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Lee H, Fu JF, Gaudet K, Bryant AG, Price JC, Bennett RE, Johnson KA, Hyman BT, Hedden T, Salat DH, Yen YF, Huang SY. Aberrant vascular architecture in the hippocampus correlates with tau burden in mild cognitive impairment and Alzheimer's disease. J Cereb Blood Flow Metab 2024; 44:787-800. [PMID: 38000018 PMCID: PMC11197134 DOI: 10.1177/0271678x231216144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/04/2023] [Accepted: 10/21/2023] [Indexed: 11/26/2023]
Abstract
Cerebrovascular dysfunction is a significant contributor to Alzheimer's disease (AD) progression. AD mouse models show altered capillary morphology, density, and diminished blood flow in areas of tau and beta-amyloid accumulation. The purpose of this study was to examine alterations in vascular structure and their contributions to perfusion deficits in the hippocampus in AD and mild cognitive impairment (MCI). Seven individuals with AD and MCI (1 AD/6 MCI), nine cognitively intact older healthy adults, and seven younger healthy adults underwent pseudo-continuous arterial spin labeling (PCASL) and gradient-echo/spin-echo (GESE) dynamic susceptibility contrast (DSC) MRI. Cerebral blood flow (CBF), cerebral blood volume, relative vessel size index (rVSI), and mean vessel density were calculated from model fitting. Lower CBF from PCASL and SE DSC MRI was observed in the hippocampus of AD/MCI group. rVSI in the hippocampus of the AD/MCI group was larger than that of the two healthy groups (FDR-P = 0.02). No difference in vessel density was detected between the groups. We also explored relationship of tau burden from 18F-flortaucipir positron emission tomography and vascular measures from MRI. Tau burden was associated with larger vessel size and lower CBF in the hippocampus. We postulate that larger vessel size may be associated with vascular alterations in AD/MCI.
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Affiliation(s)
- Hansol Lee
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Jessie Fanglu Fu
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Kyla Gaudet
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Annie G Bryant
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Rachel E Bennett
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Trey Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David H Salat
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Yi-Fen Yen
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Susie Y Huang
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
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2
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Zhang K, Triphan SMF, Kurz FT, Ziener CH, Kauczor HU, Schlemmer HP, Sedlaczek O. Navigator-based slice tracking for prospective motion correction in kidney vessel architecture imaging. Magn Reson Imaging 2023; 98:26-35. [PMID: 36603781 DOI: 10.1016/j.mri.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To apply a navigator-based slice tracking method to prospectively compensate the respiratory motion for kidney vessel architecture imaging (VAI). MATERIALS AND METHODS A dual gradient echo spin echo 2D EPI sequence was developed for kidney VAI. A single gradient-echo slice selection and projection readout at the location of the diaphragm along the inferior-superior direction was applied as a navigator. Navigator acquisition and fat suppression were inserted before each transverse imaging slice. Motion information was calculated after exclusion of the signal saturation in the navigator signal caused by imaging slices. The motion information was then directly sent back to the sequence and slice positioning was adjusted in real-time. The whole sequence was applied during a contrast agent pass-through. RESULTS VAI parametric maps show the structural heterogeneity of the renal vasculature. The respiratory motion from the navigator signal was precisely calculated and slice positioning was changed in real-time based on the motion information. The vibration amplitude of the signal intensity of the liver tissue at the liver-lung interface in the case of prospective motion correction (PMC) on is about 28% of the PMC off case. Compared to the case of PMC off, the coefficient of variation was reduced 30% of the case of PMC on. CONCLUSIONS This study demonstrates the feasibility of the motion-compensating technique in kidney VAI. The sequence may improve the evaluation of microvasculature in kidney diseases.
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Affiliation(s)
- Ke Zhang
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Christian H Ziener
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Oliver Sedlaczek
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
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Callewaert B, Jones EAV, Himmelreich U, Gsell W. Non-Invasive Evaluation of Cerebral Microvasculature Using Pre-Clinical MRI: Principles, Advantages and Limitations. Diagnostics (Basel) 2021; 11:diagnostics11060926. [PMID: 34064194 PMCID: PMC8224283 DOI: 10.3390/diagnostics11060926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022] Open
Abstract
Alterations to the cerebral microcirculation have been recognized to play a crucial role in the development of neurodegenerative disorders. However, the exact role of the microvascular alterations in the pathophysiological mechanisms often remains poorly understood. The early detection of changes in microcirculation and cerebral blood flow (CBF) can be used to get a better understanding of underlying disease mechanisms. This could be an important step towards the development of new treatment approaches. Animal models allow for the study of the disease mechanism at several stages of development, before the onset of clinical symptoms, and the verification with invasive imaging techniques. Specifically, pre-clinical magnetic resonance imaging (MRI) is an important tool for the development and validation of MRI sequences under clinically relevant conditions. This article reviews MRI strategies providing indirect non-invasive measurements of microvascular changes in the rodent brain that can be used for early detection and characterization of neurodegenerative disorders. The perfusion MRI techniques: Dynamic Contrast Enhanced (DCE), Dynamic Susceptibility Contrast Enhanced (DSC) and Arterial Spin Labeling (ASL), will be discussed, followed by less established imaging strategies used to analyze the cerebral microcirculation: Intravoxel Incoherent Motion (IVIM), Vascular Space Occupancy (VASO), Steady-State Susceptibility Contrast (SSC), Vessel size imaging, SAGE-based DSC, Phase Contrast Flow (PC) Quantitative Susceptibility Mapping (QSM) and quantitative Blood-Oxygenation-Level-Dependent (qBOLD). We will emphasize the advantages and limitations of each strategy, in particular on applications for high-field MRI in the rodent's brain.
