbourne, Parkville, Australia
| | - Mark E Howard
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
- The University of Melbourne, Parkville, Australia
| | - Julie Tolson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
- The University of Melbourne, Parkville, Australia
| | - Bronwyn Stevens
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Rachel Schembri
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Ivana Rosenzweig
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
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22
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Lin X, Tan X, Wu F, Yu Q. A Novel Tumor Hypoxia Imaging Agent: [ 99mTc]Tc(CO) 3-CPA-2-NIM. Curr Radiopharm 2023; 16:300-307. [PMID: 36959152 DOI: 10.2174/1874471016666230320144641] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/21/2022] [Accepted: 01/17/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION Hypoxia imaging agents can selectively remain in hypoxic tissue, which can directly reflect the location and degree of hypoxia. METHODS Synthesized a novel tumor hypoxia imaging probe [99mTc]Tc(CO)3-CPA-2-NIM and evaluated its biological behavior with the purpose to assess its possibility of becoming a qualified tumor hypoxia imaging agent. RESULTS Radiochemcial purity of [99mTc]Tc(CO)3-CPA-2-NIM was greater than 95% after HPLC purification. Lipophilicity coefficient of this complex was -1.74 ± 0.10 (n = 5, number of experiments), indicating it was a hydrophilic complex. In vitro cell experiments demonstrated that this complex has selectivity for hypoxia at oxygen concentrations < 10 ppm (parts per million). Biodistribution experiment in S180 tumor bearing mice showed that tumor uptake reached its highest at 2 h post-injection with mice tumor-to-muscle ratio. CONCLUSIONS Complex [99mTc]Tc(CO)3-CPA-2-NIM has the possibility of becoming a tumor hypoxia imaging agent.
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Affiliation(s)
- Xiao Lin
- Department of Environmental Chemistry, National Institute of Environmental Health, CDC, China
| | - Xiaojie Tan
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China
| | - Fengyu Wu
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China
| | - Qian Yu
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China
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23
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Bourigault P, Skwarski M, Macpherson RE, Higgins GS, McGowan DR. Timing of hypoxia PET/CT imaging after 18F-fluoromisonidazole injection in non-small cell lung cancer patients. Sci Rep 2022; 12:21746. [PMID: 36526815 PMCID: PMC9758119 DOI: 10.1038/s41598-022-26199-7] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Positron emission tomography (PET)/computed tomography (CT) using the radiotracer 18F-Fluoromisonidazole (FMISO) has been widely employed to image tumour hypoxia and is of interest to help develop novel hypoxia modifiers and guide radiation treatment planning. Yet, the optimal post-injection (p.i.) timing of hypoxic imaging remains questionable. Therefore, we investigated the correlation between hypoxia-related quantitative values in FMISO-PET acquired at 2 and 4 h p.i. in patients with non-small cell lung cancer (NSCLC). Patients with resectable NSCLC participated in the ATOM clinical trial (NCT02628080) which investigated the hypoxia modifying effects of atovaquone. Two-hour and four-hour FMISO PET/CT images acquired at baseline and pre-surgery visits (n = 58) were compared. Cohort 1 (n = 14) received atovaquone treatment, while cohort 2 (n = 15) did not. Spearman's rank correlation coefficients (ρ) assessed the relationship between hypoxia-related metrics, including standardised uptake value (SUV), tumour-to-blood ratio (TBR), and tumour hypoxic volume (HV) defined by voxels with TBR ≥ 1.4. As the primary imaging-related trial endpoint used to evaluate the action of atovaquone on tumour hypoxia in patients with NSCLC was change in tumour HV from baseline, this was also assessed in patients (n = 20) with sufficient baseline 2- and 4-h scan HV to reliably measure change (predefined as ≥ 1.5 mL). Tumours were divided into four subregions or distance categories: edge, outer, inner, and centre, using MATLAB. In tumours overall, strong correlation (P < 0.001) was observed for SUVmax ρ = 0.87, SUVmean ρ = 0.91, TBRmax ρ = 0.83 and TBRmean ρ = 0.81 between 2- and 4-h scans. Tumour HV was moderately correlated (P < 0.001) with ρ = 0.69 between 2- and 4-h scans. Yet, in tumour subregions, the correlation of HV decreased from the centre ρ = 0.71 to the edge ρ = 0.45 (P < 0.001). SUV, TBR, and HV values were consistently higher on 4-h scans than on 2-h scans, indicating better tracer-to-background contrast. For instance, for TBRmax, the mean, median, and interquartile range were 1.9, 1.7, and 1.6-2.0 2-h p.i., and 2.6, 2.4, and 2.0-3.0 4-h p.i., respectively. Our results support that FMISO-PET scans should be performed at 4 h p.i. to evaluate tumour hypoxia in NSCLC.Trial registration: ClinicalTrials.gov, NCT02628080. Registered 11/12/2015, https://clinicaltrials.gov/ct2/show/NCT02628080 .
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Affiliation(s)
| | - Michael Skwarski
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ruth E Macpherson
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Geoff S Higgins
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Daniel R McGowan
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK.
- Department of Medical Physics and Clinical Engineering, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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24
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Yang L, Afshari MJ, Ge J, Kou D, Chen L, Zhou D, Li C, Wu S, Zhang L, Zeng J, Zhong J, Stauber RH, Gao M. Functionalized Ultrasmall Iron Oxide Nanoparticles for T1-Weighted Magnetic Resonance Imaging of Tumor Hypoxia. Molecules 2022; 27:molecules27206929. [PMID: 36296522 PMCID: PMC9610745 DOI: 10.3390/molecules27206929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Hypoxia is a common biological condition in many malignant solid tumors that plays an imperative role in regulating tumor growth and impacting the treatment’s therapeutic effect. Therefore, the hypoxia assessment is of great significance in predicting tumor development and evaluating its prognosis. Among the plenty of existing tumor diagnosis techniques, magnetic resonance imaging (MRI) offers certain distinctive features, such as being free of ionizing radiation and providing images with a high spatial resolution. In this study, we develop a fluorescent traceable and hypoxia-sensitive T1-weighted MRI probe (Fe3O4-Met-Cy5.5) via conjugating notable hypoxia-sensitive metronidazole moiety and Cy5.5 dye with ultrasmall iron oxide (Fe3O4) nanoparticles. The results of in vitro and in vivo experiments show that Fe3O4-Met-Cy5.5 has excellent performance in relaxivity, biocompatibility, and hypoxia specificity. More importantly, the obvious signal enhancement in hypoxic areas indicates that the probe has great feasibility for sensing tumor hypoxia via T1-weighted MRI. These promising results may unlock the potential of Fe3O4 nanoparticles as T1-weighted contrast agents for the development of clinical hypoxia probes.
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Affiliation(s)
- Lei Yang
- College of Food Science & Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Mohammad Javad Afshari
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Jianxian Ge
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Dandan Kou
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Lei Chen
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Dandan Zhou
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Cang Li
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Shuwang Wu
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Leshuai Zhang
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Jianfeng Zeng
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
- Correspondence: (J.Z.); (M.G.)
| | - Jian Zhong
- College of Food Science & Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Roland H. Stauber
- Department of Nanobiomedicine, ENT, University Medical Center of Mainz, Langenbeckstr. 1, 55101 Mainz, Germany
| | - Mingyuan Gao
- College of Food Science & Technology, Shanghai Ocean University, Shanghai 201306, China
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
- Correspondence: (J.Z.); (M.G.)
