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Wang L, Yang JD, Yoo CC, Lai KKY, Braun J, McGovern DPB, Xie Y, Pandol SJ, Lu SC, Li D. Magnetic resonance imaging for characterization of hepatocellular carcinoma metabolism. Front Physiol 2022; 13:1056511. [PMID: 36589457 PMCID: PMC9800006 DOI: 10.3389/fphys.2022.1056511] [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: 09/28/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
With a better understanding of the pathophysiological and metabolic changes in hepatocellular carcinoma (HCC), multiparametric and novel functional magnetic resonance (MR) and positron emission tomography (PET) techniques have received wide interest and are increasingly being applied in preclinical and clinical research. These techniques not only allow for non-invasive detection of structural, functional, and metabolic changes in malignant tumor cells but also characterize the tumor microenvironment (TME) and the interactions of malignant tumor cells with the TME, which has hypoxia and low pH, resulting from the Warburg effect and accumulation of metabolites produced by tumor cells and other cellular components. The heterogeneity and complexity of the TME require a combination of images with various parameters and modalities to characterize tumors and guide therapy. This review focuses on the value of multiparametric magnetic resonance imaging and PET/MR in evaluating the structural and functional changes of HCC and in detecting metabolites formed owing to HCC and the TME.
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Affiliation(s)
- Lixia Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Ju Dong Yang
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Charles C. Yoo
- Office of the Medical Director 1st MRI, Los Angeles, CA, United States
| | - Keane K. Y. Lai
- Department of Molecular Medicine, Beckman Research Institute of City of Hope and City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jonathan Braun
- F. Widjaja Inflammatory Bowel Disease Institute, Division of Digestive and Liver Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Dermot P. B. McGovern
- F. Widjaja Inflammatory Bowel Disease Institute, Division of Digestive and Liver Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Stephen J. Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Shelly C. Lu
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States,Department of Bioengineering, University of California, Los Angeles, CA, United States,*Correspondence: Debiao Li,
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Suresh M, Menne S. Application of the woodchuck animal model for the treatment of hepatitis B virus-induced liver cancer. World J Gastrointest Oncol 2021; 13:509-535. [PMID: 34163570 PMCID: PMC8204361 DOI: 10.4251/wjgo.v13.i6.509] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/02/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
This review describes woodchucks chronically infected with the woodchuck hepatitis virus (WHV) as an animal model for hepatocarcinogenesis and treatment of primary liver cancer or hepatocellular carcinoma (HCC) induced by the hepatitis B virus (HBV). Since laboratory animal models susceptible to HBV infection are limited, woodchucks experimentally infected with WHV, a hepatitis virus closely related to HBV, are increasingly used to enhance our understanding of virus-host interactions, immune response, and liver disease progression. A correlation of severe liver pathogenesis with high-level viral replication and deficient antiviral immunity has been established, which are present during chronic infection after WHV inoculation of neonatal woodchucks for modeling vertical HBV transmission in humans. HCC in chronic carrier woodchucks develops 17 to 36 mo after neonatal WHV infection and involves liver tumors that are comparable in size, morphology, and molecular gene signature to those of HBV-infected patients. Accordingly, woodchucks with WHV-induced liver tumors have been used for the improvement of imaging and ablation techniques of human HCC. In addition, drug efficacy studies in woodchucks with chronic WHV infection have revealed that prolonged treatment with nucleos(t)ide analogs, alone or in combination with other compounds, minimizes the risk of liver disease progression to HCC. More recently, woodchucks have been utilized in the delineation of mechanisms involved in innate and adaptive immune responses against WHV during acute, self-limited and chronic infections. Therapeutic interventions based on modulating the deficient host antiviral immunity have been explored in woodchucks for inducing functional cure in HBV-infected patients and for reducing or even delaying associated liver disease sequelae, including the onset of HCC. Therefore, woodchucks with chronic WHV infection constitute a well-characterized, fully immunocompetent animal model for HBV-induced liver cancer and for preclinical evaluation of the safety and efficacy of new modalities, which are based on chemo, gene, and immune therapy, for the prevention and treatment of HCC in patients for which current treatment options are dismal.
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Affiliation(s)
- Manasa Suresh
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC 20057, United States
| | - Stephan Menne
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC 20057, United States
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Rivera D, Kalleveen I, de Castro CA, van Laarhoven H, Klomp D, van der Kemp W, Stoker J, Nederveen A. Inherently decoupled 1 H antennas and 31 P loops for metabolic imaging of liver metastasis at 7 T. NMR IN BIOMEDICINE 2020; 33:e4221. [PMID: 31922319 DOI: 10.1002/nbm.4221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
High field 31 P spectroscopy has thus far been limited to diffuse liver disease. Unlike lower field-strength scanners, there is no body coil in the bore of the 7 T and despite inadequate penetration depth (<10 cm), surface coils are the current state-of-the-art for acquiring anatomical images to support multinuclear studies. We present a system of proton antennas and phosphorus loops for 31 P spectroscopy and provide the first ultrahigh-field phosphorus metabolic imaging of a tumor in the abdomen. Herein we characterize the degree to which antennas are isolated from underlying loops. Next, we evaluate the penetration depth of the two antennas available during multinuclear examinations. Finally, we combine phosphorus spectroscopy (two loops) with parallel transmit imaging (eight antennas) in a patient. The loops and antennas are inherently decoupled (no added circuitry, <0.1% power coupling). The penetration depth of two antennas gives twice that of conventional loops. The liver and full axial slice of the abdomen were imaged with eight transmit/receive antennas using parallel transmit B1-shimming to overcome image voids. Phosphorus spectroscopy from a liver metastasis resolved individual peaks for phosphocholine and phosphoethenalomine. Proton antennas are inherently decoupled from phosphorus loops. By using two proton antennas it is possible to perform region-of-interest image-based shimming in over 80% of the liver volume, thereby enabling phosphorus spectroscopy of localized disease. Shimming of the full extent of the abdominal cross-section is feasible using a parallel transmit array of eight antennas. A system architecture capable of supporting eight-channel parallel transmit and multinuclear spectroscopy is optimal for supporting multiparametric body imaging, including metabolic imaging, for monitoring the response of patients with liver metastases to cancer treatments and for patient risk stratification. In the meantime, the existing infrastructure using two antennas is sufficient for preliminary studies in metabolic imaging of tumors in the liver.