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Affiliation(s)
- Bram Callewaert
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
- CMVB, Center for Molecular and Vascular Biology, University of Leuven, Herestraat 49, bus 911, 3000 Leuven, Belgium;
| | - Elizabeth A. V. Jones
- CMVB, Center for Molecular and Vascular Biology, University of Leuven, Herestraat 49, bus 911, 3000 Leuven, Belgium;
- CARIM, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Uwe Himmelreich
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
- Correspondence:
| | - Willy Gsell
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
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Choi HI, Ryu CW, Kim S, Rhee HY, Jahng GH. Changes in Microvascular Morphology in Subcortical Vascular Dementia: A Study of Vessel Size Magnetic Resonance Imaging. Front Neurol 2020; 11:545450. [PMID: 33192974 PMCID: PMC7658467 DOI: 10.3389/fneur.2020.545450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Cerebral small vessel disease is the most common cause of subcortical vascular dementia (SVaD). Unfortunately, conventional imaging techniques do not always demonstrate the microvascular pathology that is associated with small vessel disease. The purpose of this study was to evaluate the changes in the microvascular structure of SVaD and to identify how the microvascular changes in vessel size, detected with imaging, affect the gray matter. Methods: Ten SVaD patients and 12 healthy controls underwent vessel size imaging with gradient-echo and spin-echo sequences before and after contrast agent injection. Four microvessel index maps, including total blood volume fraction (BVf), mean vessel density (Q), mean vessel diameter (mVD), and vessel size index (VSI) were calculated. ROI value of each microvessel parameter was compared between SVaD patients and controls. Voxel-wise comparison of microvessel parameters was also performed to assess the regional difference. The relationship between the microvessel parameters in white matter and total gray matter volume (TGV) were assessed. Results: Both mVD and VSI were significantly different between the SVaD and controls in the ROI-based comparisons (unpaired t-test, p < 0.05). mVD and VSI were significantly increased in the SVaD group at the subcortical, periventricular white matter, basal ganglia, and thalami compared with the controls (FDR corrected, p < 0.05). VSI in the white matter areas were significantly negatively correlated with TGV (r = −0.446, p < 0.05). Conclusions: The increase of mVD and VSI in SVaD patients reflects the damage of the microvessels in the white matter, and these changes may lead to the damage of the gray matter.
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Affiliation(s)
- Hyeon-Il Choi
- Department of Radiology, Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Chang-Woo Ryu
- Department of Radiology, Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.,College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Songvin Kim
- Department of Radiology, Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Geon-Ho Jahng
- Department of Radiology, Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
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5
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Stadlbauer A, Eyüpoglu I, Buchfelder M, Dörfler A, Zimmermann M, Heinz G, Oberndorfer S. Vascular architecture mapping for early detection of glioblastoma recurrence. Neurosurg Focus 2019; 47:E14. [DOI: 10.3171/2019.9.focus19613] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/04/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVETreatment failure and inevitable tumor recurrence are the main reasons for the poor prognosis of glioblastoma (GB). Gross-total resection at repeat craniotomy for GB recurrence improves patient overall survival but requires early and reliable detection. It is known, however, that even advanced MRI approaches have limited diagnostic performance for distinguishing tumor progression from pseudoprogression. The novel MRI technique of vascular architectural mapping (VAM) provides deeper insight into tumor microvascularity and neovascularization. In this study the authors evaluated the usefulness of VAM for the monitoring of GB patients and quantitatively analyzed the features of neovascularization of early- and progressed-stage GB recurrence.METHODSIn total, a group of 115 GB patients who received overall 374 follow-up MRI examinations after standard treatment were retrospectively evaluated in this study. The clinical routine MRI (cMRI) protocol at 3 Tesla was extended with the authors’ experimental VAM approach, requiring 2 minutes of extra time for data acquisition. Custom-made MATLAB software was used for calculation of imaging biomarker maps of macrovascular perfusion from perfusion cMRI as well as of microvascular perfusion and architecture from VAM data. Additionally, cMRI data were analyzed by two board-certified radiologists in consensus. Statistical procedures included receiver operating characteristic (ROC) analysis to determine diagnostic performances for GB recurrence detection.RESULTSOverall, cMRI showed GB recurrence in 89 patients, and in 28 of these patients recurrence was detected earlier with VAM data, by 1 (20 patients) or 2 (8 patients) follow-up examinations, than with cMRI data. The mean time difference between recurrence detection with VAM and cMRI data was 147 days. During this time period the mean tumor volume increased significantly (p < 0.001) from 9.7 to 26.8 cm3. Quantitative analysis of imaging biomarkers demonstrated microvascular but no macrovascular hyperperfusion in early GB recurrence. Therefore, ROC analysis revealed superior diagnostic performance for VAM compared with cMRI.CONCLUSIONSThis study demonstrated that the targeted assessment of microvascular features using the VAM technique provided valuable information about early neovascularization activity in recurrent GB that is complementary to perfusion cMRI and may be helpful for earlier and more precise monitoring of patients suffering from GB. This VAM approach is compatible with existing cMRI protocols. Prospective clinical trials are necessary to investigate the clinical usefulness and potential benefit of increased overall survival with the use of VAM in patients with recurrent GB.