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25
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Gertsenshteyn I, Epel B, Ahluwalia A, Kim H, Fan X, Barth E, Zamora M, Markiewicz E, Tsai HM, Sundramoorthy S, Leoni L, Lukens J, Bhuiyan M, Freifelder R, Kucharski A, Giurcanu M, Roman BB, Karczmar G, Kao CM, Halpern H, Chen CT. The optimal 18F-fluoromisonidazole PET threshold to define tumor hypoxia in preclinical squamous cell carcinomas using pO 2 electron paramagnetic resonance imaging as reference truth. Eur J Nucl Med Mol Imaging 2022; 49:4014-4024. [PMID: 35792927 PMCID: PMC9529789 DOI: 10.1007/s00259-022-05889-4] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/19/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE To identify the optimal threshold in 18F-fluoromisonidazole (FMISO) PET images to accurately locate tumor hypoxia by using electron paramagnetic resonance imaging (pO2 EPRI) as ground truth for hypoxia, defined by pO2 [Formula: see text] 10 mmHg. METHODS Tumor hypoxia images in mouse models of SCCVII squamous cell carcinoma (n = 16) were acquired in a hybrid PET/EPRI imaging system 2 h post-injection of FMISO. T2-weighted MRI was used to delineate tumor and muscle tissue. Dynamic contrast enhanced (DCE) MRI parametric images of Ktrans and ve were generated to model tumor vascular properties. Images from PET/EPR/MRI were co-registered and resampled to isotropic 0.5 mm voxel resolution for analysis. PET images were converted to standardized uptake value (SUV) and tumor-to-muscle ratio (TMR) units. FMISO uptake thresholds were evaluated using receiver operating characteristic (ROC) curve analysis to find the optimal FMISO threshold and unit with maximum overall hypoxia similarity (OHS) with pO2 EPRI, where OHS = 1 shows perfect overlap and OHS = 0 shows no overlap. The means of dice similarity coefficient, normalized Hausdorff distance, and accuracy were used to define the OHS. Monotonic relationships between EPRI/PET/DCE-MRI were evaluated with the Spearman correlation coefficient ([Formula: see text]) to quantify association of vasculature on hypoxia imaged with both FMISO PET and pO2 EPRI. RESULTS FMISO PET thresholds to define hypoxia with maximum OHS (both OHS = 0.728 [Formula: see text] 0.2) were SUV [Formula: see text] 1.4 [Formula: see text] SUVmean and SUV [Formula: see text] 0.6 [Formula: see text] SUVmax. Weak-to-moderate correlations (|[Formula: see text]|< 0.70) were observed between PET/EPRI hypoxia images with vascular permeability (Ktrans) or fractional extracellular-extravascular space (ve) from DCE-MRI. CONCLUSION This is the first in vivo comparison of FMISO uptake with pO2 EPRI to identify the optimal FMISO threshold to define tumor hypoxia, which may successfully direct hypoxic tumor boosts in patients, thereby enhancing tumor control.
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Affiliation(s)
- Inna Gertsenshteyn
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | - Boris Epel
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | | | - Heejong Kim
- Department of Radiology, The University of Chicago, Chicago, IL, USA
| | - Xiaobing Fan
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Eugene Barth
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | - Marta Zamora
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Erica Markiewicz
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Hsiu-Ming Tsai
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Subramanian Sundramoorthy
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | - Lara Leoni
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - John Lukens
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | - Mohammed Bhuiyan
- Department of Radiology, The University of Chicago, Chicago, IL, USA
| | | | - Anna Kucharski
- Department of Radiology, The University of Chicago, Chicago, IL, USA
| | - Mihai Giurcanu
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Brian B Roman
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Gregory Karczmar
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Chien-Min Kao
- Department of Radiology, The University of Chicago, Chicago, IL, USA
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA
| | - Howard Halpern
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA
- Center for EPR Imaging In Vivo Physiology, The University of Chicago, Chicago, IL, USA
| | - Chin-Tu Chen
- Department of Radiology, The University of Chicago, Chicago, IL, USA.
- Integrated Small Animal Imaging Research Resource, OSRF, The University of Chicago, Chicago, IL, USA.
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26
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Petusseau AF, Bruza P, Pogue BW. Protoporphyrin IX delayed fluorescence imaging: a modality for hypoxia-based surgical guidance. J Biomed Opt 2022; 27:106005. [PMID: 36217225 PMCID: PMC9549807 DOI: 10.1117/1.jbo.27.10.106005] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
SIGNIFICANCE Hypoxia imaging for surgical guidance has never been possible, yet it is well known that most tumors have microregional chronic and/or cycling hypoxia present as well as chaotic blood flow. The ability to image oxygen partial pressure (pO2) is therefore a unique control of tissue metabolism and can be used in a range of disease applications to understand the complex biochemistry of oxygen supply and consumption. AIM Delayed fluorescence (DF) from the endogenous molecule protoporphyrin IX (PpIX) has been shown to be a truly unique reporter of the local oxygen partial pressure in tissue. PpIX is endogenously synthesized by mitochondria in most tissues, and the particular property of DF emission is directly related to low microenvironmental oxygen concentration. Here, it is shown that PpIX has a unique emission in hypoxic tumor tissue regions, which is measured as a DF signal in the red to near-infrared spectrum. APPROACH A time-gated imaging system was used for PpIX DF for wide field direct mapping of pO2 changes. Acquiring both prompt and DF in a rapid sequential cycle allowed for imaging oxygenation in a way that was insensitive to the PpIX concentration. By choosing adequate parameters, the video rate acquisition of pO2 images could be achieved, providing real-time tissue metabolic information. RESULTS In this report, we show the first demonstration of imaging hypoxia signals from PpIX in a pancreatic cancer model, exhibiting >5X contrast relative to surrounding normal oxygenated tissues. Additionally, tissue palpation amplifies the signal and provides intuitive temporal contrast based upon neoangiogenic blood flow differences. CONCLUSIONS PpIX DF provides a mechanism for tumor contrast that could easily be translated to human use as an intrinsic contrast mechanism for oncologic surgical guidance.
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Affiliation(s)
- Arthur F. Petusseau
- Dartmouth College, Thayer School of Engineering and Dartmouth Cancer Center, Hanover, New Hampshire, United States
| | - Petr Bruza
- Dartmouth College, Thayer School of Engineering and Dartmouth Cancer Center, Hanover, New Hampshire, United States
| | - Brian W. Pogue
- University of Wisconsin–Madison, Department of Medical Physics, Madison, Wisconsin, United States
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27
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Luo Y, Qiao B, Yang C, Zhang P, Xie Z, Cao J, Yang A, Xiang Q, Ran H, Wang Z, Hao L, Cao Y, Zhou Z, Ren J. Low Intensity Focused Ultrasound Ignited “Deep-Penetration Nanobomb” (DPNB) for Tetramodal Imaging Guided Hypoxia-Tolerant Sonodynamic Therapy Against Hypoxic Tumors. Int J Nanomedicine 2022; 17:4547-4565. [PMID: 36199475 PMCID: PMC9527552 DOI: 10.2147/ijn.s361648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/31/2022] [Indexed: 12/07/2022] Open
Abstract
Background Sonodynamic therapy (SDT) has been regarded as a novel therapeutic modality for killing tumors. However, the hypoxic tumor microenvironment, especially deep-seated tumors distant from blood vessels, severely restricts therapeutic efficacy due to the oxygen-dependent manner of SDT. Methods Herein, we report a novel ultrasonic cavitation effect-based therapeutic modality that is able to facilitate the hypoxia-tolerant SDT for inducing hypoxic tumor death. A tLyP-1 functionalized liposomes is fabricated, composed of hematoporphyrin monomethyl ether gadolinium as the sonosentizer and perfluoropentane (PFP) as the acoustic environment regulator. Moreover, the tLyP-1 functioned liposomes could achieve active tumor homing and effective deep-penetrating into hypoxic tumors. Upon low intensity focused ultrasound (LIFU) irradiation, the acoustic droplet vaporization effect of PFP induced fast liquid-to-gas transition and quick bubbles explosion to generate hydroxyl radicals, efficiently promoting cell death in both normoxic and hypoxic microenvironment (acting as deep-penetration nanobomb, DPNB). Results The loading of PFP is proved to significantly enhance the therapeutic efficacy of hypoxic tumors. In particular, these DPNB can also act as ultrasound, photoacoustic, magnetic resonance, and near-infrared fluorescence tetramodal imaging agents for guiding the therapeutic process. Conclusion This study is the first report involving that liquid-to-gas transition based SDT has the potential to combat hypoxic tumors.
