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Li S, Yang X, Lu T, Yuan L, Zhang Y, Zhao J, Deng J, Xue C, Sun Q, Liu X, Zhang W, Zhou J. Extracellular volume fraction can predict the treatment response and survival outcome of colorectal cancer liver metastases. Eur J Radiol 2024; 175:111444. [PMID: 38531223 DOI: 10.1016/j.ejrad.2024.111444] [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: 11/24/2023] [Revised: 03/09/2024] [Accepted: 03/21/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To assess the prognostic value of pre- and post-therapeutic changes in extracellular volume (ECV) fraction of liver metastases (LMs) for treatment response (TR) and survival outcomes in colorectal cancer liver metastases (CRLM). METHODS 186 LMs were confirmed by pathology or follow-up (Training: 130; Test: 56). We analyzed the changes in ECV fraction of LMs before and after 2 cycles of chemotherapy combined with bevacizumab. After 12 cycles, we evaluated the TR on LMs based on the RECIST v1.1. Relative changes in ECV fraction and Hounsfield Units (HU), defined as ΔECV and ΔHU, were associated with progression-free survival (PFS), overall survival (OS), and TR. We identified TR predictors with multivariate logistic regression and PFS, OS risk factors with COX analysis. RESULTS 186 LMs were classified as TR lesions (TR+: 84) and non-TR lesions (TR-:102). ΔECV, ΔHUA-E, and texture could distinguish the TR of LMs in training and test set (P < 0.05). ΔECV [Odds ratio (OR): 1.03; 95% Confidence interval (CI): 1.02-1.05, P < 0.01] was an independent predictor of TR-. Area under the curve (AUC), sensitivity and specificity of TR model in training and test set were 0.87, 0.84, 90.14%, 90.32%, 72.88%, 64.00%, respectively. High CRD_score indicates that patients have shorter PFS [Hazard ratio (HR): 2.01; 95%CI: 1.02-3.98, P = 0.045)] and OS (HR: 1.89, 95%CI: 1.04-3.42, P = 0.038). CONCLUSION ΔECV can be used as an independent predictor of TR of CRLM chemotherapy combined with bevacizumab.
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Affiliation(s)
- Shenglin Li
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
| | - Xinmei Yang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Ting Lu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Long Yuan
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Yuting Zhang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Jun Zhao
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Juan Deng
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Caiqiang Xue
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Qiu Sun
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China
| | - Xianwang Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Wenjuan Zhang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
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Du Y, Zhang S, Liang T, Shang J, Guo C, Lian J, Gong H, Yang J, Niu G. Dynamic contrast-enhanced MRI perfusion parameters are imaging biomarkers for angiogenesis in lung cancer. Acta Radiol 2023; 64:572-580. [PMID: 35369721 DOI: 10.1177/02841851221088581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may have the potential to reflect angiogenesis and proliferation of pulmonary neoplasms. PURPOSE To verify whether DCE-MRI can identify pulmonary neoplasm property and evaluate the correlation of DCE-MRI perfusion parameters with microvessel density (MVD) and Ki-67 in lung cancer. MATERIAL AND METHODS This study enrolled 65 patients with one pulmonary neoplasm who underwent computed tomography-guided percutaneous lung biopsy with pathological diagnosis (43 malignant, 22 benign; mean age = 59.71 ± 11.72 years). All patients did DCE-MRI before biopsy. Quantitative MRI parameters including endothelial transfer constant (Ktrans), flux rate constant (Kep), and fractional extravascular extracellular space (EES) volume (Ve) were calculated by extended Tofts linear model. MVD was evaluated by CD34-expressing tumor vessels. Proliferation was assessed by Ki-67 staining. The correlations of parameters with MVD and Ki-67 expression were analyzed. RESULTS Ktrans and Kep values were significantly increased in malignant lesions compared to benign lesions (P = 0.001 and 0.022, respectively), whereas no statistical difference in Ve was found. The CD34 expression was positively correlated to Ktrans (r = 0.608; P = 0.004) and Kep (r = 0.556; P = 0.001). Subsequent subtype analyses also showed positive correlations of Ktrans and Kep with MVD in adenocarcinoma group (r = 0.550 and 0.563; P = 0.012 and 0.015, respectively). No significant correlation was found between these parameters and Ki-67. CONCLUSION Ktrans and Kep may distinguish benign and malignant pulmonary neoplasm. Ktrans and Kep, with their positive correlation to MVD, can be used as non-invasive parameters reflecting lung cancer angiogenesis.
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Affiliation(s)
- Yonghao Du
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Shuo Zhang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Jin Shang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Chenguang Guo
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Jie Lian
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Huilin Gong
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Gang Niu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
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Rheinheimer S, Christopoulos P, Erdmann S, Saupe J, Golpon H, Vogel-Claussen J, Dinkel J, Thomas M, Heussel CP, Kauczor HU, Heussel G. Dynamic contrast enhanced MRI of pulmonary adenocarcinomas for early risk stratification: higher contrast uptake associated with response and better prognosis. BMC Med Imaging 2022; 22:215. [PMID: 36471318 PMCID: PMC9724354 DOI: 10.1186/s12880-022-00943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To explore the prognostic value of serial dynamic contrast-enhanced (DCE) MRI in patients with advanced pulmonary adenocarcinoma undergoing first-line therapy with either tyrosine-kinase inhibitors (TKI) or platinum-based chemotherapy (PBC). METHODS Patients underwent baseline (day 0, n = 98), and post-therapeutic DCE MRI (PBC: day + 1, n = 52); TKI: day + 7, n = 46) at 1.5T. Perfusion curves were acquired at 10, 40, and 70 s after contrast application and analysed semiquantitatively. Treatment response was evaluated at 6 weeks by CT (RECIST 1.1); progression-free survival (PFS) and overall survival were analysed with respect to clinical and perfusion parameters. Relative uptake was defined as signal difference between contrast and non-contrast images, divided by the non-contrast signal. Predictors of survival were selected using Cox regression analysis. Median follow-up was 825 days. RESULTS In pre-therapeutic and early post-therapeutic MRI, treatment responders (n = 27) showed significantly higher relative contrast uptake within the tumor at 70 s after application as compared to non-responders (n = 71, p ≤ 0.02), response defined as PR by RECIST 1.1 at 6 weeks. There was no significant change of perfusion at early MRI after treatment. In multivariate regression analysis of selected parameters, the strongest association with PFS were relative uptake at 40 s in the early post-treatment MRI and pre-treatment clinical data (presence of liver metastases, ECOG performance status). CONCLUSION Higher contrast uptake within the tumor at pre-treatment and early post-treatment MRI was associated with treatment response and better prognosis. DCE MRI of pulmonary adenocarcinoma may provide important prognostic information.
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Affiliation(s)
- Stephan Rheinheimer
- grid.7700.00000 0001 2190 4373Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.5253.10000 0001 0328 4908Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,Radiology, Asklepios Hospital Munich, Robert-Koch-Allee 2, 82131 Gauting, Germany
| | - Petros Christopoulos
- grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Thoracic Oncology, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Stella Erdmann
- Medical Biometry, Institute of Medical Biometry, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Julia Saupe
- grid.7700.00000 0001 2190 4373Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.5253.10000 0001 0328 4908Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Heiko Golpon
- grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.10423.340000 0000 9529 9877Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Jens Vogel-Claussen
- grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,Diagnostic and Interventional Radiology and Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany ,grid.10423.340000 0000 9529 9877Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Julien Dinkel
- grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,Radiology, Asklepios Hospital Munich, Robert-Koch-Allee 2, 82131 Gauting, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Michael Thomas
- grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Thoracic Oncology, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Claus Peter Heussel
- grid.7700.00000 0001 2190 4373Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.5253.10000 0001 0328 4908Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Hans-Ulrich Kauczor
- grid.5253.10000 0001 0328 4908Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
| | - Gudula Heussel
- grid.7700.00000 0001 2190 4373Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Thoracic Oncology, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126 Heidelberg, Germany ,grid.452624.3German Center for Lung Research (DZL), Giessen, Germany
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Weber JPD, Spiro JE, Scheffler M, Wolf J, Nogova L, Tittgemeyer M, Maintz D, Laue H, Persigehl T. Reproducibility of dynamic contrast enhanced MRI derived transfer coefficient Ktrans in lung cancer. PLoS One 2022; 17:e0265056. [PMID: 35259199 PMCID: PMC8903254 DOI: 10.1371/journal.pone.0265056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/22/2022] [Indexed: 12/25/2022] Open
Abstract
Dynamic contrast enhanced MRI (DCE-MRI) is a useful method to monitor therapy assessment in malignancies but must be reliable and comparable for successful clinical use. The aim of this study was to evaluate the inter- and intrarater reproducibility of DCE-MRI in lung cancer. At this IRB approved single centre study 40 patients with lung cancer underwent up to 5 sequential DCE-MRI examinations. DCE-MRI were performed using a 3.0T system. The volume transfer constant Ktrans was assessed by three readers using the two-compartment Tofts model. Inter- and intrarater reliability and agreement was calculated by wCV, ICC and their 95% confident intervals. DCE-MRI allowed a quantitative measurement of Ktrans in 107 tumors where 91 were primary carcinomas or intrapulmonary metastases and 16 were extrapulmonary metastases. Ktrans showed moderate to good interrater reliability in overall measurements (ICC 0.716-0.841; wCV 30.3-38.4%). Ktrans in pulmonary lesions ≥ 3 cm showed a good to excellent reliability (ICC 0.773-0.907; wCV 23.0-29.4%) compared to pulmonary lesions < 3 cm showing a moderate to good reliability (ICC 0.710-0.889; wCV 31.6-48.7%). Ktrans in intrapulmonary lesions showed a good reliability (ICC 0.761-0.873; wCV 28.9-37.5%) compared to extrapulmonary lesions with a poor to moderate reliability (ICC 0.018-0.680; wCV 28.1-51.8%). The overall intrarater agreement was moderate to good (ICC 0.607-0.795; wCV 24.6-30.4%). With Ktrans, DCE MRI offers a reliable quantitative biomarker for early non-invasive therapy assessment in lung cancer patients, but with a coefficient of variation of up to 48.7% in smaller lung lesions.