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Affiliation(s)
| | | | | | - Arnd Dörfler
- 3Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany; and
| | | | | | - Stefan Oberndorfer
- 4Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria
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6
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Stadlbauer A, Zimmermann M, Doerfler A, Oberndorfer S, Buchfelder M, Coras R, Kitzwögerer M, Roessler K. Intratumoral heterogeneity of oxygen metabolism and neovascularization uncovers 2 survival-relevant subgroups of IDH1 wild-type glioblastoma. Neuro Oncol 2019; 20:1536-1546. [PMID: 29718366 DOI: 10.1093/neuonc/noy066] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The intratumoral heterogeneity of oxygen metabolism in combination with variable patterns of neovascularization (NV) as well as reprogramming of energy metabolism affects the landscape of tumor microenvironments (TMEs) in glioblastoma. Knowledge of the hypoxic and perivascular niches within the TME is essential for understanding treatment failure. Methods Fifty-two patients with untreated glioblastoma (isocitrate dehydrogenase 1 wild type [IDH1wt]) were examined with a physiological MRI protocol including a multiparametric quantitative blood oxygen level dependent (qBOLD) approach and vascular architecture mapping (VAM). Imaging biomarker information about oxygen metabolism (mitochondrial oxygen tension) and neovascularization (microvascular density and type) were fused for classification of 6 different TMEs: necrosis, hypoxia with/without neovascularization, oxidative phosphorylation (OxPhos), and glycolysis with/without neovascularization. Association of the different TME volume fractions with progression-free survival (PFS) was assessed using Kaplan-Meier analysis and Cox proportional hazards models. Results A common spatial structure of TMEs was detected: central necrosis surrounded by tumor hypoxia (with defective and functional neovasculature) and different TMEs with a predominance of OxPhos and glycolysis for energy production, respectively. The percentage of the different TMEs on the total tumor volume uncovered 2 clearly different subtypes of glioblastoma IDH1wt: a glycolytic dominated phenotype with predominantly functional neovasculature and a necrotic/hypoxic dominated phenotype with approximately 50% of defective neovasculature. Patients with a necrotic/hypoxic dominated phenotype showed significantly shorter PFS (P = 0.035). Conclusions Our non-invasive mapping approach allows for classification of the TME and detection of tumor-supportive niches in glioblastoma which may be helpful for both clinical patient management and research.
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Affiliation(s)
- Andreas Stadlbauer
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.,Institute of Medical Radiology, University Clinic of St Pölten, St Pölten, Austria
| | - Max Zimmermann
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Oberndorfer
- Department of Neurology, University Clinic of St Pölten, St Pölten, Austria
| | - Michael Buchfelder
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Roland Coras
- Department of Neuropathology, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Karl Roessler
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
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7
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Zhang K, Yun SD, Triphan SMF, Sturm VJ, Buschle LR, Hahn A, Heiland S, Bendszus M, Schlemmer HP, Shah NJ, Ziener CH, Kurz FT. Vessel architecture imaging using multiband gradient-echo/spin-echo EPI. PLoS One 2019; 14:e0220939. [PMID: 31398234 PMCID: PMC6688807 DOI: 10.1371/journal.pone.0220939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 07/26/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives To apply the MB (multiband) excitation and blipped-CAIPI (blipped-controlled aliasing in parallel imaging) techniques in a spin and gradient-echo (SAGE) EPI sequence to improve the slice coverage for vessel architecture imaging (VAI). Materials and methods Both MB excitation and blipped-CAIPI with in-plane parallel imaging were incorporated into a gradient-echo (GE)/spin-echo (SE) EPI sequence for simultaneous tracking of the dynamic MR signal changes in both GE and SE contrasts after the injection of contrast agent. MB and singleband (SB) excitation were compared using a 20-channel head coil at 3 Tesla, and high-resolution MB VAI could be performed in 32 glioma patients. Results Whole-brain covered high resolution VAI can be achieved after applying multiband excitation with a factor of 2 and in-plane parallel imaging with a factor of 3. The quality of the images resulting from MB acceleration was comparable to those from the SB method: images were reconstructed without any loss of spatial resolution or severe distortions. In addition, MB and SB signal-to-noise ratios (SNR) were similar. A relative low g-factor induced from the MB acceleration method was achieved after using a blipped-CAIPI technique (1.35 for GE and 1.33 for SE imaging). Performing quantitative VAI, we found that, among all VAI parametric maps, microvessel type indicator (MTI), distance map (I) and vascular-induced bolus peak-time shift (VIPS) were highly correlated. Likewise, VAI parametric maps of slope, slope length and short axis were highly correlated. Conclusions Multiband accelerated SAGE successfully doubles the number of readout slices in the same measurement time when compared to conventional readout sequences. The corresponding VAI parametric maps provide insights into the complexity and heterogeneity of vascular changes in glioma.
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Affiliation(s)
- Ke Zhang
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Seong Dae Yun
- Institute of Neuroscience and Medicine- 4, Medical Imaging Physics, Forschungszentrum Jülich, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Volker J Sturm
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lukas R Buschle
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Artur Hahn
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - N Jon Shah
- Institute of Neuroscience and Medicine- 4, Medical Imaging Physics, Forschungszentrum Jülich, Germany.,Department of Neurology, Faculty of Medicine, JARA, RWTH Aachen University, Aachen, Germany
| | - Christian H Ziener
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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8
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Vejdani Afkham B, Masjoodi S, Oghabian MA, Ghodsi SR, Nazem Zadeh MR, Esmati E, Farzin M, Gilasi M, Hashemi H. Evaluation of contrast agent dose and diffusion coefficient measurement on vessel size index estimation. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 32:529-537. [PMID: 31270714 DOI: 10.1007/s10334-019-00760-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The goal of this study is to examine the effect of contrast agent (CA) dose and diffusion coefficient on the estimation of vessel size index (VSI). MATERIALS AND METHODS Three groups of four participants were enrolled in this study and two different experiments were performed. Different dose of CA, namely 0.1 mmol/kg and 0.05 mmol/kg were assessed in two groups of normal subjects. Diffusion coefficient effect was assessed in the third group with high-grade glioma. Imaging included gradient echo and spin-echo DSC and DTI on a 3-T MR Scanner. RESULTS VSI estimation using half of standard dose of CA showed higher values compared to the application of standard, with a ratio of 2 for the WM and 1.5 for the GM. VSI estimates for tumor tissues (22 µm) were considerably higher compared to contra-lateral Normal-Appearing WM (NAWM, 4 µm, P < 0.01) and Normal-Appearing GM (NAGM, 8 µm, P < 0.04). DISCUSSION Application of standard dose for CA injection and also taking into account the effect of diffusion coefficient can lead to a better correlation of VSI with previous theoretically predicted values and improvement of individual diagnostics in tumor evaluations.