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Affiliation(s)
- Yuanli Luo
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Bin Qiao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Chao Yang
- Radiology Department, Chongqing General Hospital, Chongqing, 400014, People’s Republic of China
| | - Ping Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Zhuoyan Xie
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Jin Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Anyu Yang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Qinyanqiu Xiang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Haitao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Zhigang Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Lan Hao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Yang Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Zhiyi Zhou
- General Practice Department, Chongqing General Hospital, Chongqing, 400014, People’s Republic of China
- Correspondence: Zhiyi Zhou; Jianli Ren, Email ;
| | - Jianli Ren
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
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Cheung A, Tu L, Macnab A, Kwon BK, Shadgan B. Detection of hypoxia by near-infrared spectroscopy and pulse oximetry: a comparative study. J Biomed Opt 2022; 27:077001. [PMID: 35879816 PMCID: PMC9309379 DOI: 10.1117/1.jbo.27.7.077001] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Pulse oximetry is widely used in clinical practice to monitor changes in arterial oxygen saturation (SpO2). However, decreases in SpO2 can be delayed relative to the actual clinical event, and near-infrared spectroscopy (NIRS) may detect alterations in oxygenation earlier than pulse oximetry, as shown in previous cerebral oxygenation monitoring studies. AIM We aim to compare the response of transcutaneous muscle NIRS measures of the tissue saturation index with pulse oximetry SpO2 during hypoxia. APPROACH Episodes of acute hypoxia were induced in nine anesthetized Yucatan miniature pigs. A standard pulse oximeter was attached to the ear of the animal, and a transcutaneous NIRS sensor was placed on the hind limb muscle. Hypoxia was induced by detaching the ventilator from the animal and reattaching it once the pulse oximeter reported 70% SpO2. RESULTS Twenty-four episodes of acute hypoxia were analyzed. Upon the start of hypoxia, the transcutaneous NIRS measures changed in 5.3 ± 0.4 s, whereas the pulse oximetry measures changed in 14.9 ± 1.0 s (p < 0.0001). CONCLUSIONS Transcutaneous muscle NIRS can detect the effects of hypoxia significantly sooner than pulse oximetry in the Yucatan miniature pig. A transcutaneous NIRS sensor may be used as an earlier detector of oxygen saturation changes in the clinical setting than the standard pulse oximeter.
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Affiliation(s)
- Amanda Cheung
- University of British Columbia, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
| | - Lorna Tu
- University of British Columbia, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
| | - Andrew Macnab
- University of British Columbia, Departments of Pediatrics and Urologic Sciences, Vancouver, British Columbia, Canada
| | - Brian K. Kwon
- University of British Columbia, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Orthopaedics, Vancouver, British Columbia, Canada
| | - Babak Shadgan
- University of British Columbia, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Orthopaedics, Vancouver, British Columbia, Canada
- University of British Columbia, School of Biomedical Engineering, Vancouver, British Columbia, Canada
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Bresser PL, Sathekge MM, Vorster M. PET/CT features of a novel gallium-68 labelled hypoxia seeking agent in patients diagnosed with tuberculosis: a proof-of-concept study. Nucl Med Commun 2022; 43:787-793. [PMID: 35506285 DOI: 10.1097/mnm.0000000000001580] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Positron emission tomography/computed tomography (PET/CT) in infection and inflammation has yielded promising results across a range of radiopharmaceuticals. In particular, PET/CT imaging of tuberculosis (TB) allows for a better understanding of this complex disease by providing insights into molecular processes within the TB microenvironment. TB lesions are hypoxic with research primarily focussed on cellular processes occurring under hypoxic stress. With the development of hypoxia seeking PET/CT radiopharmaceuticals, that can be labelled in-house using a germanium-68/gallium-68 (68Ge/68Ga) generator, a proof-of-concept for imaging hypoxia in TB is presented. METHODS Ten patients diagnosed with TB underwent whole-body PET/CT imaging, 60-90 min after intravenous administration of 74-185 MBq (2-5 mCi) 68Ga-nitroimidazole. No oral or intravenous contrast was administered. Images were visually and semiquantitatively assessed for abnormal 68Ga-uptake in the lungs. RESULTS A total of 28 lesions demonstrating hypoxic uptake were identified. Low- to moderate-uptake was seen in nodules, areas of consolidation and cavitation as well as effusions. The mean standard uptake value (SUVmean) of the lesions was 0.47 (IQR, 0.32-0.82) and SUVmax was 0.71 (IQR, 0.41-1.11). The lesion to muscle ratio (median, 1.70; IQR, 1.15-2.31) was higher than both the left ventricular and the aorta lesion to blood ratios. CONCLUSION Moving towards the development of unique host-directed therapies (HDT), modulation of oxygen levels may improve therapeutic outcome by reprogramming TB lesions to overcome hypoxia. This proof-of-concept study suggests that hypoxia in TB lesions can be imaged and quantified using 68Ga-nitroimidazole PET/CT. Subsequently, hypoxic load can be estimated to inform personalised treatment plans of patients diagnosed with TB.
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Affiliation(s)
- Philippa L Bresser
- Department of Nuclear Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mike M Sathekge
- Department of Nuclear Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, University of Kwazulu Natal, Durban, South Africa
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Subasinghe SAAS, Pautler RG, Samee MAH, Yustein JT, Allen MJ. Dual-Mode Tumor Imaging Using Probes That Are Responsive to Hypoxia-Induced Pathological Conditions. Biosensors (Basel) 2022; 12:bios12070478. [PMID: 35884281 PMCID: PMC9313010 DOI: 10.3390/bios12070478] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 05/02/2023]
Abstract
Hypoxia in solid tumors is associated with poor prognosis, increased aggressiveness, and strong resistance to therapeutics, making accurate monitoring of hypoxia important. Several imaging modalities have been used to study hypoxia, but each modality has inherent limitations. The use of a second modality can compensate for the limitations and validate the results of any single imaging modality. In this review, we describe dual-mode imaging systems for the detection of hypoxia that have been reported since the start of the 21st century. First, we provide a brief overview of the hallmarks of hypoxia used for imaging and the imaging modalities used to detect hypoxia, including optical imaging, ultrasound imaging, photoacoustic imaging, single-photon emission tomography, X-ray computed tomography, positron emission tomography, Cerenkov radiation energy transfer imaging, magnetic resonance imaging, electron paramagnetic resonance imaging, magnetic particle imaging, and surface-enhanced Raman spectroscopy, and mass spectrometric imaging. These overviews are followed by examples of hypoxia-relevant imaging using a mixture of probes for complementary single-mode imaging techniques. Then, we describe dual-mode molecular switches that are responsive in multiple imaging modalities to at least one hypoxia-induced pathological change. Finally, we offer future perspectives toward dual-mode imaging of hypoxia and hypoxia-induced pathophysiological changes in tumor microenvironments.
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Affiliation(s)
| | - Robia G. Pautler
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA; (R.G.P.); (M.A.H.S.)
| | - Md. Abul Hassan Samee
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA; (R.G.P.); (M.A.H.S.)
| | - Jason T. Yustein
- Integrative Molecular and Biomedical Sciences and the Department of Pediatrics in the Texas Children’s Cancer and Hematology Centers and The Faris D. Virani Ewing Sarcoma Center, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Matthew J. Allen
- Department of Chemistry, Wayne State University, 5101 Cass Avenue, Detroit, MI 48202, USA;
- Correspondence:
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Yuan X, Zhu X, Chen Y, Liu W, Qian W, Xu Y, Zhu Y. Cardiac energetics alteration in a chronic hypoxia rat model: A non-invasive in vivo31P magnetic resonance spectroscopy study. J Xray Sci Technol 2022; 30:165-175. [PMID: 34744047 DOI: 10.3233/xst-210985] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Energetics alteration plays a crucial role in the myocardial injury process in chronic hypoxia diseases (CHD). 31P magnetic resonance spectroscopy (MRS) can investigate alterations in cardiac energetics in vivo. OBJECTIVE To characterize the potential value of 31P MRS in evaluating cardiac energetics alteration of chronic hypoxic rats (CHRs). METHODS Twenty-four CHRs were induced by SU5416 combined with hypoxia and divided into four groups according to the modeling time of one, two, three and five weeks, respectively. Control group also contains six rats. 31P MRS was performed weekly and the ratio of concentrations of phosphocreatine (PCr) to adenosine triphosphate (ATP) (PCr/ATP) was obtained. In addition, the cardiac structure index and systolic function parameters, including the right ventricular ejection fraction (RVEF), right ventricular end-diastolic volume index (RVEDVi), right ventricular end-systolic volume index (RVESVi), and the left ventricular function parameters, were measured. RESULTS Decreased resting cardiac PCr/ATP ratio in CHRs was observed at the first week, compared to the control group (2.90±0.35 vs. 3.31±0.45, p = 0.045), while the RVEF, RVEDVi, and RVESVi decreased at the second week (p < 0.05). The PCr/ATP ratio displayed a significant correlation with RVEF (r = 0.605, p = 0.001), RVEDVi, and RVESVi (r = -0.661, r = -0.703; p < 0.001). CONCLUSIONS 31P MRS can easily detect the cardiac energetics alteration in a CHR model before the onset of ventricular dysfunction. The decreased PCr/ATP ratio likely reveales myocardial injury and cardiac dysfunction.