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Affiliation(s)
| | - Judith Eva Spiro
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Comprehensive Pneumology Center, Member of the German Center for Lung Research, Munich, Germany
| | - Matthias Scheffler
- Lung Cancer Group, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Jürgen Wolf
- Lung Cancer Group, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Lucia Nogova
- Lung Cancer Group, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | | | - David Maintz
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Hendrik Laue
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
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Cheriyan J, Roberts A, Roberts C, Graves MJ, Patterson I, Slough RA, Schroyer R, Fernando D, Kumar S, Lee S, Parker GJM, Sarov-Blat L, McEniery C, Middlemiss J, Sprecher D, Janiczek RL. Evaluation of Dynamic Contrast-Enhanced MRI Measures of Lung Congestion and Endothelial Permeability in Heart Failure: A Prospective Method Validation Study. J Magn Reson Imaging 2022; 56:450-461. [PMID: 35343008 PMCID: PMC9544235 DOI: 10.1002/jmri.28174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
Abstract
Background Methods for accurate quantification of lung fluid in heart failure (HF) are needed. Dynamic contrast‐enhanced (DCE)‐MRI may be an appropriate modality. Purpose DCE‐MRI evaluation of fraction of fluid volume in the interstitial lung space (ve) and vascular permeability (Ktrans). Study Type Prospective, single‐center method validation. Population Seventeen evaluable healthy volunteers (HVs), 12 participants with HF, and 3 with acute decompensated HF (ADHF). Field Strength/Sequence T1 mapping (spoiled gradient echo variable flip angle acquisition) followed by dynamic series (three‐dimensional spoiled gradient‐recalled echo acquisitions [constant echo time, repetition time, and flip angle at 1.5 T]). Assessment Three whole‐chest scans were acquired: baseline (Session 1), 1‐week later (Session 2), following exercise (Session 3). Extended Tofts model quantified ve and Ktrans (voxel‐wise basis); total lung median measures were extracted and fitted via repeat measure analysis of variance (ANOVA) model. Patient tolerability of the scanning protocol was assessed. Statistical Tests This was constructed as an experimental medicine study. Primary endpoints: Ktrans and ve at baseline (HV vs. HF), change in Ktrans and ve following exercise, and following lung congestion resolution (ADHF). Ktrans and ve were fitted separately using ANOVA. Secondary endpoint: repeatability, that is, within‐participant variability in ve and Ktrans between sessions (coefficient of variation estimated via mixed effects model). Results There was no significant difference in mean Ktrans between HF and HV (P ≤ 0.17): 0.2216 minutes−1 and 0.2353 minutes−1 (Session 1), 0.2044 minutes−1 and 0.2567 minutes−1 (Session 2), 0.1841 minutes−1 and 0.2108 minutes−1 (Session 3), respectively. ve was greater in the HF group (all scans, P ≤ 0.02). Results were repeatable between Sessions 1 and 2; mean values for HF and HV were 0.4946 and 0.3346 (Session 1), 0.4353 and 0.3205 (Session 2), respectively. There was minimal difference in Ktrans or ve between scans for participants with ADHF (small population precluded significance testing). Scanning was well tolerated. Data Conclusion While no differences were detected in Ktrans, ve was greater in chronic HF patients vs. HV, augmented beyond plasma and intracellular volume. DCE‐MRI is a valuable diagnostic and physiologic tool to evaluate changes in fluid volume in the interstitial lung space associated with symptomatic HF. Level of Evidence 2 Technical Efficacy Stage 2
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Affiliation(s)
- Joseph Cheriyan
- Research, GSK Clinical Unit Cambridge, Cambridge, UK.,Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.,Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Martin J Graves
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ilse Patterson
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rhys A Slough
- Cardiovascular Clinical Trials Office, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | - Sarah Lee
- Consulting, Amallis Consulting Ltd, London, UK
| | - Geoffrey J M Parker
- Imaging Services, Bioxydyn Ltd, Manchester, UK.,Centre for Medical Imaging Computing, Department of Computer Science, University College London, London, UK
| | - Lea Sarov-Blat
- Research and Development, GSK, Crescent Drive, Philadelphia, Pennsylvania, USA
| | - Carmel McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Jessica Middlemiss
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Dennis Sprecher
- Consulting, BioView Consulting LLC, Blue Bell, Pennsylvania, USA
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Adams CJ, Meade TJ. Towards Imaging Pt Chemoresistance Using Gd(III)-Pt(II) Theranostic MR Contrast Agents. ChemMedChem 2021; 16:3663-3671. [PMID: 34355523 PMCID: PMC8678168 DOI: 10.1002/cmdc.202100389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/08/2021] [Indexed: 12/16/2022]
Abstract
Cisplatin and related Pt(II) chemotherapeutics are indispensable tools for the treatment of various solid tumors. Despite their widespread clinical use in approximately 50 % of chemotherapy regimens, they are hindered by issues with off-target toxicity and chemoresistance, both innate and acquired. To date, there is no effective way to predict the outcome of Pt(II) chemotherapy because the genes associated with resistance are not completely known or understood. Instead, patients undergo weeks to months of potentially harmful therapy before knowing if it is effective. Here we report two Gd(III)-Pt(II) theranostic MR contrast agents that contain cisplatin and carboplatin-based moieties respectively. We used these agents to demonstrate that accumulation differences in Pt(II) sensitive and resistant cells, a dominant factor in chemoresistance, can be imaged by MR. Both theranostic agents bind to DNA, are cytotoxic, and enhance the intracellular T1 -weighted MR contrast of multiple cell lines. Most importantly, the cisplatin-based agent accumulates less in Pt(II) resistant cells in vitro and in vivo, resulting in decreased MR contrast enhancement compared to the parent Pt(II) sensitive cell line. This straightforward method to image a key factor of Pt(II) resistance using MRI is an important first step towards the ultimate goals of predicting response to Pt(II) chemotherapy and monitoring for the onset of chemoresistance - a critical unmet need in medicine that could significantly improve patient outcomes.
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Affiliation(s)
- Casey J. Adams
- Department of Chemistry, Northwestern University, 2170 Campus Drive, Evanston, IL 60208 (USA)
| | - Thomas J. Meade
- Department of Chemistry, Northwestern University, 2170 Campus Drive, Evanston, IL 60208 (USA)
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7
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Liu H, Zheng L, Shi G, Xu Q, Wang Q, Zhu H, Feng H, Wang L, Zhang N, Xue M, Dai Y. Pulmonary Functional Imaging for Lung Adenocarcinoma: Combined MRI Assessment Based on IVIM-DWI and OE-UTE-MRI. Front Oncol 2021; 11:677942. [PMID: 34307146 PMCID: PMC8292137 DOI: 10.3389/fonc.2021.677942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/11/2021] [Indexed: 01/11/2023] Open
Abstract
Purpose The goal of current study was to introduce noninvasive and reproducible MRI methods for in vivo functional assessment of lung adenocarcinoma (LUAD). Methods Forty-four patients with pathologically confirmed LUAD were included in this study. All the lesions were classified as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA). The IA lesions were further divided into five subtype patterns, including acinar, lepidic, papillary, micropapillary and solid. Tumors were grouped depending on predominant subtype: low grade (AIS, MIA or lepidic predominant), intermediate grade (papillary or acinar predominant) and high grade (micropapillary, or solid predominant). Spirometry was performed according to American Thoracic Society guidelines. For each patient, Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) analysis and oxygen-enhanced MRI (OE-MRI) analysis were performed. Spearman's test was used to assess the relationship between a) whole lung mean percent signal enhancement (PSE) and pulmonary function tests (PFTs) parameters; b) IVIM-derived parameters and PFTs parameters; c) tumor mean PSE and IVIM-derived parameters. Kruskal -Wallis tests were applied to test the difference of tumor mean PSE and IVIM-derived parameters between different histological tumor grades. Receiver operating characteristics (ROC) analysis was used to evaluate the diagnostic performance. Results Whole lung mean PSE was significantly positively correlated with PFTs parameters (r = 0.40 ~ 0.44, P < 0.05). f value derived from IVIM-DWI was significantly negatively correlated with PFTs parameters (r = -0.38 ~ -0.47, P < 0.05). Both tumor mean PSE (P = 0.030 < 0.05) and f (P = 0.022 < 0.05) could differentiate different histological grades. f was negatively correlated with tumor mean PSE (r = -0.61, P < 0.001). For the diagnostic performance, the combination of tumor mean PSE and f outperformed than using tumor mean PSE or f alone in both sensitivity and area under the ROC curve. Conclusions The combined measurement of OE-MRI and IVIM-DWI may serve as a promising method for the noninvasive and non-radiation evaluation of pulmonary function. Quantitative analyses achieved by OE-MRI and IVIM-DWI offer an approach of the classification of LUAD subtypes.