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Affiliation(s)
- Behrouz Vejdani Afkham
- Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Masjoodi
- Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Reza Nazem Zadeh
- Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Esmati
- Radiation Oncology, Cancer Institute, Tehran University of Medical Science, Tehran, Iran
| | - Mostafa Farzin
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Gilasi
- Medical Imaging Center, Imam Khomeini Hospital, Tehran, Iran
| | - Hasan Hashemi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Radiology, Imam Khomeini Hospital, Institute of Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1417743855, Iran.
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9
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Stadlbauer A, Mouridsen K, Doerfler A, Bo Hansen M, Oberndorfer S, Zimmermann M, Buchfelder M, Heinz G, Roessler K. Recurrence of glioblastoma is associated with elevated microvascular transit time heterogeneity and increased hypoxia. J Cereb Blood Flow Metab 2018; 38:422-432. [PMID: 28273720 PMCID: PMC5851132 DOI: 10.1177/0271678x17694905] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Dynamic susceptibility contrast (DSC) perfusion MRI provide information about differences in macro- and microvasculature when executed with gradient-echo (GE; sensitive to macrovasculature) and spin-echo (SE; sensitive to microvasculature) contrast. This study investigated whether there are differences between macro- and microvascular transit time heterogeneity (MVTH and µVTH) and tissue oxygen tension (PO2mit) in newly-diagnosed and recurrent glioblastoma. Fifty-seven patients with glioblastoma (25 newly-diagnosed/32 recurrent) were examined with GE- and SE-DSC perfusion sequences, and a quantitative blood-oxygen-level-dependent (qBOLD) approach. Maps of MVTH, µVTH and coefficient of variation (MCOV and µCOV) were calculated from GE- and SE-DSC data, respectively, using an extended flow-diffusion equation. PO2mit maps were calculated from qBOLD data. Newly-diagnosed and recurrent glioblastoma showed significantly lower ( P ≤ 0.001) µCOV values compared to both normal brain and macrovasculature (MCOV) of the lesions. Recurrent glioblastoma had significantly higher µVTH ( P = 0.014) and µCOV ( P = 0.039) as well as significantly lower PO2mit values ( P = 0.008) compared to newly-diagnosed glioblastoma. The macrovasculature, however, showed no significant differences. Our findings provide evidence of microvascular adaption in the disorganized tumor vasculature for retaining the metabolic demands in stress response of therapeutically-uncontrolled glioblastomas. Thus, µVTH and PO2mit mapping gives insight into the tumor microenvironment (vascular and hypoxic niches) responsible for therapy resistance.
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Affiliation(s)
- Andreas Stadlbauer
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.,2 Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Kim Mouridsen
- 3 Center of Functionally Integrative Neuroscience and MIND Lab, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Arnd Doerfler
- 4 Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Mikkel Bo Hansen
- 3 Center of Functionally Integrative Neuroscience and MIND Lab, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stefan Oberndorfer
- 5 Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Max Zimmermann
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gertraud Heinz
- 2 Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Karl Roessler
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
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10
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Stadlbauer A, Zimmermann M, Oberndorfer S, Doerfler A, Buchfelder M, Heinz G, Roessler K. Vascular Hysteresis Loops and Vascular Architecture Mapping in Patients with Glioblastoma treated with Antiangiogenic Therapy. Sci Rep 2017; 7:8508. [PMID: 28819189 PMCID: PMC5561153 DOI: 10.1038/s41598-017-09048-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/19/2017] [Indexed: 01/06/2023] Open
Abstract
In this study, we investigated the variability of vascular hysteresis loop (VHL) shapes and the spatial heterogeneity of neovascularization and microvascular alterations using vascular architecture mapping (VAM) in patients with recurrent glioblastoma during bevacizumab mono-therapy. VAM data were acquired in 13 patients suffering from recurrent glioblastoma prior to and 3 months after bevacizumab treatment onset using a dual contrast agent injections approach as part of routine MRI. Two patients were additionally examined after the first cycle of bevacizumab to check for early treatment response. VHLs were evaluated as biomarker maps of neovascularization activity: microvessel type indicator (MTI) and curvature (Curv) of the VHL-long-axis. Early response to bevacizumab was dominated by reduction of smaller microvasculature (around 10 µm). In the 3-month follow-up, responding tumors additionally showed a reduction in larger microvasculature (>20 µm). VAM biomarker images revealed spatially heterogeneous microvascular alterations during bevacizumab treatment. Responding, non-responding, progressive, and remote-progressive tumor areas were observed. MTI may be useful to predict responding and non-responding tumor regions, and Curv to assess severity of vasogenic edema. Analysis of VHLs in combination with VAM biomarkers may lead to a new perspective on investigating the spatial heterogeneity of neovascularization and microvascular alterations in glioblastoma during antiangiogenic therapy.