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Affiliation(s)
- Xiaohan Yuan
- Department of Ultrasuond, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaomei Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yang Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wangyan Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen Qian
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yi Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yinsu Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Narva SI, Seppänen MP, Raiko JRH, Forsback SJ, Orte KJ, Virtanen JM, Hynninen J, Hietanen S. Imaging of Tumor Hypoxia With 18F-EF5 PET/MRI in Cervical Cancer. Clin Nucl Med 2021; 46:952-957. [PMID: 34619699 DOI: 10.1097/rlu.0000000000003914] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF THE REPORT The aim of this study was to evaluate the distribution of hypoxia using 18F-EF5 as a hypoxia tracer in cervical cancer patients with PET/MRI. We investigated the association between this 18F-EF5-PET tracer and the immunohistochemical expression of endogenous hypoxia markers: HIF1α, CAIX, and GLUT1. PATIENTS AND METHODS Nine patients with biopsy-proven primary squamous cell cervix carcinoma (FIGO 2018 radiological stages IB1-IIIC2r) were imaged with dual tracers 18F-EF5 and 18F-FDG using PET/MRI (Int J Gynaecol Obstet. 2019;145:129-135). 18F-EF5 images were analyzed by calculating the tumor-to-muscle ratio to determine the hypoxic tissue (T/M ratio >1.5) and further hypoxic subvolume (HSV) and percentage hypoxic area. These 18F-EF5 hypoxic parameters were correlated with the size and localization of tumors in 18F-FDG PET/MRI and the results of hypoxia immunohistochemistry. RESULTS All primary tumors were clearly 18F-FDG and 18F-EF5 PET positive and heterogeneously hypoxic with multiple 18F-EF5-avid areas in locally advanced cancer and single areas in clinically stage I tumors. The location of hypoxia was detected mainly in the periphery of tumor. Hypoxia parameters 18F-EF5 max T/M ratio and HSV in primary tumors correlated independently with the advanced stage (P = 0.036 and P = 0.040, respectively), and HSV correlated with the tumor size (P = 0.027). The location of hypoxia in 18F-EF5 imaging was confirmed with a higher hypoxic marker expression HIF1α and CAIX in tumor fresh biopsies. CONCLUSIONS The 18F-EF5 imaging has promising potential in detecting areas of tumor hypoxia in cervical cancer.
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Mezentseva LV, Dudnik EN, Nikenina EV, Husainov IR, Zapara MA, Samartseva VG. Analysis of Changes in Microcirculation Parameters of Symmetrical Areas of the Human Head under Conditions of Hypoxic Influences. Bull Exp Biol Med 2021; 171:691-694. [PMID: 34709517 DOI: 10.1007/s10517-021-05296-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Indexed: 11/30/2022]
Abstract
The reactions of microcirculation parameters of symmetrical areas of the human head to hypoxic loads were studied. The study was conducted in 10 healthy male volunteers aged 18-19 years. Short-term hypoxia was modeled using a ReOxy Cardio normobaric device (S. A. Aimediq). Synchronous measurements of microcirculation parameters in symmetrical temporal regions of the head at the basal state and immediately after short-term hypoxic exposure were carried out by the method of laser Doppler flowmetry. We evaluated statistical characteristics of perfusion of both sides, as well as regression characteristics of the relationship between changes in the microcirculation parameters and the initial values of these parameters. It was shown that the reaction of the microcirculation parameters in symmetrical regions of the head to hypoxia depends on the initial microcirculation parameters in ipsi- and contralateral sides. 3D graphs were constructed and regression equations describing these relationships were formulated. A new method of geometric sensing is proposed, which allows predicting the direction of reactions to hypoxic effects. The obtained data illustrate the specificity of regulation of microcirculation of paired organs determined by the presence of functional asymmetry. A new method of geometric zoning is proposed, which allows solving the problems of personalized assessments of the state of the microcirculation system in patients.
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Affiliation(s)
- L V Mezentseva
- P. K. Anokhin Research Institute of Normal Physiology, Moscow, Russia.
| | - E N Dudnik
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E V Nikenina
- P. K. Anokhin Research Institute of Normal Physiology, Moscow, Russia
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - I R Husainov
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - M A Zapara
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - V G Samartseva
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Schwartz RG, Vidula H. 2020 vision: New insights on hypoxia imaging to assess cardiac and extra-cardiac active inflammatory sarcoidosis. J Nucl Cardiol 2021; 28:2149-2150. [PMID: 32034664 DOI: 10.1007/s12350-020-02032-4] [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: 01/04/2020] [Accepted: 01/04/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ronald G Schwartz
- Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, AC-G, Rochester, NY, 14642-8679, USA.
- Division of Nuclear Medicine, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA.
| | - Himabindu Vidula
- Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, AC-G, Rochester, NY, 14642-8679, USA
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Furuya S, Naya M, Manabe O, Hirata K, Ohira H, Aikawa T, Koyanagawa K, Magota K, Tsujino I, Anzai T, Kuge Y, Oyama-Manabe N, Kudo K, Shiga T, Tamaki N. 18F-FMISO PET/CT detects hypoxic lesions of cardiac and extra-cardiac involvement in patients with sarcoidosis. J Nucl Cardiol 2021; 28:2141-2148. [PMID: 31820409 DOI: 10.1007/s12350-019-01976-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 08/22/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND 18F-fluoromisonidazole (FMISO) is a hypoxia positron emission tomography (PET) tracer. Here, we evaluated cardiac and extra-cardiac sarcoidosis using both FMISO and 18F-fluorodeoxyglucose (FDG) PET/CT in a prospective cohort of patients with sarcoidosis. METHODS Ten consecutive sarcoidosis patients with suspected cardiac involvement were prospectively enrolled. Each patient fasted overnight (for ≥ 18 hours) preceded by a low-carbohydrate diet before FDG PET/CT but not given special dietary instructions before the FMISO PET/CT scan. We visually and semiquantitatively assessed the uptakes of FMISO and FDG using the maximal standardized uptake value (SUVmax). The metabolic volume (MV) of FDG was calculated as the volume within the boundary determined by the threshold (mean SUV of blood pool × 1.5). RESULTS Nine patients showed focal FDG uptake in the myocardium and were diagnosed with cardiac sarcoidosis. Among the patients with extra-cardiac lesions, FDG uptake was seen in 8 lymph nodes and 3 lung lesions. FMISO uptake was seen in the 7 cardiac (77.8%) and 6 extra-cardiac (54.5%) lesions. None of the patients showed physiological FMISO uptake in the myocardium. The SUVmax values of the lesions with FMISO uptake were higher than those of the lesions without FMISO uptake in both the cardiac (SUVmax: 9.9, IQR: 8.4-10.0 vs 7.3, IQR: 6.3-8.2) and non-cardiac lesions (SUVmax: 17.6, IQR: 14.5-19.3 vs 6.1, IQR: 5.9-6.2; P = 0.006). The MV values of the lesions with FMISO uptake were significantly higher than those of the lesions without FMISO uptake (111.3, IQR: 78.3-135.7 vs 6.4, IQR: 1.9-23.3; P = 0.0009). CONCLUSIONS FMISO showed no physiological myocardial uptake and did not require special preparation. FMISO PET has the potential to detect hypoxic lesions in patients with sarcoidosis.