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Affiliation(s)
- Hui Liu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liyun Zheng
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Gaofeng Shi
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qian Xu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qi Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongshan Zhu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui Feng
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lijia Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Zhang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Xue
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yongming Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
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Wu W, Zhou S, Hippe DS, Liu H, Wang Y, Mayr NA, Yuh WT, Xia L, Bowen SR. Whole-Lesion DCE-MRI Intensity Histogram Analysis for Diagnosis in Patients with Suspected Lung Cancer. Acad Radiol 2021; 28:e27-e34. [PMID: 32102748 DOI: 10.1016/j.acra.2020.01.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/17/2020] [Accepted: 01/18/2020] [Indexed: 02/07/2023]
Abstract
RATIONALE AND OBJECTIVES To explore the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) intensity histogram metrics, relative to time intensity curve (TIC)-derived metrics, in patients with suspected lung cancer. MATERIALS AND METHODS This retrospective study enrolled 49 patients with suspected lung cancer on routine CT imaging who underwent DCE-MRI scans and had final histopathologic diagnosis. Three TIC-derived metrics (maximum enhancement ratio, peak time [Tmax] and slope) and eight intensity histogram metrics (volume, integral, maximum, minimum, median, coefficient of variation [CoV], skewness, and kurtosis) were extracted from DCE-MRI images. TIC-derived and intensity histogram metrics were compared between benignity versus malignancy using the Wilcoxon rank-sum test. Associations between imaging metrics and malignancy risk were assessed by univariate and multivariate logistic regression odds ratios (ORs). RESULTS There were 33 malignant lesions and 16 benign lesions based on histopathology. Lower CoV (OR = 0.2 per 1-SD increase, p = 0.0006), lower Tmax (OR = 0.4 per 1-SD increase, p = 0.005), and steeper slope (OR = 2.4 per 1-SD increase, p = 0.010) were significantly associated with increased risk of malignancy. Under multivariate analysis, CoV was significantly independently associated with malignancy likelihood after accounting for either Tmax (OR = 0.3 per 1-SD increase, p = 0.007) or slope (OR = 0.3 per 1-SD increase, p = 0.011). CONCLUSION This initial study found that DCE-MRI CoV was independently associated with malignancy in patients with suspected lung cancer. CoV has the potential to help diagnose indeterminate pulmonary lesions and may complement TIC-derived DCE-MRI metrics. Further studies are warranted to validate the diagnostic value of DCE-MRI intensity histogram analysis.
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Lee SH, Rimner A, Deasy JO, Hunt MA, Tyagi N. Dual-input tracer kinetic modeling of dynamic contrast-enhanced MRI in thoracic malignancies. J Appl Clin Med Phys 2019; 20:169-188. [PMID: 31602789 PMCID: PMC6839367 DOI: 10.1002/acm2.12740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 12/29/2022] Open
Abstract
Pulmonary perfusion with dynamic contrast‐enhanced (DCE‐) MRI is typically assessed using a single‐input tracer kinetic model. Preliminary studies based on perfusion CT are indicating that dual‐input perfusion modeling of lung tumors may be clinically valuable as lung tumors have a dual blood supply from the pulmonary and aortic system. This study aimed to investigate the feasibility of fitting dual‐input tracer kinetic models to DCE‐MRI datasets of thoracic malignancies, including malignant pleural mesothelioma (MPM) and nonsmall cell lung cancer (NSCLC), by comparing them to single‐input (pulmonary or systemic arterial input) tracer kinetic models for the voxel‐level analysis within the tumor with respect to goodness‐of‐fit statistics. Fifteen patients (five MPM, ten NSCLC) underwent DCE‐MRI prior to radiotherapy. DCE‐MRI data were analyzed using five different single‐ or dual‐input tracer kinetic models: Tofts‐Kety (TK), extended TK (ETK), two compartment exchange (2CX), adiabatic approximation to the tissue homogeneity (AATH) and distributed parameter (DP) models. The pulmonary blood flow (BF), blood volume (BV), mean transit time (MTT), permeability‐surface area product (PS), fractional interstitial volume (vI), and volume transfer constant (KTrans) were calculated for both single‐ and dual‐input models. The pulmonary arterial flow fraction (γ), pulmonary arterial blood flow (BFPA) and systemic arterial blood flow (BFA) were additionally calculated for only dual‐input models. The competing models were ranked and their Akaike weights were calculated for each voxel according to corrected Akaike information criterion (cAIC). The optimal model was chosen based on the lowest cAIC value. In both types of tumors, all five dual‐input models yielded lower cAIC values than their corresponding single‐input models. The 2CX model was the best‐fitted model and most optimal in describing tracer kinetic behavior to assess microvascular properties in both MPM and NSCLC. The dual‐input 2CX‐model‐derived BFA was the most significant parameter in differentiating adenocarcinoma from squamous cell carcinoma histology for NSCLC patients.
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Affiliation(s)
- Sang Ho Lee
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Margie A Hunt
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Neelam Tyagi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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10
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Predicting tumor responses and patient survival in chemoradiotherapy-treated patients with non-small-cell lung cancer using dynamic contrast-enhanced integrated magnetic resonance-positron-emission tomography. Strahlenther Onkol 2019; 195:707-718. [PMID: 30610356 DOI: 10.1007/s00066-018-1418-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 12/14/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE We investigated whether radiologic parameters by dynamic contrast-enhanced (DCE) integrated magnetic resonance-positron-emission tomography (MR-PET) predicts tumor response to treatment and survival in non-metastatic non-small-cell lung cancer (NSCLC) patients receiving chemoradiotherapy (CRT). METHODS Patients underwent DCE integrated MR-PET imaging 1 week before CRT. The following parameters were analyzed: primary tumor size, gross tumor volume, maximal standardized uptake value (SUVmax), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC), volume transfer constant (Ktrans), reverse reflux rate constant (kep), extracellular extravascular volume fraction (ve), blood plasma volume fraction (vp), and initial area under the time-concentration curve defined over the first 60 s post-enhancement (iAUC60). CRT responses were defined using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). RESULTS Thirty patients were included. Non-responders demonstrated higher baseline TLG (p = 0.012), and lower baseline Ktrans (p = 0.020) and iAUC60 (p = 0.016) compared to responders, indicating the usefulness of DCE integrated MR-PET to predict treatment responses. Receiver operating characteristic curve indicated that TLG has the best differentiation capability to predict responders. By setting the threshold of TLG to 277, the sensitivity, specificity, and accuracy were 66.7%, 83.3%, and 75.0%, respectively, with an area under the curve of 0.776. The median follow-up time was 19.6 (range 7.8-32.0) months. In univariate analyses, baseline TLG >277 (p = 0.005) and baseline Ktrans <254 (10-3 min-1; p = 0.015) correlated with poor survival after CRT. In multivariate analysis, baseline TLG >277 remained the significant factor in predicting progression (p = 0.012) and death (p = 0.031). CONCLUSIONS The radiologic parameters derived from DCE integrated MR-PET scans are useful for predicting treatment response in NSCLC patients treated with CRT; furthermore, these parameters are correlated with clinical and survival outcomes including tumor progression and death.
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Xu J, Mei L, Liu L, Wang K, Zhou Z, Zheng J. Early assessment of response to chemotherapy in lung cancer using dynamic contrast-enhanced MRI: a proof-of-concept study. Clin Radiol 2018; 73:625-631. [PMID: 29571650 DOI: 10.1016/j.crad.2018.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/16/2018] [Indexed: 10/17/2022]
Abstract
AIM To evaluate the early treatment response to chemotherapy in patients with lung cancer using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty-two patients with lung cancer underwent DCE-MRI before chemotherapy and 1 week after the start of the first course of chemotherapy. Pharmacokinetic parameters (Ktrans, Kep, and Ve) derived from DCE MRI were generated using the post-processing platform. These parameters and corresponding changes were compared between responders and non-responders after treatment using Student's t or Mann-Whitney U-tests. Diagnostic efficiency of kinetic parameters in differentiating responders from non-responders after 1 week of chemotherapy was also investigated. RESULTS Thirteen responders after 1 week of chemotherapy had a significant decrease in Ktrans and Ve compared with the pretreatment value (p<0.05), and had no significant changes in Kep (p>0.05). Nine non-responders had no significant changes in Ktrans, Kep, and Ve compared with the pretreatment value (p>0.05). Changes in Ktrans (ΔKtrans) were significantly larger in responders than that in non-responders (p<0.05). Changes in Ve and Kep (ΔVe andΔKep) were without statistical significance after treatment between responders and non-responders (p>0.05). The cut-off value of ΔKtrans in best predicting tumour's chemotherapeutic response was 0.032/min and the corresponding AUC (area under the curve), sensitivity, specificity, and accuracy were 0.821, 84.62%, 77.78%, and 81.82%, respectively. CONCLUSION DCE MRI may be useful for evaluating the early response to chemotherapy in patients with lung cancer, but larger, more definitive studies are needed.
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Affiliation(s)
- J Xu
- Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China; Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - L Mei
- Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China
| | - L Liu
- Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China
| | - K Wang
- Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China
| | - Z Zhou
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - J Zheng
- Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China.
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Chen L, Liu D, Zhang J, Xie B, Zhou X, Grimm R, Huang X, Wang J, Feng L. Free-breathing dynamic contrast-enhanced MRI for assessment of pulmonary lesions using golden-angle radial sparse parallel imaging. J Magn Reson Imaging 2018; 48:459-468. [PMID: 29437281 DOI: 10.1002/jmri.25977] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 01/30/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been shown to be a promising technique for assessing lung lesions. However, DCE-MRI often suffers from motion artifacts and insufficient imaging speed. Therefore, highly accelerated free-breathing DCE-MRI is of clinical interest for lung exams. PURPOSE To test the performance of rapid free-breathing DCE-MRI for simultaneous qualitative and quantitative assessment of pulmonary lesions using Golden-angle RAdial Sparse Parallel (GRASP) imaging. STUDY TYPE Prospective. POPULATION Twenty-six patients (17 males, mean age = 55.1 ± 14.4) with known pulmonary lesions. FIELD STRENGTH/SEQUENCE 3T MR scanner; a prototype fat-saturated, T1 -weighted stack-of-stars golden-angle radial sequence for data acquisition and a Cartesian breath-hold volumetric-interpolated examination (BH-VIBE) sequence for comparison. ASSESSMENT After a dual-mode GRASP reconstruction, one with 3-second temporal resolution (3s-GRASP) and the other with 15-second temporal resolution (15s-GRASP), all GRASP and BH-VIBE images were pooled together for blind assessment by two experienced radiologists, who independently scored the overall image quality, lesion delineation, overall artifact level, and diagnostic confidence of each case. Perfusion analysis was performed for the 3s-GRASP images using a Tofts model to generate the volume transfer coefficient (Ktrans ) and interstitial volume (Ve ). STATISTICAL TESTS Nonparametric paired two-tailed Wilcoxon signed-rank test; Cohen's kappa; unpaired Student's t-test. RESULTS 15s-GRASP achieved comparable image quality with conventional BH-VIBE (P > 0.05), except for the higher overall artifact level in the precontrast phase (P = 0.018). The Ktrans and Ve in inflammation were higher than those in malignant lesions (Ktrans : 0.78 ± 0.52 min-1 vs. 0.37 ± 0.22 min-1 , P = 0.020; Ve : 0.36 ± 0.16 vs. 0.26 ± 0.1, P = 0.177). Also, the Ktrans and Ve in malignant lesions were also higher than those in benign lesions (Ktrans : 0.37 ± 0.22 min-1 vs. 0.04 ± 0.04 min-1 , P = 0.001; Ve : 0.26 ± 0.12 vs. 0.10 ± 0.00, P = 0.063). DATA CONCLUSION This feasibility study demonstrated the performance of high spatiotemporal resolution free-breathing DCE-MRI of the lung using GRASP for qualitative and quantitative assessment of pulmonary lesions. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:459-468.