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Affiliation(s)
- Andreas Stadlbauer
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany. .,Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria.
| | - Max Zimmermann
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Oberndorfer
- Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gertraud Heinz
- Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Karl Roessler
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
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11
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Fredrickson J, Serkova NJ, Wyatt SK, Carano RAD, Pirzkall A, Rhee I, Rosen LS, Bessudo A, Weekes C, de Crespigny A. Clinical translation of ferumoxytol-based vessel size imaging (VSI): Feasibility in a phase I oncology clinical trial population. Magn Reson Med 2017; 77:814-825. [PMID: 26918893 PMCID: PMC5677523 DOI: 10.1002/mrm.26167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 01/26/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE To assess the feasibility of acquiring vessel size imaging (VSI) metrics using ferumoxytol injections and stock pulse sequences in a multicenter Phase I trial of a novel therapy in patients with advanced metastatic disease. METHODS Scans were acquired before, immediately after, and 48 h after injection, at screening and after 2 weeks of treatment. ΔR2 , ΔR2*, vessel density (Q), and relative vascular volume fractions (VVF) were estimated in both normal tissue and tumor, and compared with model-derived theoretical and experimental estimates based on preclinical murine xenograft data. RESULTS R2 and R2* relaxation rates were still significantly elevated in tumors and liver 48 h after ferumoxytol injection; liver values returned to baseline by week 2. Q was relatively insensitive to changes in ΔR2*, indicating lack of dependence on contrast agent concentration. Variability in Q was higher among human tumors compared with xenografts and was mostly driven by ΔR2 . Relative VVFs were higher in human tumors compared with xenografts, while values in muscle were similar between species. CONCLUSION Clinical ferumoxytol-based VSI is feasible using standard MRI techniques in a multicenter study of patients with lesions outside of the brain. Ferumoxytol accumulation in the liver does not preclude measurement of VSI parameters in liver metastases. Magn Reson Med 77:814-825, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jill Fredrickson
- Oncology Clinical Development, Genentech, Inc., South San Francisco, CA, USA
| | - Natalie J. Serkova
- Department of Anesthesiology, University of Colorado Cancer Center, Aurora, CO, USA
| | - Shelby K. Wyatt
- Department of Biomedical Imaging, Genentech, Inc., South San Francisco, CA, USA
| | | | - Andrea Pirzkall
- Oncology Clinical Development, Genentech, Inc., South San Francisco, CA, USA
| | - Ina Rhee
- Oncology Clinical Development, Genentech, Inc., South San Francisco, CA, USA
| | - Lee S. Rosen
- Department of Medicine, Division of Hematology and Oncology, UCLA, Santa Monica, CA, USA
| | - Alberto Bessudo
- San Diego Pacific Oncology Hematology Associates, Inc., Encinitas, CA, USA
| | - Colin Weekes
- Department of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA
| | - Alex de Crespigny
- Oncology Clinical Development, Genentech, Inc., South San Francisco, CA, USA
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12
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Stadlbauer A, Zimmermann M, Heinz G, Oberndorfer S, Doerfler A, Buchfelder M, Rössler K. Magnetic resonance imaging biomarkers for clinical routine assessment of microvascular architecture in glioma. J Cereb Blood Flow Metab 2017; 37:632-643. [PMID: 27317652 PMCID: PMC5381464 DOI: 10.1177/0271678x16655549] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knowledge about the topological and structural heterogeneity of the microvasculature is important for diagnosis and monitoring of glioma. A vessel caliber and type-dependent temporal shift in the magnetic resonance imaging signal forms the basis for vascular architecture mapping. This study introduced a clinically feasible approach for assessment of vascular pathologies in gliomas using vascular architecture mapping. Sixty consecutive patients with known or suspected gliomas were examined using vascular architecture mapping as part of the routine magnetic resonance imaging protocol. Maps of microvessel radius and density, which adapted to the vasculature-dependent temporal shift phenomenon, were calculated using a costume-made software tool. Microvessel radius and density were moderately to severely elevated in a heterogeneous, inversely correlated pattern within high-grade gliomas. Additionally, three new imaging biomarkers were introduced: Microvessel type indicator allowing differentiation between supplying arterial and draining venous microvasculature in high-grade gliomas. Vascular-induced bolus peak time shift may presumably be sensitive for early neovascularization in the infiltration zone. Surprisingly, curvature showed significant changes in peritumoral vasogenic edema which correlated with neovascularization in the tumor core of high-grade gliomas. These new magnetic resonance imaging biomarkers give insights into complexity and heterogeneity of vascular changes in glioma; however, histological validations in more well-defined patient populations are required.