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Affiliation(s)
- Sho Furuya
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Osamu Manabe
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiroshi Ohira
- First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Keiichi Magota
- Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan
| | - Ichizo Tsujino
- First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Yuji Kuge
- Central Institute of Isotope Science, Hokkaido University, Sapporo, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tohru Shiga
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Liu J, Ding G, Chen S, Xue C, Chen M, Wu X, Yuan Q, Zheng J, Yang R. Multifunctional Programmable DNA Nanotrain for Activatable Hypoxia Imaging and Mitochondrion-Targeted Enhanced Photodynamic Therapy. ACS Appl Mater Interfaces 2021; 13:9681-9690. [PMID: 33606499 DOI: 10.1021/acsami.0c21681] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Programmable DNA-based nanostructures (e.g., nanotrains, nanoflowers, and DNA dendrimers) provide new approaches for safe and effective biological imaging and tumor therapy. However, few studies have reported that DNA-based nanostructures respond to the hypoxic microenvironment for activatable imaging and organelle-targeted tumor therapy. Herein, we innovatively report an azoreductase-responsive, mitochondrion-targeted multifunctional programmable DNA nanotrain for activatable hypoxia imaging and enhanced efficacy of photodynamic therapy (PDT). Cyanine structural dye (Cy3) and black hole quencher 2 (BHQ2), which were employed as a fluorescent mitochondrion-targeted molecule and azoreductase-responsive element, respectively, covalently attached to the DNA hairpin monomers. The extended guanine (G)-rich sequence at the end of the DNA hairpin monomer served as a nanocarrier for the photosensitizer 5,10,15,20-tetrakis(4-N-methylpyridiniumyl) porphyrin (TMPyP4). Upon initiation between the DNA hairpin monomer and initiation probe, the fluorescence of Cy3 and the singlet oxygen (1O2) generation of TMPyP4 in the programmable nanotrain were effectively quenched by BHQ2 through the fluorescence resonance energy transfer (FRET) process. Once the programmable nanotrain entered cancer cells, the azo bond in BHQ2 will be reduced to amino groups by the high expression of azoreductase under hypoxia conditions; then, the fluorescence of Cy3 and the 1O2 generation of TMPyP4 will significantly be restored. Furthermore, due to the mitochondrion-targeting characteristic endowed by Cy3, the TMPyP4-loaded nanotrain would accumulate in the mitochondria of cancer cells and then demonstrate enhanced PDT efficacy under light irradiation. We expect that this programmable DNA nanotrain-based multifunctional nanoplatform could be effectively used for activatable imaging and high performance of PDT in hypoxia-related biomedical field.
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Affiliation(s)
- Jin Liu
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Institute of Chemical Biology and Nanomedicine (ICBN), Hunan University, Changsha 410082, China
| | - Ge Ding
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen 518055, China
| | - Shiya Chen
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Institute of Chemical Biology and Nanomedicine (ICBN), Hunan University, Changsha 410082, China
| | - Caoye Xue
- Hunan Institute of Sports Science, Changsha 410003, China
| | - Mian Chen
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen 518055, China
| | - Xu Wu
- NHC Key Laboratory of Carcinogenesis and Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Science, Central South University, Changsha 410083, China
| | - Quan Yuan
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Institute of Chemical Biology and Nanomedicine (ICBN), Hunan University, Changsha 410082, China
| | - Jing Zheng
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Institute of Chemical Biology and Nanomedicine (ICBN), Hunan University, Changsha 410082, China
| | - Ronghua Yang
- School of Chemistry and Biological Engineering, Changsha University of Science and Technology, Changsha 410004, China
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Gertsenshteyn I, Epel B, Barth E, Leoni L, Markiewicz E, Tsai HM, Fan X, Giurcanu M, Bodero D, Zamora M, Sundramoorthy S, Kim H, Freifelder R, Bhuiyan M, Kucharski A, Karczmar G, Kao CM, Halpern H, Chen CT. Improving Tumor Hypoxia Location in 18F-Misonidazole PET with Dynamic Contrast-enhanced MRI Using Quantitative Electron Paramagnetic Resonance Partial Oxygen Pressure Images. Radiol Imaging Cancer 2021; 3:e200104. [PMID: 33817651 PMCID: PMC8011450 DOI: 10.1148/rycan.2021200104] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/30/2021] [Accepted: 02/09/2021] [Indexed: 11/11/2022]
Abstract
Purpose To enhance the spatial accuracy of fluorine 18 (18F) misonidazole (MISO) PET imaging of hypoxia by using dynamic contrast-enhanced (DCE) MR images as a basis for modifying PET images and by using electron paramagnetic resonance (EPR) partial oxygen pressure (pO2) as the reference standard. Materials and Methods Mice (n = 10) with leg-borne MCa4 mammary carcinomas underwent EPR imaging, T2-weighted and DCE MRI, and 18F-MISO PET/CT. Images were registered to the same space for analysis. The thresholds of hypoxia for PET and EPR images were tumor-to-muscle ratios greater than or equal to 2.2 mm Hg and less than or equal to 14 mm Hg, respectively. The Dice similarity coefficient (DSC) and Hausdorff distance (d H ) were used to quantify the three-dimensional overlap of hypoxia between pO2 EPR and 18F-MISO PET images. A training subset (n = 6) was used to calculate optimal DCE MRI weighting coefficients to relate EPR to the PET signal; the group average weights were then applied to all tumors (from six training mice and four test mice). The DSC and d H were calculated before and after DCE MRI-corrected PET images were obtained to quantify the improvement in overlap with EPR pO2 images for measuring tumor hypoxia. Results The means and standard deviations of the DSC and d H between hypoxic regions in original PET and EPR images were 0.35 mm ± 0.23 and 5.70 mm ± 1.7, respectively, for images of all 10 mice. After implementing a preliminary DCE MRI correction to PET data, the DSC increased to 0.86 mm ± 0.18 and the d H decreased to 2.29 mm ± 0.70, showing significant improvement (P < .001) for images of all 10 mice. Specifically, for images of the four independent test mice, the DSC improved with correction from 0.19 ± 0.28 to 0.80 ± 0.29 (P = .02), and the d H improved from 6.40 mm ± 2.5 to 1.95 mm ± 0.63 (P = .01). Conclusion Using EPR information as a reference standard, DCE MRI information can be used to correct 18F-MISO PET information to more accurately reflect areas of hypoxia.Keywords: Animal Studies, Molecular Imaging, Molecular Imaging-Cancer, PET/CT, MR-Dynamic Contrast Enhanced, MR-Imaging, PET/MR, Breast, Oncology, Tumor Mircoenvironment, Electron Paramagnetic ResonanceSupplemental material is available for this article.© RSNA, 2021.