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Affiliation(s)
- Lihua Chen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.,Department of Radiology, PLA 101st Hospital, Wuxi Jiangsu, China
| | - Daihong Liu
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Bing Xie
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaoyue Zhou
- MR Collaboration, North East Asia, Siemens Healthcare, Shanghai, China
| | | | - Xuequan Huang
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Li Feng
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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Chen YF, Yuan A, Cho KH, Lu YC, Kuo MYP, Chen JH, Chang YC. Functional evaluation of therapeutic response of HCC827 lung cancer to bevacizumab and erlotinib targeted therapy using dynamic contrast-enhanced and diffusion-weighted MRI. PLoS One 2017; 12:e0187824. [PMID: 29121075 PMCID: PMC5679602 DOI: 10.1371/journal.pone.0187824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/02/2017] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the therapeutic responses of lung cancer mice models with adenocarcinoma HCC827 (gefitinib sensitive) and HCC827R (gefitinib resistant) to the epidermal growth factor receptor-tyrosine kinase inhibitor erlotinib alone and in combination with the anti-angiogenesis agent bevacizumab using dynamic contrast enhanced (DCE) and diffusion-weighted MRI. In the HCC827 model, temporal changes in DCE-MRI derived parameters (Ktrans, kep, and iAUC90) and apparent diffusion coefficient (ADC) were significantly correlated with tumor size. Ktrans and iAUC90 significantly decreased at week 2 in the groups receiving erlotinib alone and in combination with bevacizumab, whereas kep decreased at week 1 and 2 in both treatment groups. In addition, there was a significant difference in iAUC90 between the treatment groups at week 1. Compared to the control group of HCC827, there was a significant reduction in microvessel density and increased tumor apoptosis in the two treatment group. ADC value increased in the erlotinib alone group at week 1 and week 2, and in the erlotinib combined with bevacizumab group at week 2. Enlarged areas of central tumor necrosis were associated with a higher ADC value. However, progressive enlargement of the tumors but no significant differences in DCE parameters or ADC were noted in the HCC827R model. These results showed that both erlotinib alone and in combination with bevacizumab could effectively inhibit tumor growth in the gefitinib-sensitive lung cancer mice model, and that this was associated with decreased vascular perfusion, increased ADC percentage, decreased microvessel density, and increased tumor apoptosis with a two-week treatment cycle.
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Affiliation(s)
- Yi-Fang Chen
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Ang Yuan
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Hung Cho
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan
| | - Yi-Chien Lu
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mark Yen-Ping Kuo
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Jyh-Horng Chen
- Interdisciplinary MRI/MRS Lab, Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail:
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Kim HS, Yoon YC, Kwon S, Lee JH, Ahn S, Ahn HS. Dynamic Contrast-enhanced MR Imaging Parameters in Bone Metastases from Non–Small Cell Lung Cancer: Comparison between Lesions with and Lesions without Epidermal Growth Factor Receptor Mutation in Primary Lung Cancer. Radiology 2017; 284:815-823. [DOI: 10.1148/radiol.2017162336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Hyun Su Kim
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
| | - Young Cheol Yoon
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
| | - Soyi Kwon
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
| | - Ji Hyun Lee
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
| | - Soohyun Ahn
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
| | - Hyeon Seon Ahn
- From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul 135-710, Korea (H.S.K., Y.C.Y., S.K., J.H.L.); Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea (Y.C.Y.); and Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (S.A., H.S.A.)
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Jiao Y, Ren Y, Zheng X. [Quantitative Imaging Assessment of Tumor Response to Chemoradiation
in Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017. [PMID: 28641699 PMCID: PMC5973359 DOI: 10.3779/j.issn.1009-3419.2017.06.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
精准医疗的实施要求及时准确地对治疗疗效进行评估,以便于治疗方案的调整和优化,从而进一步提高疗效,改善预后。以定量评估为基础的影像组学以其无创、直观和可重复的特点在临床疗效评估方面具有不可替代的作用。本文将综述定量影像学在肺癌放化疗疗效评估中的应用现状及其相关进展。
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Affiliation(s)
- Yuxin Jiao
- Department of Radiology Oncology;Department of Radiology, Fudan University Huadong Hospital, Shanghai 200040, China
| | - Yanping Ren
- Department of Radiology Oncology, Fudan University Huadong Hospital, Shanghai 200040, China
| | - Xiangpeng Zheng
- Department of Radiology Oncology;Zhang Guozhen Diagnosis and Treatment Center of Micronodular Lung Cancer (DTC-MLC), Fudan University Huadong Hospital, Shanghai 200040, China
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Müller A, Jagoda P, Fries P, Gräber S, Bals R, Buecker A, Jungnickel C, Beisswenger C. Three-dimensional ultrashort echo time MRI and Short T 2 images generated from subtraction for determination of tumor burden in lung cancer: Preclinical investigation in transgenic mice. Magn Reson Med 2017; 79:1052-1060. [PMID: 28497643 DOI: 10.1002/mrm.26741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the potential of 3D ultrashort echo time MRI and short T2 images generated by subtraction for determination of total tumor burden in lung cancer. METHODS As an animal model of spontaneously developing non-small cell lung cancer, the K-rasLA1 transgenic mouse was used. Three-dimensional MR imaging was performed with radial k-space acquisition and echo times of 20 µs and 1 ms. For investigation of the short T2 component in the recorded signal, subtraction images were generated from these data sets and used for consensus identification of tumors. Next, manual segmentation was performed on all MR images by two independent investigators. MRI data were compared with the results from histologic investigations and among the investigators. RESULTS Tumor number and total tumor burden from imaging experiments correlated strongly with the results of histologic investigations. Intra- and interuser comparison showed highest correlations between the individual measurements for ultra-short TE MRI. CONCLUSIONS Three-dimensional MRI protocols facilitate accurate tumor identification in mice harboring lung tumors. Ultrashort TE MRI is the superior imaging strategy when investigating lung tumors of miscellaneous size with 3D MR imaging strategies. Magn Reson Med 79:1052-1060, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Andreas Müller
- Clinic for Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany
| | - Philippe Jagoda
- Clinic for Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany
| | - Peter Fries
- Clinic for Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany
| | - Stefan Gräber
- Department of Internal Medicine V-Pulmonology, Allergology, and Respiratory Critical Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Robert Bals
- Department of Biostatistics and Medical Informatics, Institute for Epidemiology, Saarland University Hospital, Homburg, Germany
| | - Arno Buecker
- Clinic for Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany
| | - Christopher Jungnickel
- Department of Internal Medicine V-Pulmonology, Allergology, and Respiratory Critical Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Christoph Beisswenger
- Department of Internal Medicine V-Pulmonology, Allergology, and Respiratory Critical Care Medicine, Saarland University Hospital, Homburg, Germany
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Huang YS, Chen JLY, Hsu FM, Huang JY, Ko WC, Chen YC, Jaw FS, Yen RF, Chang YC. Response assessment of stereotactic body radiation therapy using dynamic contrast-enhanced integrated MR-PET in non-small cell lung cancer patients. J Magn Reson Imaging 2017; 47:191-199. [DOI: 10.1002/jmri.25758] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Yu-Sen Huang
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
- Department of Medical Imaging; National Taiwan University Hospital; Yun-Lin Branch Yun-Lin Taiwan
| | - Jenny Ling-Yu Chen
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
- Department of Oncology; National Taiwan University, Hospital and National Taiwan University College of Medicine; Taipei Taiwan
- Department of Radiation Oncology; National Taiwan University Hospital; Hsin-Chu Branch Hsin-Chu Taiwan
| | - Feng-Ming Hsu
- Department of Oncology; National Taiwan University, Hospital and National Taiwan University College of Medicine; Taipei Taiwan
| | - Jei-Yie Huang
- Department of Nuclear Medicine; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Wei-Chun Ko
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Yi-Chang Chen
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
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DCE-MRI Perfusion and Permeability Parameters as predictors of tumor response to CCRT in Patients with locally advanced NSCLC. Sci Rep 2016; 6:35569. [PMID: 27762331 PMCID: PMC5071875 DOI: 10.1038/srep35569] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 09/21/2016] [Indexed: 02/06/2023] Open
Abstract
In this prospective study, 36 patients with stage III non-small cell lung cancers (NSCLC), who underwent dynamic contrast-enhanced MRI (DCE-MRI) before concurrent chemo-radiotherapy (CCRT) were enrolled. Pharmacokinetic analysis was carried out after non-rigid motion registration. The perfusion parameters [including Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT)] and permeability parameters [including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), fractional plasma volume (Vp)] were calculated, and their relationship with tumor regression was evaluated. The value of these parameters on predicting responders were calculated by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was conducted to find the independent variables. Tumor regression rate is negatively correlated with Ve and its standard variation Ve_SD and positively correlated with Ktrans and Kep. Significant differences between responders and non-responders existed in Ktrans, Kep, Ve, Ve_SD, MTT, BV_SD and MTT_SD (P < 0.05). ROC indicated that Ve < 0.24 gave the largest area under curve of 0.865 to predict responders. Multivariate logistic regression analysis also showed Ve was a significant predictor. Baseline perfusion and permeability parameters calculated from DCE-MRI were seen to be a viable tool for predicting the early treatment response after CCRT of NSCLC.