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Affiliation(s)
- Andreas Stadlbauer
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.,2 Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Max Zimmermann
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gertraud Heinz
- 2 Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Stefan Oberndorfer
- 3 Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Arnd Doerfler
- 4 Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, German y
| | - Michael Buchfelder
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- 1 Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
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13
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Stadlbauer A, Zimmermann M, Kitzwögerer M, Oberndorfer S, Rössler K, Dörfler A, Buchfelder M, Heinz G. MR Imaging-derived Oxygen Metabolism and Neovascularization Characterization for Grading and IDH Gene Mutation Detection of Gliomas. Radiology 2016; 283:799-809. [PMID: 27982759 DOI: 10.1148/radiol.2016161422] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To explore the diagnostic performance of physiological magnetic resonance (MR) imaging of oxygen metabolism and neovascularization activity for grading and characterization of isocitrate dehydrogenase (IDH) gene mutation status of gliomas. Materials and Methods This retrospective study had institutional review board approval; written informed consent was obtained from all patients. Eighty-three patients with histopathologically proven glioma (World Health Organization [WHO] grade II-IV) were examined with quantitative blood oxygen level-dependent imaging and vascular architecture mapping. Biomarker maps of neovascularization activity (microvessel radius, microvessel density, and microvessel type indicator [MTI]) and oxygen metabolism (oxygen extraction fraction [OEF] and cerebral metabolic rate of oxygen [CMRO2]) were calculated. Receiver operating characteristic analysis was used to determine diagnostic performance for grading and detection of IDH gene mutation status. Results Low-grade (WHO grade II) glioma showed areas with increased OEF (+18%, P < .001, n = 20), whereas anaplastic glioma (WHO grade III) and glioblastoma (WHO grade IV) showed decreased OEF when compared with normal brain tissue (-54% [P < .001, n = 21] and -49% [P < .001, n = 41], respectively). This allowed clear differentiation between low- and high-grade glioma (area under the receiver operating characteristic curve [AUC], 1) for the patient cohort. MTI had the highest diagnostic performance (AUC, 0.782) for differentiation between gliomas of grades III and IV among all biomarkers. CMRO2 was decreased (P = .037) in low-grade glioma with a mutated IDH gene, and MTI was significantly increased in glioma grade III with IDH mutation (P = .013) when compared with the IDH wild-type counterparts. CMRO2 showed the highest diagnostic performance for IDH gene mutation detection in low-grade glioma (AUC, 0.818) and MTI in high-grade glioma (AUC, 0.854) and for all WHO grades (AUC, 0.899) among all biomarkers. Conclusion MR imaging-derived oxygen metabolism and neovascularization characterization may be useful for grading and IDH mutation detection of gliomas and requires only 7 minutes of extra imaging time. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Andreas Stadlbauer
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Max Zimmermann
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Melitta Kitzwögerer
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Oberndorfer
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Arnd Dörfler
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gertraud Heinz
- From the Institute of Medical Radiology (A.S., G.H.), Department of Pathology (M.K.), and Department of Neurology (S.O.), University Clinic of St Pölten, Propst Führer-Strasse 4, A-3100 St Pölten, Austria; and Departments of Neurosurgery (A.S., M.Z., K.R., M.B.) and Neuroradiology (A.D.), University of Erlangen-Nürnberg, Erlangen, Germany
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14
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Imaging Tumor Vascularity and Response to Anti-Angiogenic Therapy Using Gaussia Luciferase. Sci Rep 2016; 6:26353. [PMID: 27198044 PMCID: PMC4873808 DOI: 10.1038/srep26353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 04/28/2016] [Indexed: 12/15/2022] Open
Abstract
We developed a novel approach to assess tumor vascularity using recombinant Gaussia luciferase (rGluc) protein and bioluminescence imaging. Upon intravenous injection of rGluc followed by its substrate coelenterazine, non-invasive visualization of tumor vascularity by bioluminescence imaging was possible. We applied this method for longitudinal monitoring of tumor vascularity in response to the anti-angiogenic drug tivozanib. This simple and sensitive method could be extended to image blood vessels/vasculature in many different fields.
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15
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Kang HY, Xiao HL, Chen JH, Tan Y, Chen X, Xie T, Fang JQ, Wang S, Yang Y, Zhang WG. Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading. AJNR Am J Neuroradiol 2015; 37:51-7. [PMID: 26381565 DOI: 10.3174/ajnr.a4477] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/14/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology. MATERIALS AND METHODS Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients. RESULTS Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas (P < .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters (r > 0.8, P < .05) and between relative cerebral blood volume and microvessel area (r = 0.6579, P < .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values. CONCLUSIONS Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas.
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Affiliation(s)
- H-Y Kang
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - H-L Xiao
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) Pathology (H.-L.X.)
| | - J-H Chen
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - Y Tan
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - X Chen
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - T Xie
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - J-Q Fang
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.)
| | - S Wang
- Departments of Radiology (S.W.)
| | - Y Yang
- Medicine (Y.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - W-G Zhang
- From Departments of Radiology (H.-Y.K., J.-H.C., H.-L.X., Y.T., X.C., T.X., J.-q.F., W.-G.Z.) State Key Laboratory of Trauma, Burns and Combined Injury (W.-G.Z.), Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China
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16
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Kellner E, Breyer T, Gall P, Müller K, Trippel M, Staszewski O, Stein F, Saborowski O, Dyakova O, Urbach H, Kiselev VG, Mader I. MR evaluation of vessel size imaging of human gliomas: Validation by histopathology. J Magn Reson Imaging 2015; 42:1117-25. [PMID: 25683112 DOI: 10.1002/jmri.24864] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/19/2015] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To compare the vessel size and the cerebral blood volume in human gliomas with histopathology. Vessel size imaging (VSI) is a dynamic susceptibility contrast method for the assessment of the vessel size in normal and pathological tissue. Previous publications in rodents showed a satisfactory conformity with the vessel size derived from histopathology. To assess the clinical value, further, the progression-free interval was determined and correlated. MATERIALS AND METHODS Twenty-five gliomas (WHO grade °II [n = 10], °III [n = 3], °IV [n = 12]) were prospectively included and received a stereotaxic biopsy after VSI. The vessel size and the cerebral blood volume (CBV) were calculated in regions of interest at the tumor edge and correlated with the vessel size measured by histopathology. RESULTS Both VSI and CBV showed a good correlation with the vessel size in histopathology (up to r = 0.84, P < 0.001, and r = 0.62, P < 0.001, respectively). Slope and offset of the linear regression (y = 0.77x + 0.36 μm) suggest that the size of normal capillaries is overestimated with VSI, while for grossly enlarged vessels an underestimation occurs. Both VSI and CBV were negatively correlated with the progression-free interval (r = -0.57, P = 0.008, and r = -0.50, P = 0.025, respectively). CONCLUSION The correlation between VSI and vessel size from histopathology is in good accordance with the animal studies. The overestimation of small capillary sizes is also known from the animal trials. Vessel size and CBV showed similar results, both for the correlation with the histopathological vessel size and the progression-free interval.