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Affiliation(s)
- Inna Gertsenshteyn
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Boris Epel
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Eugene Barth
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Lara Leoni
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Erica Markiewicz
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Hsiu-Ming Tsai
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Xiaobing Fan
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Mihai Giurcanu
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Darwin Bodero
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Marta Zamora
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Subramanian Sundramoorthy
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Heejong Kim
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Richard Freifelder
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Mohammed Bhuiyan
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Anna Kucharski
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Gregory Karczmar
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Chien-Min Kao
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Howard Halpern
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
| | - Chin-Tu Chen
- From the Department of Radiology (I.G., X.F., H.K., R.F., M.B., A.K., G.K., C.M.K., C.T.C.), National Institutes of Health Center for Electron Paramagnetic Resonance Imaging in Vivo Physiology (I.G., B.E., E.B., D.B., S.S., H.H.), Department of Radiation and Cellular Oncology (I.G., B.E., E.B., D.B., H.H.), Integrated Small Animal Imaging Research Resource (L.L., E.M., H.M.T., X.F., D.B., M.Z., C.M.K., C.T.C.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC-2026, Chicago, IL 60637
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Hartung G, Badr S, Moeini M, Lesage F, Kleinfeld D, Alaraj A, Linninger A. Voxelized simulation of cerebral oxygen perfusion elucidates hypoxia in aged mouse cortex. PLoS Comput Biol 2021; 17:e1008584. [PMID: 33507970 PMCID: PMC7842915 DOI: 10.1371/journal.pcbi.1008584] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/30/2020] [Indexed: 12/13/2022] Open
Abstract
Departures of normal blood flow and metabolite distribution from the cerebral microvasculature into neuronal tissue have been implicated with age-related neurodegeneration. Mathematical models informed by spatially and temporally distributed neuroimage data are becoming instrumental for reconstructing a coherent picture of normal and pathological oxygen delivery throughout the brain. Unfortunately, current mathematical models of cerebral blood flow and oxygen exchange become excessively large in size. They further suffer from boundary effects due to incomplete or physiologically inaccurate computational domains, numerical instabilities due to enormous length scale differences, and convergence problems associated with condition number deterioration at fine mesh resolutions. Our proposed simple finite volume discretization scheme for blood and oxygen microperfusion simulations does not require expensive mesh generation leading to the critical benefit that it drastically reduces matrix size and bandwidth of the coupled oxygen transfer problem. The compact problem formulation yields rapid and stable convergence. Moreover, boundary effects can effectively be suppressed by generating very large replica of the cortical microcirculation in silico using an image-based cerebrovascular network synthesis algorithm, so that boundaries of the perfusion simulations are far removed from the regions of interest. Massive simulations over sizeable portions of the cortex with feature resolution down to the micron scale become tractable with even modest computer resources. The feasibility and accuracy of the novel method is demonstrated and validated with in vivo oxygen perfusion data in cohorts of young and aged mice. Our oxygen exchange simulations quantify steep gradients near penetrating blood vessels and point towards pathological changes that might cause neurodegeneration in aged brains. This research aims to explain mechanistic interactions between anatomical structures and how they might change in diseases or with age. Rigorous quantification of age-related changes is of significant interest because it might aide in the search for imaging biomarkers for dementia and Alzheimer’s disease. Brain function critically depends on the maintenance of physiological blood supply and metabolism in the cortex. Disturbances to adequate perfusion have been linked to age-related neurodegeneration. However, the precise correlation between age-related hemodynamic changes and the resulting decline in oxygen delivery is not well understood and has not been quantified. Therefore, we introduce a new compact, and therefore highly scalable, computational method for predicting the physiological relationship between hemodynamics and cortical oxygen perfusion for large sections of the cortical microcirculation. We demonstrate the novel mesh generation-free (MGF), multi-scale simulation approach through realistic in vivo case studies of cortical microperfusion in the mouse brain. We further validate mechanistic correlations and a quantitative relationship between blood flow and brain oxygenation using experimental data from cohorts of young, middle aged and old mouse brains. Our computational approach overcomes size and performance limitations of previous unstructured meshing techniques to enable the prediction of oxygen tension with a spatial resolution of least two orders of magnitude higher than previously possible. Our simulation results support the hypothesis that structural changes in the microvasculature induce hypoxic pockets in the aged brain that are absent in the healthy, young mouse.
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Affiliation(s)
- Grant Hartung
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Shoale Badr
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Mohammad Moeini
- Polytechnique Montréal, Department of Electrical Engineering, Montreal, Canada
| | - Frédéric Lesage
- Polytechnique Montréal, Department of Electrical Engineering, Montreal, Canada
| | - David Kleinfeld
- Department of Physics, University of California San Diego, San Diego, California, United States of America
| | - Ali Alaraj
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Andreas Linninger
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States of America
- * E-mail:
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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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Radnis C, Qiu S, Jhaveri M, Da Silva I, Szewka A, Koffman L. Radiographic and clinical neurologic manifestations of COVID-19 related hypoxemia. J Neurol Sci 2020; 418:117119. [PMID: 32957036 PMCID: PMC7474836 DOI: 10.1016/j.jns.2020.117119] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023]
Abstract
The novel coronavirus SARS-CoV-2 is known to cause hypoxemia and acute respiratory distress syndrome (ARDS) in a significant portion of those with severe disease. Survivors of critical illness and ARDS often experience neurocognitive impairment but, to date, there is scant literature correlating radiographic hypoxic brain injury to hypoxemia related to ARDS. In this case series, we describe three cases of hypoxic brain injury seen on magnetic resonance imaging (MRI) in patients with hypoxemia secondary to COVID-19-related ARDS. The lack of severe observed hypoxemia in two of the cases suggests that unrecognized or asymptomatic hypoxemia may play a role in hypoxic brain injury related to COVID-19.
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Affiliation(s)
- Caitlin Radnis
- Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Sunny Qiu
- Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA
| | - Miral Jhaveri
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL 60612, USA
| | - Ivan Da Silva
- Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA
| | - Aimee Szewka
- Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA
| | - Lauren Koffman
- Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA
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Courcier J, de la Taille A, Nourieh M, Leguerney I, Lassau N, Ingels A. Carbonic Anhydrase IX in Renal Cell Carcinoma, Implications for Disease Management. Int J Mol Sci 2020; 21:E7146. [PMID: 32998233 PMCID: PMC7582814 DOI: 10.3390/ijms21197146] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 01/14/2023] Open
Abstract
Carbonic Anhydrase IX (CAIX) is a well-described enzyme in renal cell carcinoma, with its expression being regulated by the hypoxia-inducible factor 1 alpha, it is known for interfering with hypoxia processes. Renal carcinoma encompasses a broad spectrum of histological entities and is also described as a heterogeneous malignant tumor. Recently, various combinations of checkpoint inhibitors and targeted therapies have been validated to manage this disease. Reliable markers to confirm the diagnosis, estimate the prognosis, predict or monitor the treatment response are required. Molecular imaging developments allow a comprehensive analysis of the tumor, overcoming the spatial heterogeneity issue. CAIX, being highly expressed at the tumor cell surfaces of clear cell renal carcinoma, also represents a potential treatment target. In this manuscript we reviewed the current knowledge from the literature on the pathophysiological interactions between renal cell carcinoma and CAIX, the role of CAIX as a marker for diagnosis, prognosis, treatment monitoring and molecular imaging, and the potential target for therapeutic strategies.
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MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/metabolism
- Antineoplastic Agents, Immunological/therapeutic use
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carbonic Anhydrase IX/antagonists & inhibitors
- Carbonic Anhydrase IX/genetics
- Carbonic Anhydrase IX/metabolism
- Carcinoma, Renal Cell/diagnostic imaging
- Carcinoma, Renal Cell/drug therapy
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/immunology
- Cell Cycle Checkpoints/drug effects
- Cell Cycle Checkpoints/genetics
- Disease Management
- Gene Expression Regulation, Neoplastic
- Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use
- Humans
- Hypoxia/diagnostic imaging
- Hypoxia/drug therapy
- Hypoxia/genetics
- Hypoxia/immunology
- Kidney Neoplasms/diagnostic imaging
- Kidney Neoplasms/drug therapy
- Kidney Neoplasms/genetics
- Kidney Neoplasms/immunology
- Molecular Imaging/methods
- Molecular Targeted Therapy/methods
- Prognosis
- Recombinant Fusion Proteins/therapeutic use
- Signal Transduction
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Affiliation(s)
- Jean Courcier
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France; (J.C.); (I.L.); (N.L.)
- Department of Urology, Henri Mondor Hospital, Université Paris Est Créteil (UPEC), 94000 Créteil, France;
| | - Alexandre de la Taille
- Department of Urology, Henri Mondor Hospital, Université Paris Est Créteil (UPEC), 94000 Créteil, France;
| | - Maya Nourieh
- Department of Pathology, Henri Mondor Hospital, UPEC, 94000 Créteil, France;
| | - Ingrid Leguerney
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France; (J.C.); (I.L.); (N.L.)
| | - Nathalie Lassau
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France; (J.C.); (I.L.); (N.L.)
- Department of Imaging, Institute Gustave Roussy, 94800 Villejuif, France
| | - Alexandre Ingels
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France; (J.C.); (I.L.); (N.L.)