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Affiliation(s)
- Debra Rivera
- Department of Electrical Engineering, Technical University Eindhoven, Eindhoven, the Netherlands
- MR Coils, BV Zaltbommel, the Netherlands
| | | | | | | | - Dennis Klomp
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wybe van der Kemp
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jaap Stoker
- Radiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Aart Nederveen
- Radiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Pritchard WF, Woods DL, Esparza-Trujillo JA, Starost MF, Mauda-Havakuk M, Mikhail AS, Bakhutashvili I, Leonard S, Jones EC, Krishnasamy V, Karanian JW, Wood BJ. Transarterial Chemoembolization in a Woodchuck Model of Hepatocellular Carcinoma. J Vasc Interv Radiol 2020; 31:812-819.e1. [PMID: 32107125 DOI: 10.1016/j.jvir.2019.08.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/15/2019] [Accepted: 08/31/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess the feasibility of transarterial chemoembolization with drug-eluting embolic (DEE) microspheres in a woodchuck model of hepatocellular carcinoma (HCC). MATERIALS AND METHODS Nine woodchucks were studied: 4 normal animals and 5 animals infected with woodchuck hepatitis virus in which HCC had developed. Three animals with HCC underwent multidetector CT. A 3-F sheath was introduced into the femoral artery, and the hepatic arteries were selectively catheterized with 2.0-2.4-F microcatheters. Normal animals underwent diagnostic angiography and bland embolization. Animals with HCC underwent DEE transarterial chemoembolization with 70-150-μm radiopaque microspheres loaded with 37.5 mg doxorubicin per milliliter. Cone-beam CT and multidetector CT were performed. Following euthanasia, explanted livers underwent micro-CT, histopathologic examination, and fluorescence imaging of doxorubicin. RESULTS The tumors were hypervascular and supplied by large-caliber tortuous vessels, with arteriovenous shunts present in 2 animals. There was heterogeneous enhancement on multidetector CT with areas of necrosis. Six tumors were identified. The most common location was the right medial lobe (n = 3). Mean tumor volume was 30.7 cm3 ± 12.3. DEE chemoembolization of tumors was achieved. Excluding the 2 animals with arteriovenous shunts, the mean volume of DEE microspheres injected was 0.49 mL ± 0.17. Fluorescence imaging showed diffusion of doxorubicin from the DEE microspheres into the tumor. CONCLUSIONS Woodchuck HCC shares imaging appearances and biologic characteristics with human HCC. Selective catheterization and DEE chemoembolization may similarly be performed. Woodchucks may be used to model interventional therapies and possibly characterize radiologic-pathologic correlations.
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Affiliation(s)
- William F Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892.
| | - David L Woods
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Juan A Esparza-Trujillo
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Matthew F Starost
- Division of Veterinary Resources, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Michal Mauda-Havakuk
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Andrew S Mikhail
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Ivane Bakhutashvili
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Shelby Leonard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Elizabeth C Jones
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Venkatesh Krishnasamy
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - John W Karanian
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892; National Institute of Biomedical Imaging and Bioengineering and National Cancer Institute Center for Cancer Research, National Institutes of Health, 10 Center Dr., Room 3N320B, MSC 1182, Bethesda, MD 20892
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Burke CT, Cullen JM, State A, Gadi S, Wilber K, Rosenthal M, Bulysheva A, Pease A, Mauro MA, Fuchs H. Development of an animal model for radiofrequency ablation of primary, virally induced hepatocellular carcinoma in the woodchuck. J Vasc Interv Radiol 2011; 22:1613-1618.e1. [PMID: 21959057 DOI: 10.1016/j.jvir.2011.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 08/12/2011] [Accepted: 08/15/2011] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To develop a consistent and reproducible method in an animal model for studies of radiofrequency (RF) ablation of primary hepatocellular carcinoma (HCC). MATERIALS AND METHODS Fifteen woodchucks were inoculated with woodchuck hepatitis virus (WHV) to establish chronic infections. When serum γ-glutamyl transpeptidase levels became elevated, the animals were evaluated with ultrasound, and, in most cases, preoperative magnetic resonance (MR) imaging to confirm tumor development. Ultimately, RF ablation of tumors was performed by using a 1-cm probe with the animal submerged in a water bath for grounding. Ablation effectiveness was evaluated with contrast-enhanced MR imaging and gross and histopathologic analysis. RESULTS RF ablation was performed in 15 woodchucks. Modifications were made to the initial study design to adapt methodology for the woodchuck. The last 10 of these animals were treated with a standardized protocol using a 1-cm probe that produced a consistent area of tumor necrosis (mean size of ablation, 10.2 mm × 13.1 mm) and led to no complications. CONCLUSIONS A safe, reliable and consistent method was developed to study RF ablation of spontaneous primary HCC using chronically WHV-infected woodchucks, an animal model of hepatitis B virus-induced HCC.
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Affiliation(s)
- Charles T Burke
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27599-7510, USA.
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