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Khalil A, Majlath M, Gounant V, Hess A, Laissy JP, Debray MP. Contribution of magnetic resonance imaging in lung cancer imaging. Diagn Interv Imaging 2016; 97:991-1002. [PMID: 27693089 DOI: 10.1016/j.diii.2016.08.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/06/2016] [Accepted: 08/23/2016] [Indexed: 12/25/2022]
Abstract
Lung cancer is the leading cause of cancer death worldwide. Prognosis and treatment outcomes are known to be related to the disease stage at the time of diagnosis. Therefore, an accurate assessment of the extent of disease is critical to determine the most appropriate therapy. Currently available imaging modalities for diagnosis and follow-up consist of morphological and functional imaging. Morphological investigations are mainly performed with CT-scan and in some cases with MRI. In this review, we describe the contribution of MRI in lung cancer staging focusing on solid pulmonary nodule characterization and TNM staging assessment using chest and whole-body MRI examinations, detailing in each chapter current recommendations and future developments.
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Affiliation(s)
- A Khalil
- Service de radiologie, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris Diderot, Paris, France.
| | - M Majlath
- Service de radiologie, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris Diderot, Paris, France
| | - V Gounant
- Service d'oncologie thoracique, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - A Hess
- Service de radiologie, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - J P Laissy
- Service de radiologie, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris Diderot, Paris, France
| | - M P Debray
- Service de radiologie, hôpital Bichat-Claude-Bernard, HUPNVS, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
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Wang P, Yoo B, Sherman S, Mukherjee P, Ross A, Pantazopoulos P, Petkova V, Farrar C, Medarova Z, Moore A. Predictive imaging of chemotherapeutic response in a transgenic mouse model of pancreatic cancer. Int J Cancer 2016; 139:712-8. [PMID: 26996122 DOI: 10.1002/ijc.30098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/20/2016] [Accepted: 03/14/2016] [Indexed: 12/11/2022]
Abstract
The underglycosylated mucin 1 tumor antigen (uMUC1) is a biomarker that forecasts the progression of adenocarcinomas. In this study, we evaluated the utility of a dual-modality molecular imaging approach based on targeting uMUC1 for monitoring chemotherapeutic response in a transgenic murine model of pancreatic cancer (KCM triple transgenic mice). An uMUC1-specific contrast agent (MN-EPPT) was synthesized for use with magnetic resonance imaging (MRI) and fluorescence optical imaging. It consisted of dextran-coated iron oxide nanoparticles conjugated to the near infrared fluorescent dye Cy5.5 and to a uMUC1-specific peptide (EPPT). KCM triple transgenic mice were given gemcitabine as chemotherapy while control animals received saline injections following the same schedule. Changes in uMUC1 levels following chemotherapy were monitored using T2-weighted MRI and optical imaging before and 24 hr after injection of the MN-EPPT. uMUC1 expression in tumors from both groups was evaluated by histology and qRT-PCR. We observed that the average delta-T2 in the gemcitabine-treated group was significantly reduced compared to the control group indicating lower accumulation of MN-EPPT, and correspondingly, a lower level of uMUC1 expression. In vivo optical imaging confirmed the MRI findings. Fluorescence microscopy of pancreatic tumor sections showed a lower level of uMUC1 expression in the gemcitabine-treated group compared to the control, which was confirmed by qRT-PCR. Our data proved that changes in uMUC1 expression after gemcitabine chemotherapy could be evaluated using MN-EPPT-enhanced in vivo MR and optical imaging. These results suggest that the uMUC1-targeted imaging approach could provide a useful tool for the predictive assessment of therapeutic response.
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Affiliation(s)
- Ping Wang
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Byunghee Yoo
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Sarah Sherman
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Pinku Mukherjee
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alana Ross
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Pamela Pantazopoulos
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Victoria Petkova
- Molecular Medicine Core, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christian Farrar
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Zdravka Medarova
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Anna Moore
- Molecular Imaging Laboratory, MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
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Weller A, O'Brien MER, Ahmed M, Popat S, Bhosle J, McDonald F, Yap TA, Du Y, Vlahos I, deSouza NM. Mechanism and non-mechanism based imaging biomarkers for assessing biological response to treatment in non-small cell lung cancer. Eur J Cancer 2016; 59:65-78. [PMID: 27016624 DOI: 10.1016/j.ejca.2016.02.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 12/18/2022]
Abstract
Therapeutic options in locally advanced non-small cell lung cancer (NSCLC) have expanded in the past decade to include a palate of targeted interventions such as high dose targeted thermal ablations, radiotherapy and growing platform of antibody and small molecule therapies and immunotherapies. Although these therapies have varied mechanisms of action, they often induce changes in tumour architecture and microenvironment such that response is not always accompanied by early reduction in tumour mass, and evaluation by criteria other than size is needed to report more effectively on response. Functional imaging techniques, which probe the tumour and its microenvironment through novel positron emission tomography and magnetic resonance imaging techniques, offer more detailed insights into and quantitation of tumour response than is available on anatomical imaging alone. Use of these biomarkers, or other rational combinations as readouts of pathological response in NSCLC have potential to provide more accurate predictors of treatment outcomes. In this article, the robustness of the more commonly available positron emission tomography and magnetic resonance imaging biomarker indices is examined and the evidence for their application in NSCLC is reviewed.
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Affiliation(s)
- A Weller
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, UK.
| | - M E R O'Brien
- Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - M Ahmed
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - S Popat
- Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - J Bhosle
- Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - F McDonald
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - T A Yap
- Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - Y Du
- Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
| | - I Vlahos
- Radiology Department, St George's Hospital NHS Trust, London, SW17 0QT, UK
| | - N M deSouza
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, UK
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Kim H, Arnoletti PJ, Christein J, Heslin MJ, Posey JA, Pednekar A, Mark Beasley T, Morgan DE. Pancreatic adenocarcinoma: a pilot study of quantitative perfusion and diffusion-weighted breath-hold magnetic resonance imaging. ACTA ACUST UNITED AC 2016; 39:744-52. [PMID: 24549880 DOI: 10.1007/s00261-014-0107-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To confirm the feasibility of breath-hold DCE-MRI and DWI at 3T to obtain the intra-abdominal quantitative physiologic parameters, K(trans), k ep, and ADC, in patients with untreated pancreatic ductal adenocarcinomas. METHODS Diffusion-weighted single-shot echo-planar imaging (DW-SS-EPI) and dynamic contrast-enhanced (DCE) MRI were used for 16 patients with newly diagnosed biopsy-proven pancreatic ductal adenocarcinomas. K(trans), k ep, and apparent diffusion coefficient (ADC) values of pancreatic tumors, non-tumor adjacent pancreatic parenchyma (NAP), liver metastases, and normal liver tissues were quantitated and statistically compared. RESULTS Fourteen patients were able to adequately hold their breath for DCE-MRI, and 15 patients for DW-SS-EPI. Four patients had liver metastases within the 6 cm of Z axis coverage centered on the pancreatic primary tumors. K(trans) values (10(-3) min(-1)) of primary pancreatic tumors, NAP, liver metastases, and normal liver tissues were 7.3 ± 4.2 (mean ± SD), 25.8 ± 14.9, 8.1 ± 5.9, and 45.1 ± 15.6, respectively, k ep values (10(-2) min(-1)) were 3.0 ± 0.9, 7.4 ± 3.1, 5.2 ± 2.0, and 12.1 ± 2.8, respectively, and ADC values (10(-3) mm(2)/s) were 1.3 ± 0.2, 1.6 ± 0.3, 1.1 ± 0.1, and 1.3 ± 0.1, respectively. K(trans), k ep, and ADC values of primary pancreatic tumors were significantly lower than those of NAP (p < 0.05), while K(trans) and k ep values of liver metastases were significantly lower than those of normal liver tissues (p < 0.05). CONCLUSIONS 3T breath-hold quantitative physiologic MRI is a feasible technique that can be applied to a majority of patients with pancreatic adenocarcinomas.
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Affiliation(s)
- Hyunki Kim
- Departments of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294-0019, USA,
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van den Boogaart VEM, de Lussanet QG, Houben RMA, de Ruysscher D, Groen HJM, Marcus JT, Smit EF, Dingemans AMC, Backes WH. Inter-reader reproducibility of dynamic contrast-enhanced magnetic resonance imaging in patients with non-small cell lung cancer treated with bevacizumab and erlotinib. Lung Cancer 2016; 93:20-7. [PMID: 26898610 DOI: 10.1016/j.lungcan.2015.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/16/2015] [Accepted: 12/25/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED Objectives When evaluating anti-tumor treatment response by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) it is necessary to assure its validity and reproducibility. This has not been well addressed in lung tumors. Therefore we have evaluated the inter-reader reproducibility of response classification by DCE-MRI in patients with non-small cell lung cancer (NSCLC) treated with bevacizumab and erlotinib enrolled in a multicenter trial. MATERIALS AND METHODS Twenty-one patients were scanned before and 3 weeks after start of treatment with DCE-MRI in a multicenter trial. The scans were evaluated by two independent readers. The primary lung tumor was used for response assessment. Responses were assessed in terms of relative changes in tumor mean trans endothelial transfer rate (K(trans)) and its heterogeneity in terms of the spatial standard deviation. Reproducibility was expressed by the inter-reader variability, intra-class correlation coefficient (ICC) and dichotomous response classification. RESULTS The inter-reader variability and ICC for the relative K(trans) were 5.8% and 0.930, respectively. For tumor heterogeneity the inter-reader variability and ICC were 0.017 and 0.656, respectively. For the two readers the response classification for relative K(trans) was concordant in 20 of 21 patients (k=0.90, p<0.0001) and for tumor heterogeneity in 19 of 21 patients (k=0.80, p<0.0001). CONCLUSIONS Strong agreement was seen with regard to the inter-reader variability and reproducibility of response classification by the two readers of lung cancer DCE-MRI scans.