- Department of Urology, Henri Mondor Hospital, Université Paris Est Créteil (UPEC), 94000 Créteil, France;
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Wang RJ, Katha G, Phiri M, Delbridge P, Gordon SB, Calfee CS, Huang L, Rylance J. Sonographic B-Lines, Fluid Resuscitation, and Hypoxemia in Malawian Patients with Suspected Sepsis. Am J Respir Crit Care Med 2020; 202:463-466. [PMID: 32286847 PMCID: PMC7397793 DOI: 10.1164/rccm.202003-0640le] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Richard J. Wang
- University of California San FranciscoSan Francisco, California
| | - Grace Katha
- Queen Elizabeth Central HospitalBlantyre, Malawi
| | - Miriam Phiri
- Malawi Liverpool Wellcome Clinical Research ProgrammeBlantyre, Malawi
| | - Philip Delbridge
- Royal Liverpool University HospitalLiverpool, United Kingdom and
| | - Stephen B. Gordon
- Malawi Liverpool Wellcome Clinical Research ProgrammeBlantyre, Malawi
- Liverpool School of Tropical MedicineLiverpool, United Kingdom
| | | | - Laurence Huang
- University of California San FranciscoSan Francisco, California
| | - Jamie Rylance
- Malawi Liverpool Wellcome Clinical Research ProgrammeBlantyre, Malawi
- Liverpool School of Tropical MedicineLiverpool, United Kingdom
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Tong J, Quek WY. Not so innocuous after all: a case report of platypnoea-orthodeoxia syndrome. Singapore Med J 2020; 61:338-339. [PMID: 32754767 PMCID: PMC7905129 DOI: 10.11622/smedj.2018102] [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] [Indexed: 11/18/2022]
Affiliation(s)
- Jieli Tong
- Department of Cardiology, Tan Tock Seng Hospital, Singapore.
| | - Wei Yong Quek
- Department of Cardiology, Tan Tock Seng Hospital, Singapore.
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Lane SL, Doyle AS, Bales ES, Lorca RA, Julian CG, Moore LG. Increased uterine artery blood flow in hypoxic murine pregnancy is not sufficient to prevent fetal growth restriction†. Biol Reprod 2020; 102:660-670. [PMID: 31711123 PMCID: PMC7068112 DOI: 10.1093/biolre/ioz208] [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: 03/29/2019] [Revised: 08/19/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
Incomplete maternal vascular responses to pregnancy contribute to pregnancy complications including intrauterine growth restriction (IUGR) and preeclampsia. We aimed to characterize maternal vascular dysfunction in a murine model of fetal growth restriction as an approach toward identifying targetable pathways for improving pregnancy outcomes. We utilized a murine model of late-gestation hypoxia-induced IUGR that reduced E18.5 fetal weight by 34%. Contrary to our hypothesis, uterine artery blood flow as measured in vivo by Doppler ultrasound was increased in mice housed under hypobaric hypoxia (385 mmHg; 5500 m) vs normoxia (760 mmHg; 0 m). Using wire myography, uterine arteries isolated from hypoxic mice had similar vasodilator responses to the two activators A769662 and acetylcholine as those from normoxic mice, although the contribution of an increase in nitric oxide production to uterine artery vasodilation was reduced in the hypoxic vs normoxic groups. Vasoconstrictor responses to phenylephrine and potassium chloride were unaltered by hypoxia. The levels of activated adenosine monophosphate-activated protein kinase (AMPK) were reduced with hypoxia in both the uterine artery and placenta as measured by western blot and immunohistochemistry. We concluded that the rise in uterine artery blood flow may be compensatory to hypoxia but was not sufficient to prevent fetal growth restriction. Although AMPK signaling was reduced by hypoxia, AMPK was still receptive to pharmacologic activation in the uterine arteries in which it was a potent vasodilator. Thus, AMPK activation may represent a new therapy for pregnancy complications involving reduced uteroplacental perfusion.
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Affiliation(s)
- Sydney L Lane
- Integrated Physiology PhD Program, University of Colorado Denver Graduate School, Aurora, CO, USA
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Alexandrea S Doyle
- Division of Bioinformatics and Personalized Medicine, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Elise S Bales
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Ramón A Lorca
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Colleen G Julian
- Division of Bioinformatics and Personalized Medicine, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Lorna G Moore
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, USA
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Nie X, Elvington A, Laforest R, Zheng J, Voller TF, Zayed MA, Abendschein DR, Bandara N, Xu J, Li R, Randolph GJ, Gropler RJ, Lapi SE, Woodard PK. 64Cu-ATSM Positron Emission Tomography/Magnetic Resonance Imaging of Hypoxia in Human Atherosclerosis. Circ Cardiovasc Imaging 2020; 13:e009791. [PMID: 31910670 PMCID: PMC7328725 DOI: 10.1161/circimaging.119.009791] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Xingyu Nie
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Biomedical Engineering, Washington University in St. Louis, MO
| | - Andrew Elvington
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Richard Laforest
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Thomas F. Voller
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Mohamed A. Zayed
- Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Dana R. Abendschein
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Nilantha Bandara
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Jinbin Xu
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Ran Li
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Gwendalyn J. Randolph
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Robert J. Gropler
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Suzanne E. Lapi
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Biomedical Engineering, Washington University in St. Louis, MO
| | - Pamela K. Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Biomedical Engineering, Washington University in St. Louis, MO
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Lundeen KM, Bhoopal JR, Simegn MA, Leatherman JW. Acute Hypoxemia and Coma in a Patient With Hemoglobin SC Disease. Chest 2019; 155:e21-e23. [PMID: 30732697 DOI: 10.1016/j.chest.2018.10.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/18/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Kayla M Lundeen
- Residency Program in Internal Medicine, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN
| | - Jaidev R Bhoopal
- Division of Pulmonary and Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN
| | - Mengistu A Simegn
- Division of Cardiology, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN
| | - James W Leatherman
- Division of Pulmonary and Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN.
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Bloygrund H, Franjy-Tal Y, Rosenzweig T, Abookasis D. Multiparameter wide-field integrated optical imaging system-based spatially modulated illumination and laser speckles in model of tissue injuries. J Biophotonics 2019; 12:e201900141. [PMID: 31187933 DOI: 10.1002/jbio.201900141] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/03/2019] [Accepted: 06/07/2019] [Indexed: 06/09/2023]
Abstract
In this report, an integrated optical platform based on spatial illumination together with laser speckle contrast technique was utilized to measure multiple parameters in live tissue including absorption, scattering, saturation, composition, metabolism, and blood flow. Measurements in three models of tissue injury including drug toxicity, artery occlusion, and acute hyperglycemia were used to test the efficacy of this system. With this hybrid apparatus, a series of structured light patterns at low and high spatial frequencies are projected onto the tissue surface and diffuse reflected light is captured by a CCD camera. A six position filter wheel, equipped with four bandpass filters centered at wavelengths of 650, 690, 800 and 880 nm is placed in front of the camera. Then, light patterns are blocked and a laser source at 650 nm illuminates the tissue while the diffusely reflected light is captured by the camera through the two remaining open holes in the wheel. In this manner, near-infrared (NIR) and laser speckle images are captured and stored together in the computer for off-line processing to reconstruct the tissue's properties. Spatial patterns are used to differentiate the effects of tissue scattering from those of absorption, allowing accurate quantification of tissue hemodynamics and morphology, while a coherent light source is used to study blood flow changes, a feature which cannot be measured with the NIR structured light. This combined configuration utilizes the strengths of each system in a complementary way, thus collecting a larger range of sample properties. In addition, once the flow and hemodynamics are measured, tissue oxygen metabolism can be calculated, a property which cannot be measured independently. Therefore, this merged platform can be considered a multiparameter wide-field imaging and spectroscopy modality. Overall, experiments demonstrate the capability of this spatially coregistered imaging setup to provide complementary, useful information of various tissue metrics in a simple and noncontact manner, making it attractive for use in a variety of biomedical applications.