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Affiliation(s)
- Elias Kellner
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Germany
| | - Tobias Breyer
- Department of Neuroradiology, University Medical Center Freiburg, Germany
| | - Peter Gall
- Siemens AG, Healthcare Sector, Erlangen, Germany
| | - Klaus Müller
- Department of Neuropathology, University Medical Center Freiburg, Germany
| | - Michael Trippel
- Department of Stereotactic Neurosurgery, University Medical Center Freiburg, Germany
| | - Ori Staszewski
- Department of Neuropathology, University Medical Center Freiburg, Germany
| | - Florian Stein
- Department of Neuropathology, University Medical Center Freiburg, Germany
| | - Olaf Saborowski
- Department of Neuroradiology, University Medical Center Freiburg, Germany
| | - Olga Dyakova
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, University Medical Center Freiburg, Germany
| | - Valerij G Kiselev
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Germany
| | - Irina Mader
- Department of Neuroradiology, University Medical Center Freiburg, Germany
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Emblem KE, Farrar CT, Gerstner ER, Batchelor TT, Borra RJH, Rosen BR, Sorensen AG, Jain RK. Vessel caliber--a potential MRI biomarker of tumour response in clinical trials. Nat Rev Clin Oncol 2014; 11:566-84. [PMID: 25113840 PMCID: PMC4445139 DOI: 10.1038/nrclinonc.2014.126] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Our understanding of the importance of blood vessels and angiogenesis in cancer has increased considerably over the past decades, and the assessment of tumour vessel calibre and structure has become increasingly important for in vivo monitoring of therapeutic response. The preferred method for in vivo imaging of most solid cancers is MRI, and the concept of vessel-calibre MRI has evolved since its initial inception in the early 1990s. Almost a quarter of a century later, unlike traditional contrast-enhanced MRI techniques, vessel-calibre MRI remains widely inaccessible to the general clinical community. The narrow availability of the technique is, in part, attributable to limited awareness and a lack of imaging standardization. Thus, the role of vessel-calibre MRI in early phase clinical trials remains to be determined. By contrast, regulatory approvals of antiangiogenic agents that are not directly cytotoxic have created an urgent need for clinical trials incorporating advanced imaging analyses, going beyond traditional assessments of tumour volume. To this end, we review the field of vessel-calibre MRI and summarize the emerging evidence supporting the use of this technique to monitor response to anticancer therapy. We also discuss the potential use of this biomarker assessment in clinical imaging trials and highlight relevant avenues for future research.
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Affiliation(s)
- Kyrre E Emblem
- The Intervention Centre, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
| | - Christian T Farrar
- Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Elizabeth R Gerstner
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 100 Blossom Street, Boston, MA 02114, USA
| | - Tracy T Batchelor
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 100 Blossom Street, Boston, MA 02114, USA
| | - Ronald J H Borra
- Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Bruce R Rosen
- Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - A Gregory Sorensen
- Siemens Healthcare Health Services, 51 Valley Stream Parkway, Malvern, PA 19355, USA
| | - Rakesh K Jain
- Edwin L. Steele Laboratory of Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, 100 Blossom Street, Boston, MA 02114, USA
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Germuska MA, Meakin JA, Bulte DP. The influence of noise on BOLD-mediated vessel size imaging analysis methods. J Cereb Blood Flow Metab 2013; 33:1857-63. [PMID: 23942365 PMCID: PMC3851896 DOI: 10.1038/jcbfm.2013.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 07/16/2013] [Accepted: 07/17/2013] [Indexed: 12/17/2022]
Abstract
Vessel size imaging (VSI) is a magnetic resonance imaging (MRI) technique that aims to provide quantitative measurements of tissue microvasculature. An emerging variation of this technique uses the blood oxygenation level-dependent (BOLD) effect as the source of the imaging contrast. Gas challenges have the advantage over contrast injection techniques in that they are noninvasive and easily repeatable because of the fast washout of the contrast. However, initial results from BOLD-VSI studies are somewhat contradictory, with substantially different estimates of the mean vessel radius. Owing to BOLD-VSI being an emerging technique, there is not yet a standard processing methodology, and different techniques have been used to calculate the mean vessel radius and reject uncertain estimates. In addition, the acquisition methodology and signal modeling vary from group to group. Owing to these differences, it is difficult to determine the source of this variation. Here we use computer modeling to assess the impact of noise on the accuracy and precision of different BOLD-VSI calculations. Our results show both potential overestimates and underestimates of the mean vessel radius, which is confirmed with a validation study at 3T.
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Affiliation(s)
- Michael A Germuska
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - James A Meakin
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Daniel P Bulte
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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19
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Regan RE, Duffin J, Fisher JA. Instability of the middle cerebral artery blood flow in response to CO2. PLoS One 2013; 8:e70751. [PMID: 23936248 PMCID: PMC3728315 DOI: 10.1371/journal.pone.0070751] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/26/2013] [Indexed: 01/09/2023] Open
Abstract
Background The middle cerebral artery supplies long end-artery branches to perfuse the deep white matter and shorter peripheral branches to perfuse cortical and subcortical tissues. A generalized vasodilatory stimulus such as carbon dioxide not only results in an increase in flow to these various tissue beds but also redistribution among them. We employed a fast step increase in carbon dioxide to detect the dynamics of the cerebral blood flow response. Methodology/Principal Findings The study was approved by the Research Ethics Board of the University Health Network at the University of Toronto. We used transcranial ultrasound to measure the time course of middle cerebral artery blood flow velocity in 28 healthy adults. Normoxic, isoxic step increases in arterial carbon dioxide tension of 10 mmHg from both hypocapnic and normocapnic baselines were produced using a new prospective targeting system that enabled a more rapid step change than has been previously achievable. In most of the 28 subjects the responses at both carbon dioxide ranges were characterised by more complex responses than a single exponential rise. Most responses were characterised by a fast initial response which then declined rapidly to a nadir, followed by a slower secondary response, with some showing oscillations before stabilising. Conclusions/Significance A rapid step increase in carbon dioxide tension is capable of inducing instability in the cerebral blood flow control system. These dynamic aspects of the cerebral blood flow responses to rapid changes in carbon dioxide must be taken into account when using transcranial blood flow velocity in a single artery segment to measure cerebrovascular reactivity.