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Affiliation(s)
- Vivian E M van den Boogaart
- Department of Pulmonary Diseases, Viecuri Medical Center, Tegelseweg 210, 5912 BL Venlo, The Netherlands; Department of Pulmonary Diseases, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Quido G de Lussanet
- Department of Radiology, Medical Center Zuiderzee, Ziekenhuisweg 100, 8233AA Lelystad, The Netherlands.
| | - Ruud M A Houben
- Department of Radiation-Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 3035, 6202 NA Maastricht, The Netherlands.
| | - Dirk de Ruysscher
- Department of Radiation-Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Harry J M Groen
- Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - J Tim Marcus
- Physics and Medical Technology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Egbert F Smit
- Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
| | - Anne-Marie C Dingemans
- Department of Pulmonary Diseases, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Walter H Backes
- Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
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Broncano J, Luna A, Sánchez-González J, Alvarez-Kindelan A, Bhalla S. Functional MR Imaging in Chest Malignancies. Magn Reson Imaging Clin N Am 2016; 24:135-155. [DOI: 10.1016/j.mric.2015.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kim SM, Haider MA, Jaffray DA, Yeung IWT. Improved accuracy of quantitative parameter estimates in dynamic contrast-enhanced CT study with low temporal resolution. Med Phys 2016; 43:388. [PMID: 26745932 DOI: 10.1118/1.4937600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE A previously proposed method to reduce radiation dose to patient in dynamic contrast-enhanced (DCE) CT is enhanced by principal component analysis (PCA) filtering which improves the signal-to-noise ratio (SNR) of time-concentration curves in the DCE-CT study. The efficacy of the combined method to maintain the accuracy of kinetic parameter estimates at low temporal resolution is investigated with pixel-by-pixel kinetic analysis of DCE-CT data. METHODS The method is based on DCE-CT scanning performed with low temporal resolution to reduce the radiation dose to the patient. The arterial input function (AIF) with high temporal resolution can be generated with a coarsely sampled AIF through a previously published method of AIF estimation. To increase the SNR of time-concentration curves (tissue curves), first, a region-of-interest is segmented into squares composed of 3 × 3 pixels in size. Subsequently, the PCA filtering combined with a fraction of residual information criterion is applied to all the segmented squares for further improvement of their SNRs. The proposed method was applied to each DCE-CT data set of a cohort of 14 patients at varying levels of down-sampling. The kinetic analyses using the modified Tofts' model and singular value decomposition method, then, were carried out for each of the down-sampling schemes between the intervals from 2 to 15 s. The results were compared with analyses done with the measured data in high temporal resolution (i.e., original scanning frequency) as the reference. RESULTS The patients' AIFs were estimated to high accuracy based on the 11 orthonormal bases of arterial impulse responses established in the previous paper. In addition, noise in the images was effectively reduced by using five principal components of the tissue curves for filtering. Kinetic analyses using the proposed method showed superior results compared to those with down-sampling alone; they were able to maintain the accuracy in the quantitative histogram parameters of volume transfer constant [standard deviation (SD), 98th percentile, and range], rate constant (SD), blood volume fraction (mean, SD, 98th percentile, and range), and blood flow (mean, SD, median, 98th percentile, and range) for sampling intervals between 10 and 15 s. CONCLUSIONS The proposed method of PCA filtering combined with the AIF estimation technique allows low frequency scanning for DCE-CT study to reduce patient radiation dose. The results indicate that the method is useful in pixel-by-pixel kinetic analysis of DCE-CT data for patients with cervical cancer.
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Affiliation(s)
- Sun Mo Kim
- Radiation Medicine Program, Princess Margaret Hospital/University Health Network, Toronto, Ontario M5G 2M9, Canada
| | - Masoom A Haider
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada and Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G 2M9, Canada
| | - David A Jaffray
- Radiation Medicine Program, Princess Margaret Hospital/University Health Network, Toronto, Ontario M5G 2M9, Canada and Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5G 2M9, Canada
| | - Ivan W T Yeung
- Radiation Medicine Program, Princess Margaret Hospital/University Health Network, Toronto, Ontario M5G 2M9, Canada; Department of Medical Physics, Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, Ontario L3Y 2P9, Canada; and Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5G 2M9, Canada
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Thaiss WM, Sauter AW, Bongers M, Horger M, Nikolaou K. Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology. Eur J Radiol 2015; 84:2368-79. [DOI: 10.1016/j.ejrad.2015.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/02/2015] [Indexed: 12/12/2022]
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Barnes SL, Sorace AG, Loveless ME, Whisenant JG, Yankeelov TE. Correlation of tumor characteristics derived from DCE-MRI and DW-MRI with histology in murine models of breast cancer. NMR IN BIOMEDICINE 2015; 28:1345-56. [PMID: 26332194 PMCID: PMC4573954 DOI: 10.1002/nbm.3377] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 07/16/2015] [Accepted: 07/19/2015] [Indexed: 05/04/2023]
Abstract
The purpose of this work was to determine the relationship between the apparent diffusion coefficient (ADC, from diffusion-weighted (DW) MRI), the extravascular, extracellular volume fraction (ve , from dynamic contrast-enhanced (DCE) MRI), and histological measurement of the extracellular space fraction. Athymic nude mice were injected with either human epidermal growth factor receptor 2 positive (HER2+) BT474 (n = 15) or triple negative MDA-MB-231 (n = 20) breast cancer cells, treated with either Herceptin (n = 8), Abraxane (low dose n = 7, high dose n = 6), or saline (n = 7 for each cell line), and imaged using DW- and DCE-MRI before, during, and after treatment. After the final imaging acquisition, the tissue was resected and evaluated by histological analysis. H&E-stained central slices were scanned using a digital brightfield microscope and evaluated with thresholding techniques to calculate the extracellular space. For both BT474 and MDA-MB-231, the median ADC of the central slice exhibited a significantly positive correlation with the corresponding central slice extracellular space as measured by H&E (p = 0.03, p < 0.01, respectively). Median ve calculated from the central slice showed differing results between the two cell lines. For BT474, a significant correlation between ve and extracellular space was calculated (p = 0.02), while MDA-MB-231 tumors did not demonstrate a significant correlation (p = 0.64). Additionally, there was no correlation discovered between ADC and ve with either whole tumor analysis or central slice analysis (p > 0.05). While ADC correlates well with the histologically determined fraction of extracellular space, these data add to the growing body of literature that suggests that ve derived from DCE-MRI is not a reliable biomarker of extracellular space for a range of physiological conditions.
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Affiliation(s)
- Stephanie L. Barnes
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Anna G. Sorace
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Mary E. Loveless
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jennifer G. Whisenant
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Thomas E. Yankeelov
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
- Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
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Multiparametric imaging of patient and tumour heterogeneity in non-small-cell lung cancer: quantification of tumour hypoxia, metabolism and perfusion. Eur J Nucl Med Mol Imaging 2015; 43:240-248. [PMID: 26338178 PMCID: PMC4700090 DOI: 10.1007/s00259-015-3169-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 08/06/2015] [Indexed: 02/07/2023]
Abstract
Purpose Multiple imaging techniques are nowadays available for clinical in-vivo visualization of tumour biology. FDG PET/CT identifies increased tumour metabolism, hypoxia PET visualizes tumour oxygenation and dynamic contrast-enhanced (DCE) CT characterizes vasculature and morphology. We explored the relationships among these biological features in patients with non-small-cell lung cancer (NSCLC) at both the patient level and the tumour subvolume level. Methods A group of 14 NSCLC patients from two ongoing clinical trials (NCT01024829 and NCT01210378) were scanned using FDG PET/CT, HX4 PET/CT and DCE CT prior to chemoradiotherapy. Standardized uptake values (SUV) in the primary tumour were calculated for the FDG and hypoxia HX4 PET/CT scans. For hypoxia imaging, the hypoxic volume, fraction and tumour-to-blood ratio (TBR) were also defined. Blood flow and blood volume were obtained from DCE CT imaging. A tumour subvolume analysis was used to quantify the spatial overlap between subvolumes. Results At the patient level, negative correlations were observed between blood flow and the hypoxia parameters (TBR >1.2): hypoxic volume (−0.65, p = 0.014), hypoxic fraction (−0.60, p = 0.025) and TBR (−0.56, p = 0.042). At the tumour subvolume level, hypoxic and metabolically active subvolumes showed an overlap of 53 ± 36 %. Overlap between hypoxic sub-volumes and those with high blood flow and blood volume was smaller: 15 ± 17 % and 28 ± 28 %, respectively. Half of the patients showed a spatial mismatch (overlap <5 %) between increased blood flow and hypoxia. Conclusion The biological imaging features defined in NSCLC tumours showed large interpatient and intratumour variability. There was overlap between hypoxic and metabolically active subvolumes in the majority of tumours, there was spatial mismatch between regions with high blood flow and those with increased hypoxia. Electronic supplementary material The online version of this article (doi:10.1007/s00259-015-3169-4) contains supplementary material, which is available to authorized users.