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Affiliation(s)
- Hadas Bloygrund
- Department of Electrical and Electronics Engineering, Ariel University, Ariel, Israel
| | - Yarden Franjy-Tal
- Department of Electrical and Electronics Engineering, Ariel University, Ariel, Israel
| | - Tovit Rosenzweig
- Department of Molecular Biology and Nutritional Studies, Ariel University, Ariel, Israel
| | - David Abookasis
- Department of Electrical and Electronics Engineering, Ariel University, Ariel, Israel
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Salem A, Little RA, Latif A, Featherstone AK, Babur M, Peset I, Cheung S, Watson Y, Tessyman V, Mistry H, Ashton G, Behan C, Matthews JC, Asselin MC, Bristow RG, Jackson A, Parker GJM, Faivre-Finn C, Williams KJ, O'Connor JPB. Oxygen-enhanced MRI Is Feasible, Repeatable, and Detects Radiotherapy-induced Change in Hypoxia in Xenograft Models and in Patients with Non-small Cell Lung Cancer. Clin Cancer Res 2019; 25:3818-3829. [PMID: 31053599 DOI: 10.1158/1078-0432.ccr-18-3932] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [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: 12/07/2018] [Revised: 02/04/2019] [Accepted: 03/14/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Hypoxia is associated with poor prognosis and is predictive of poor response to cancer treatments, including radiotherapy. Developing noninvasive biomarkers that both detect hypoxia prior to treatment and track change in tumor hypoxia following treatment is required urgently. EXPERIMENTAL DESIGN We evaluated the ability of oxygen-enhanced MRI (OE-MRI) to map and quantify therapy-induced changes in tumor hypoxia by measuring oxygen-refractory signals in perfused tissue (perfused Oxy-R). Clinical first-in-human study in patients with non-small cell lung cancer (NSCLC) was performed alongside preclinical experiments in two xenograft tumors (Calu6 NSCLC model and U87 glioma model). RESULTS MRI perfused Oxy-R tumor fraction measurement of hypoxia was validated with ex vivo tissue pathology in both xenograft models. Calu6 and U87 experiments showed that MRI perfused Oxy-R tumor volume was reduced relative to control following single fraction 10-Gy radiation and fractionated chemoradiotherapy (P < 0.001) due to both improved perfusion and reduced oxygen consumption rate. Next, evaluation of 23 patients with NSCLC showed that OE-MRI was clinically feasible and that tumor perfused Oxy-R volume is repeatable [interclass correlation coefficient: 0.961 (95% CI, 0.858-0.990); coefficient of variation: 25.880%]. Group-wise perfused Oxy-R volume was reduced at 14 days following start of radiotherapy (P = 0.015). OE-MRI detected between-subject variation in hypoxia modification in both xenograft and patient tumors. CONCLUSIONS These findings support applying OE-MRI biomarkers to monitor hypoxia modification, to stratify patients in clinical trials of hypoxia-modifying therapies, to identify patients with hypoxic tumors that may fail treatment with immunotherapy, and to guide adaptive radiotherapy by mapping regional hypoxia.
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Affiliation(s)
- Ahmed Salem
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
- Department of Clinical Oncology, The Christie Hospital NHS Trust, Manchester, United Kingdom
| | - Ross A Little
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Ayşe Latif
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - Adam K Featherstone
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Muhammad Babur
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - Isabel Peset
- Imaging and Flow Cytometry, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Susan Cheung
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Yvonne Watson
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Victoria Tessyman
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - Hitesh Mistry
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - Garry Ashton
- Histology, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Caron Behan
- Histology, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Julian C Matthews
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Marie-Claude Asselin
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Robert G Bristow
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Department of Clinical Oncology, The Christie Hospital NHS Trust, Manchester, United Kingdom
| | - Alan Jackson
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Geoff J M Parker
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom
- Bioxydyn Limited, Manchester, United Kingdom
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Department of Clinical Oncology, The Christie Hospital NHS Trust, Manchester, United Kingdom
| | - Kaye J Williams
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - James P B O'Connor
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom. James.O'
- Department of Radiology, The Christie Hospital NHS Trust, Manchester, United Kingdom
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49
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Patey O, Carvalho JS, Thilaganathan B. Perinatal changes in cardiac geometry and function in growth-restricted fetuses at term. Ultrasound Obstet Gynecol 2019; 53:655-662. [PMID: 30084123 DOI: 10.1002/uog.19193] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/30/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effect of fetal growth restriction (FGR) at term on fetal and neonatal cardiac geometry and function. METHODS This was a prospective study of 87 pregnant women delivering at term, comprising 54 normally grown and 33 FGR pregnancies. Fetal and neonatal conventional and spectral tissue Doppler and two-dimensional speckle tracking echocardiography were performed a few days before and within hours after birth. Fetal cardiac geometry, global myocardial deformation and performance and systolic and diastolic function were compared between normal and FGR pregnancies before and after birth. RESULTS Compared with normally grown fetuses, FGR fetuses exhibited more globular ventricular geometry and poorer myocardial deformation and cardiac function (left ventricular (LV) sphericity index (SI), 0.54 vs 0.49; right ventricular (RV) SI, 0.60 vs 0.54; LV torsion, 1.2 °/cm vs 3.0 °/cm; LV isovolumetric contraction time normalized by cardiac cycle length, 121 ms vs 104 ms; interventricular septum early diastolic myocardial peak velocity/atrial contraction myocardial diastolic peak velocity ratio, 0.60 vs 0.71; P < 0.01 for all). The poorest perinatal outcomes occurred in FGR fetuses with the most impaired cardiac functional indices. When compared with normally grown neonates, FGR neonates showed persistent alteration in cardiac parameters (LV-SI, 0.53 vs 0.50; RV-SI, 0.54 vs 0.44; LV torsion, 1.1 °/cm vs 1.4 °/cm; LV myocardial performance index (MPI'), 0.52 vs 0.42; P < 0.01 for all). Paired comparison of fetal vs neonatal cardiac indices in FGR demonstrated that birth was associated with a significant improvement in some, but not all, cardiac indices (RV-SI, 0.60 vs 0.54; RV-MPI', 0.49 vs 0.39; P < 0.001 for all). CONCLUSIONS Compared with normal pregnancies, FGR fetuses and neonates at term exhibit altered cardiac indices indicative of myocardial impairment that reflect adaptation to placental hypoxemia and alterations in hemodynamic load around the time of birth. Elucidating potential mechanisms that contribute to the alterations in perinatal cardiac adaptation in FGR could improve management and aid the development of better therapeutic strategies to reduce the risk of adverse pregnancy outcome. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- O Patey
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | - J S Carvalho
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | - B Thilaganathan
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
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50
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Meneghini A, Koenigkam-Santos M, Pereira M, Tonidandel P, Terra-Filho J, Cunha F, de Menezes M, Vianna E. Biomass smoke COPD has less tomographic abnormalities but worse hypoxemia compared with tobacco COPD. Braz J Med Biol Res 2019; 52:e8233. [PMID: 31038579 PMCID: PMC6487741 DOI: 10.1590/1414-431x20198233] [Citation(s) in RCA: 10] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/07/2019] [Indexed: 11/22/2022] Open
Abstract
Special attention has emerged towards biomass smoke-induced chronic obstructive pulmonary disease (COPD), providing new knowledge for prevention and therapeutic approach of non-smoker COPD patients. However, the understanding of biomass smoke COPD is still limited and somewhat controversial. The aim of the present study was to compare COPD exclusively caused by tobacco smoking with COPD exclusively caused by environmental or occupational exposures. For this cross-sectional study, COPD patients were recruited from outpatient clinics and formed two groups: non-smoker COPD group (n=16) with exposure to biomass smoke who did not smoke cigarette and tobacco smoker COPD group (n=15) with people who did not report biomass smoke exposure. Subjects underwent pulmonary function tests, thoracic high-resolution computed tomography, 6-min walk test, and sputum induction. The non-smoker COPD group had biomass smoke exposure of 133.3±86 hour-years. The tobacco COPD group smoked 48.5±27.4 pack-years. Women were 62.5 and 66.7%, respectively, of non-smokers and smokers. The non-smoker COPD group showed higher prevalence of dyspnea, lower arterial oxygen tension (PaO2), and lower arterial oxygen saturation (SaO2%) with similar spirometry results, lung volumes, and diffusion capacity. Regarding inflammatory biomarkers, differences were detected in sputum number of lymphomononuclear cells and in sputum concentrations of interleukin (IL)-6 and IL-8 with higher values in the smoker group. Emphysema was more prevalent in the tobacco smoker group, which also showed higher relative bronchial wall thickness and lower lung density by quantitative analysis. Biomass smoke induced more hypoxemia compared to tobacco in COPD patients with similar severity.
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Affiliation(s)
- A.C. Meneghini
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M. Koenigkam-Santos
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.C. Pereira
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - P.R. Tonidandel
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - J. Terra-Filho
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F.Q. Cunha
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.B. de Menezes
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E.O. Vianna
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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