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Affiliation(s)
- Rosemary E. Regan
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - James Duffin
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- Department of Anaesthesia, University of Toronto, and University Health Network, Toronto, Ontario, Canada
- * E-mail:
| | - Joseph A. Fisher
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- Department of Anaesthesia, University of Toronto, and University Health Network, Toronto, Ontario, Canada
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Xu C, Kiselev VG, Möller HE, Fiebach JB. Dynamic hysteresis between gradient echo and spin echo attenuations in dynamic susceptibility contrast imaging. Magn Reson Med 2012; 69:981-91. [PMID: 22611004 DOI: 10.1002/mrm.24326] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/09/2012] [Accepted: 04/13/2012] [Indexed: 11/06/2022]
Abstract
Perfusion measurements using dynamic susceptibility contrast imaging provide additional information about the mean vessel size of microvasculature when supplemented with a dual gradient echo (GE) - spin echo (SE) contrast. Dynamic increase in the corresponding transverse relaxation rate constant changes, ΔR2GE and ΔR2SE , forms a loop on the (Δ R2SE3/2, ΔR2GE ) plane, rather than a reversible line. The shape of the loop and the direction of its passage differentiate between healthy brain and pathological tissue, such as tumour and ischemic tissue. By considering a tree model of microvasculature, the direction of the loop is found to be influenced mainly by the relative arterial and venous blood volume, as well as the tracer bolus dispersion. A parameter Λ is proposed to characterize the direction and shape of the loop, which might be considered as a novel imaging marker for describing the pathology of cerebrovascular network.
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Affiliation(s)
- Chao Xu
- Academic Neuroradiology, Center for Stroke Research Berlin, Charité-Universitätsmedizin, Berlin, Germany.
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Shen Y, Pu IM, Ahearn T, Clemence M, Schwarzbauer C. Quantification of venous vessel size in human brain in response to hypercapnia and hyperoxia using magnetic resonance imaging. Magn Reson Med 2012; 69:1541-52. [DOI: 10.1002/mrm.24258] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 02/14/2012] [Accepted: 02/22/2012] [Indexed: 12/17/2022]
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Xu C, Schmidt WU, Galinovic I, Villringer K, Hotter B, Ostwaldt AC, Denisova N, Kellner E, Kiselev V, Fiebach JB. The Potential of Microvessel Density in Prediction of Infarct Growth: A Two-Month Experimental Study in Vessel Size Imaging. Cerebrovasc Dis 2012; 33:303-9. [DOI: 10.1159/000335302] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 11/17/2011] [Indexed: 11/19/2022] Open
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Xu C, Schmidt WUH, Villringer K, Brunecker P, Kiselev V, Gall P, Fiebach JB. Vessel size imaging reveals pathological changes of microvessel density and size in acute ischemia. J Cereb Blood Flow Metab 2011; 31:1687-95. [PMID: 21468091 PMCID: PMC3170945 DOI: 10.1038/jcbfm.2011.38] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of this study was to test the feasibility of vessel size imaging with precise evaluation of apparent diffusion coefficient and cerebral blood volume and to apply this novel technique in acute stroke patients within a pilot group to observe the microvascular responses in acute ischemic tissue. Microvessel density-related quantity Q and mean vessel size index (VSI) were assessed in 9 healthy volunteers and 13 acute stroke patients with vessel occlusion within 6 hours after symptom onset. Our results in healthy volunteers matched with general anatomical observations. Given the limitation of a small patient cohort, the median VSI in the ischemic area was higher than that in the mirrored region in the contralateral hemisphere (P<0.05). Decreased Q was observed in the ischemic region in 2 patients, whereas no obvious changes of Q were found in the remaining 11 patients. In a patient without recanalization, the VSI hyperintensity in the subcortical area matched well with the final infarct. These data reveal that different observations of microvascular response in the acute ischemic tissue seem to emerge and vessel size imaging may provide useful information for the definition of ischemic penumbra and have an impact on future therapeutic approaches.
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Affiliation(s)
- Chao Xu
- Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Shen Y, Ahearn T, Clemence M, Schwarzbauer C. Magnetic resonance imaging of the mean venous vessel size in the human brain using transient hyperoxia. Neuroimage 2011; 55:1063-7. [PMID: 21224003 DOI: 10.1016/j.neuroimage.2010.12.084] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 11/29/2010] [Accepted: 12/03/2010] [Indexed: 10/18/2022] Open
Abstract
Vessel size imaging is an emerging magnetic resonance imaging (MRI) technique which has been demonstrated to provide clinically relevant information about microvascular morphology. While previous studies of vessel size in humans relied on MRI contrast agents or hypercapnia-induced changes in blood oxygenation, the technique described here uses transient hyperoxia to alter the venous blood oxygenation. The experimental paradigm consisted of two 3-minute intervals of breathing 100% O(2) interleaved with three 2-minute intervals of breathing room air. Parametric maps of the mean venous vessel radius were calculated from changes in the blood oxygenation level dependent (BOLD) contrast which were measured using a combined spin-echo (SE) and gradient echo (GE) echo-planar imaging (EPI) sequence. The corresponding mean values in grey and white matter were r=6.5±0.3 μm and r=6.2±0.3 μm (n=6). While the hypercapnia technique requires a specialised gas mixture containing a low concentration of CO(2) (typically 5-6%), the hyperoxia technique presented here uses the inhalation of medical oxygen (100% O(2)) which is routinely available in a clinical environment. Furthermore, 100% O(2) is generally better tolerated than low doses of CO(2) which makes this technique particularly suitable for applications in critically ill patients.
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Affiliation(s)
- Yuji Shen
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Scotland, UK
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