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Miyazaki K, Jerome NP, Collins DJ, Orton MR, d’Arcy JA, Wallace T, Moreno L, Pearson ADJ, Marshall LV, Carceller F, Leach MO, Zacharoulis S, Koh DM. Demonstration of the reproducibility of free-breathing diffusion-weighted MRI and dynamic contrast enhanced MRI in children with solid tumours: a pilot study. Eur Radiol 2015; 25:2641-50. [PMID: 25773937 PMCID: PMC4529450 DOI: 10.1007/s00330-015-3666-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 01/30/2015] [Accepted: 02/12/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The objectives are to examine the reproducibility of functional MR imaging in children with solid tumours using quantitative parameters derived from diffusion-weighted (DW-) and dynamic contrast enhanced (DCE-) MRI. METHODS Patients under 16-years-of age with confirmed diagnosis of solid tumours (n = 17) underwent free-breathing DW-MRI and DCE-MRI on a 1.5 T system, repeated 24 hours later. DW-MRI (6 b-values, 0-1000 sec/mm(2)) enabled monoexponential apparent diffusion coefficient estimation using all (ADC0-1000) and only ≥100 sec/mm(2) (ADC100-1000) b-values. DCE-MRI was used to derive the transfer constant (K(trans)), the efflux constant (kep), the extracellular extravascular volume (ve), and the plasma fraction (vp), using a study cohort arterial input function (AIF) and the extended Tofts model. Initial area under the gadolinium enhancement curve and pre-contrast T1 were also calculated. Percentage coefficients of variation (CV) of all parameters were calculated. RESULTS The most reproducible cohort parameters were ADC100-1000 (CV = 3.26%), pre-contrast T1 (CV = 6.21%), and K(trans) (CV = 15.23%). The ADC100-1000 was more reproducible than ADC0-1000, especially extracranially (CV = 2.40% vs. 2.78%). The AIF (n = 9) derived from this paediatric population exhibited sharper and earlier first-pass and recirculation peaks compared with the literature's adult population average. CONCLUSIONS Free-breathing functional imaging protocols including DW-MRI and DCE-MRI are well-tolerated in children aged 6 - 15 with good to moderate measurement reproducibility. KEY POINTS • Diffusion MRI protocol is feasible and well-tolerated in a paediatric oncology population. • DCE-MRI for pharmacokinetic evaluation is feasible and well tolerated in a paediatric oncology population. • Paediatric arterial input function (AIF) shows systematic differences from the adult population-average AIF. • Variation of quantitative parameters from paired functional MRI measurements were within 20%.
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Affiliation(s)
- Keiko Miyazaki
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - Neil P. Jerome
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - David J. Collins
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - Matthew R. Orton
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - James A. d’Arcy
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - Toni Wallace
- Department of Radiology, Royal Marsden Hospital, London, England UK
| | - Lucas Moreno
- Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, SM2 5NG UK
- Clinical Research Programme, Spanish National Cancer Research Centre (CNIO), Melchor Fernandez Almagro 3, 28029 Madrid, Spain
- Paediatric Drug Development Unit, Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT UK
| | - Andrew D. J. Pearson
- Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, SM2 5NG UK
- Paediatric Drug Development Unit, Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT UK
| | - Lynley V. Marshall
- Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, SM2 5NG UK
- Paediatric Drug Development Unit, Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT UK
| | - Fernando Carceller
- Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, SM2 5NG UK
- Paediatric Drug Development Unit, Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT UK
| | - Martin O. Leach
- Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London, SM2 5NG UK
| | - Stergios Zacharoulis
- Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, SM2 5NG UK
- Paediatric Drug Development Unit, Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT UK
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, London, England UK
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Semiautomatic Determination of Arterial Input Functions for Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Non-Small Cell Lung Cancer Patients. Invest Radiol 2015; 50:129-34. [DOI: 10.1097/rli.0000000000000108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Image-derived biomarkers and multimodal imaging strategies for lung cancer management. Eur J Nucl Med Mol Imaging 2015; 42:634-43. [DOI: 10.1007/s00259-014-2974-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 12/14/2022]
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Koenigkam-Santos M, Optazaite E, Sommer G, Safi S, Heussel CP, Kauczor HU, Puderbach M. Contrast-enhanced magnetic resonance imaging of pulmonary lesions: Description of a technique aiming clinical practice. Eur J Radiol 2015; 84:185-192. [DOI: 10.1016/j.ejrad.2014.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/04/2014] [Accepted: 10/08/2014] [Indexed: 12/26/2022]
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Kim HS, Lee KS, Ohno Y, van Beek EJ, Biederer J. PET/CT versus MRI for diagnosis, staging, and follow-up of lung cancer. J Magn Reson Imaging 2014; 42:247-60. [DOI: 10.1002/jmri.24776] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 12/19/2022] Open
Affiliation(s)
- Hyun Su Kim
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Kyung Soo Lee
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Yoshiharu Ohno
- Division of Functional and Diagnostic Imaging Research; Department of Radiology; and Advanced Biomedical Imaging Research Centre, Kobe University Graduate School of Medicine; Kobe Japan
| | | | - Juergen Biederer
- Radiologie Darmstadt; Gross-Gerau County Hospital; Gross-Gerau Germany
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Sartore-Bianchi A, Zeppellini A, Amatu A, Ricotta R, Bencardino K, Siena S. Regorafenib in metastatic colorectal cancer. Expert Rev Anticancer Ther 2014; 14:255-65. [PMID: 24559322 DOI: 10.1586/14737140.2014.894887] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Regorafenib is an oral multikinase inhibitor that blocks the activity of protein kinases involved in the regulation of tumor angiogenesis (VEGFR1, 2, 3; angiopoietin-1 receptor), oncogenesis (stem cell growth factor receptor; RET; BRAF including BRAFV600E), and tumor microenvironment (PDGFR-β and FGFR). Based on data from the Phase III CORRECT study, regorafenib stands as a further option for patient affected by metastatic colorectal cancer who have exhausted previous available therapies. Its multi-targeted effect might explain activity in advanced lines of treatment, when cancer cells have been heavily challenged with previous lines of therapy and potentially developed multiple mechanisms of resistance, but also makes difficult to identify predictive biomarkers. In this article we examine preclinical as well as clinical data of regorafenib in the therapy of metastatic colorectal cancer, challenges for potential markers of efficacy and its role in the treatment algorithm.
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Affiliation(s)
- Andrea Sartore-Bianchi
- Department of Hematology and Oncology, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy
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α-Mangostin suppresses human gastric adenocarcinoma cells in vitro via blockade of Stat3 signaling pathway. Acta Pharmacol Sin 2014; 35:1065-73. [PMID: 24976157 DOI: 10.1038/aps.2014.43] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 05/12/2014] [Indexed: 01/08/2023] Open
Abstract
AIM To investigate the anti-tumor effects of α-mangostin, a major xanthone identified in the pericarp of mangosteen (Garcinia mangostana Linn), against human gastric adenocarcinoma cells in vitro, and the mechanisms of the effects. METHODS Human gastric adenocarcinoma cell lines BGC-823 and SGC-7901 were treated with α-mangostin. The cell viability was measured with MTT assay, and cell apoptosis was examined using flow cytometry and TUNEL assay. The expression of the relevant proteins was detected using Western blot. RESULTS Treatment with α-mangostin (3-10 μg/mL) inhibited the viability of both BGC-823 and SGC-7901 cells in dose- and time-manners. Furthermore, α-mangostin (7 μg/mL) time-dependently increased the apoptosis index of the cancer cells, reduced the mitochondrial membrane potential of the cancer cells, and significantly increased the release of cytochrome c and AIF into cytoplasm. Moreover, the α-mangostin treatment markedly suppressed the constitutive Stat3 protein activation, and Stat3-regulated Bcl-xL and Mcl-1 protein levels in the cancer cells. CONCLUSION The anti-tumor effects of α-mangostin against human gastric adenocarcinoma cells in vitro can be partly attributed to blockade of Stat3 signaling pathway.
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Joo I, Lee JM, Han JK, Choi BI. Intravoxel incoherent motion diffusion-weighted MR imaging for monitoring the therapeutic efficacy of the vascular disrupting agent CKD-516 in rabbit VX2 liver tumors. Radiology 2014; 272:417-26. [PMID: 24697148 DOI: 10.1148/radiol.14131165] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) magnetic resonance (MR) imaging in the quantitative assessment of the therapeutic efficacy of a vascular disrupting agent (VDA) (CKD-516) in rabbit VX2 liver tumors. MATERIALS AND METHODS The institutional animal care and use committee approved this study. In 21 VX2 liver tumor-bearing rabbits, IVIM DW imaging examinations were serially performed with a 3.0-T imaging unit by using 12 b values from 0 to 800 sec/mm(2). The apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and blood flow-related parameter (fD*) of tumors at different time points (baseline, 4 hours, 24 hours, 3 days, and 7 days after CKD-516 administration) were compared within the treated group (n = 15) by using the Friedman test as well as between the control (n = 6) and treated groups by using the Mann-Whitney test. Correlation between the change in tumor size and IVIM DW imaging parameters was analyzed by using the Spearman rank test. RESULTS In the treated group, D* and f significantly decreased at 4 hours and then recovered to baseline at 24 hours, while D significantly increased at 24 hours (P < .005). All IVIM-derived parameters showed no significant differences between the control and treated groups at 3- and at 7-day follow-up. The greater decrease observed in f and fD* at 4 hours correlated with the smaller increase in tumor size during the 7 days of follow-up (ρ = 0.53 and 0.65, respectively; P < .05 for both). CONCLUSION The therapeutic effect induced by a VDA could be effectively evaluated by using IVIM DW imaging, and f and fD* may be early predictive indicators of tumor response.
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Affiliation(s)
- Ijin Joo
- From the Department of Radiology (I.J., J.M.L., J.K.H., B.I.C.) and Institute of Radiation Medicine (J.M.L., J.K.H., B.I.C.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
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Practical dynamic contrast enhanced MRI in small animal models of cancer: data acquisition, data analysis, and interpretation. Pharmaceutics 2013; 4:442-78. [PMID: 23105959 PMCID: PMC3480221 DOI: 10.3390/pharmaceutics4030442] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) consists of the continuous acquisition of images before, during, and after the injection of a contrast agent. DCE-MRI allows for noninvasive evaluation of tumor parameters related to vascular perfusion and permeability and tissue volume fractions, and is frequently employed in both preclinical and clinical investigations. However, the experimental and analytical subtleties of the technique are not frequently discussed in the literature, nor are its relationships to other commonly used quantitative imaging techniques. This review aims to provide practical information on the development, implementation, and validation of a DCE-MRI study in the context of a preclinical study (though we do frequently refer to clinical studies that are related to these topics).
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Cyran CC, Kazmierczak PM, Hirner H, Moser M, Ingrisch M, Havla L, Michels A, Eschbach R, Schwarz B, Reiser MF, Bruns CJ, Nikolaou K. Regorafenib effects on human colon carcinoma xenografts monitored by dynamic contrast-enhanced computed tomography with immunohistochemical validation. PLoS One 2013; 8:e76009. [PMID: 24098755 PMCID: PMC3786893 DOI: 10.1371/journal.pone.0076009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 08/19/2013] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate dynamic contrast-enhanced computed tomography for monitoring the effects of regorafenib on experimental colon carcinomas in rats by quantitative assessments of tumor microcirculation parameters with immunohistochemical validation. Materials and Methods Colon carcinoma xenografts (HT-29) implanted subcutaneously in female athymic rats (n = 15) were imaged at baseline and after a one-week treatment with regorafenib by dynamic contrast-enhanced computed tomography (128-slice dual-source computed tomography). The therapy group (n = 7) received regorafenib daily (10 mg/kg bodyweight). Quantitative parameters of tumor microcirculation (plasma flow, mL/100 mL/min), endothelial permeability (PS, mL/100 mL/min), and tumor vascularity (plasma volume, %) were calculated using a 2-compartment uptake model. Dynamic contrast-enhanced computed tomography parameters were validated with immunohistochemical assessments of tumor microvascular density (CD-31), tumor cell apoptosis (TUNEL), and proliferation (Ki-67). Results Regorafenib suppressed tumor vascularity (15.7±5.3 to 5.5±3.5%; p<0.05) and tumor perfusion (12.8±2.3 to 8.8±2.9 mL/100 mL/min; p = 0.063). Significantly lower microvascular density was observed in the therapy group (CD-31; 48±10 vs. 113±25, p<0.05). In regorafenib-treated tumors, significantly more apoptotic cells (TUNEL; 11844±2927 vs. 5097±3463, p<0.05) were observed. Dynamic contrast-enhanced computed tomography tumor perfusion and tumor vascularity correlated significantly (p<0.05) with microvascular density (CD-31; r = 0.84 and 0.66) and inversely with apoptosis (TUNEL; r = −0.66 and −0.71). Conclusions Regorafenib significantly suppressed tumor vascularity (plasma volume) quantified by dynamic contrast-enhanced computed tomography in experimental colon carcinomas in rats with good-to-moderate correlations to an immunohistochemical gold standard. Tumor response biomarkers assessed by dynamic contrast-enhanced computed tomography may be a promising future approach to a more personalized and targeted cancer therapy.
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Affiliation(s)
- Clemens C. Cyran
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
- * E-mail:
| | - Philipp M. Kazmierczak
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Heidrun Hirner
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Matthias Moser
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Michael Ingrisch
- Department of Clinical Radiology, Josef-Lissner-Laboratory for Biomedical Imaging, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Lukas Havla
- Department of Clinical Radiology, Josef-Lissner-Laboratory for Biomedical Imaging, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Alexandra Michels
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Ralf Eschbach
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Bettina Schwarz
- Department of Surgery, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Maximilian F. Reiser
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Christiane J. Bruns
- Department of Surgery, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
| | - Konstantin Nikolaou
- Department of Clinical Radiology, Laboratory for Experimental Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany
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Fangusaro J, Gururangan S, Poussaint TY, McLendon RE, Onar-Thomas A, Warren KE, Wu S, Packer RJ, Banerjee A, Gilbertson RJ, Jakacki R, Gajjar A, Goldman S, Pollack IF, Friedman HS, Boyett JM, Kun LE, Fouladi M. Bevacizumab (BVZ)-associated toxicities in children with recurrent central nervous system tumors treated with BVZ and irinotecan (CPT-11): a Pediatric Brain Tumor Consortium Study (PBTC-022). Cancer 2013; 119:4180-7. [PMID: 24104527 DOI: 10.1002/cncr.28343] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 06/20/2013] [Accepted: 06/24/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND The incidence and spectrum of acute toxicities related to the use of bevacizumab (BVZ)-containing regimens in children are largely unknown. This report describes the adverse events in a recently completed large phase 2 trial of BVZ plus irinotecan (CPT-11) in children with recurrent central nervous system tumors. METHODS Pediatric Brain Tumor Consortium trial-022 evaluated the efficacy and toxicity of BVZ (10 mg/kg administered intravenously) as a single agent for 2 doses given 2 weeks apart and then combined with CPT-11 every 2 weeks (1 course = 4 weeks) in children with recurrent central nervous system tumors. Children were treated until they experienced progressive disease, unacceptable toxicity or completed up to a maximum of 2 years of therapy. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0. Patients who received at least 1 dose of BVZ were included for toxicity assessment. RESULTS Between October 2006 and June 2010, 92 patients evaluable for toxicity were enrolled and received 687 treatment courses. The most common toxicities attributable to BVZ included grade I-III hypertension (38% of patients), grade I-III fatigue (30%), grade I-II epistaxis (24%), and grade I-IV proteinuria (22%). Twenty-two patients (24%) stopped therapy due to toxicity. CONCLUSIONS The combination of BVZ and CPT-11 was fairly well-tolerated, and most severe BVZ-related toxicities were rare, self-limiting, and manageable.
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Affiliation(s)
- Jason Fangusaro
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Kim H, Rigell CJ, Zhai G, Lee SK, Samuel SL, Martin A, Umphrey HR, Stockard CR, Beasley TM, Buchsbaum DJ, Li LS, Boothman DA, Zinn KR. Antagonistic effects of anti-EMMPRIN antibody when combined with chemotherapy against hypovascular pancreatic cancers. Mol Imaging Biol 2013; 16:85-94. [PMID: 23836505 DOI: 10.1007/s11307-013-0665-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 06/11/2013] [Accepted: 06/18/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine the antagonistic effects of anti-extracellular matrix metalloprotease inducer (anti-EMMPRIN) antibody when combined with chemotherapy using a hypovascular pancreatic tumor model. PROCEDURES Severely compromised immunodeficient mice bearing orthotopic MIA PaCa-2 tumors were used (five to six animals per group). Dynamic contrast-enhanced magnetic resonance imaging was used to examine the relationship between tumor vascularity and size. Therapy was initiated when tumors were hypovascular. Treatments included: (1) gemcitabine alone, (2) anti-EMMPRIN antibody alone, and (3) combination, each for 2 weeks. Additionally, another treatment arm included β-lapachone, an NAD(P)H/quinone 1 (NQO1) bioactivated agent. (18)F-fluoro-D-glucose-positron emission tomography/computed tomography imaging was used weekly to monitor therapeutic effects. RESULTS Gemcitabine or anti-EMMPRIN monotherapy significantly delayed tumor growth, but the combination therapy showed an antagonistic effect. Similarly, tumor growth was significantly suppressed by β-lapachone alone, and additive effects were noted when combined with gemcitabine, but the therapeutic efficacy was reduced when anti-EMMPRIN antibody was added. CONCLUSIONS Anti-EMMPRIN antibody with chemotherapy in hypovascular tumors results in antagonistic effects.
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Affiliation(s)
- Hyunki Kim
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294-0019, USA,
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Cheng JCH, Yuan A, Chen JH, Lu YC, Cho KH, Wu JK, Wu CJ, Chang YC, Yang PC. Early detection of Lewis lung carcinoma tumor control by irradiation using diffusion-weighted and dynamic contrast-enhanced MRI. PLoS One 2013; 8:e62762. [PMID: 23658769 PMCID: PMC3642149 DOI: 10.1371/journal.pone.0062762] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 03/25/2013] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To investigate the correlation between diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) derived parameters and radioresponsiveness of Lewis lung carcinoma (LLC) tumor. MATERIALS AND METHODS LLC tumor growth in C57BL/6 mouse limb was used for the experiment. The tumors were irradiated with 10 Gy×5, or 30 Gy×2 vs. sham irradiation. Fourteen tumors were subjected to DW-MRI and DCE-MRI pre-radiotherapy and weekly imaging after radiotherapy. The temporal changes in apparent diffusion coefficient (ADC) and DCE-MRI derived parameters (K(trans), k(ep), v(e), and v(p)) were correlated with tumor size, and were histologically compared with CD31 staining of resected tumors. RESULTS The 10 Gy×5 dose inhibited tumor growth for a week, while 30 Gy×2 controlled tumor growth for a 3-week observation period. One week after radiotherapy (week 2), irradiated tumors showed significantly higher values of ADC than untreated ones (10 Gy×5, p = 0.004; 30 Gy×2, p = 0.01). Significantly higher values of v(e) were shown earlier by 30 Gy×2 vs. sham (p = 0.01) and 10 Gy×5 vs. sham irradiation (p = 0.05). Sustained higher v(e) from 10 Gy×5 compared to sham irradiated tumors was evident at week 3 (p = 0.016) and week 4 (p = 0.046). A 13.8% early increase in ADC for 30 Gy×2 tumor group (p = 0.002) and a 16.5% increase for 10 Gy×5 group were noted (p = 0.01) vs. sham irradiation (which showed a 2.2% decrease). No differences were found for K(trans), k(ep), or v(p). Both radiotherapy groups demonstrated significant reduction in microvessel counts. CONCLUSION Early increase in ADC and v(e) correlated with tumor control by irradiation.
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Affiliation(s)
- Jason Chia-Hsien Cheng
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University College of Electrical Engineering and Computer Science, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ang Yuan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jyh-Horng Chen
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University College of Electrical Engineering and Computer Science, Taipei, Taiwan
| | - Yi-Chien Lu
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Hung Cho
- Instrumentation Resource Center, National Yang-Ming University, Taipei, Taiwan
| | - Jian-Kuen Wu
- Institute of Electro-Optical Science and Technology, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Jang Wu
- Institute of Electro-Optical Science and Technology, National Taiwan Normal University, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
| | - Pan-Chyr Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Current World Literature. Curr Opin Oncol 2013; 25:205-208. [DOI: 10.1097/cco.0b013e32835ec49f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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