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Zaccagna F, McLean MA, Grist JT, Kaggie J, Mair R, Riemer F, Woitek R, Gill AB, Deen S, Daniels CJ, Ursprung S, Schulte RF, Allinson K, Chhabra A, Laurent MC, Locke M, Frary A, Hilborne S, Patterson I, Carmo BD, Slough R, Wilkinson I, Basu B, Wason J, Gillard JH, Matys T, Watts C, Price SJ, Santarius T, Graves MJ, Jefferies S, Brindle KM, Gallagher FA. Imaging Glioblastoma Metabolism by Using Hyperpolarized [1- 13C]Pyruvate Demonstrates Heterogeneity in Lactate Labeling: A Proof of Principle Study. Radiol Imaging Cancer 2022; 4:e210076. [PMID: 35838532 PMCID: PMC9360994 DOI: 10.1148/rycan.210076] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 01/20/2023]
Abstract
Purpose To evaluate glioblastoma (GBM) metabolism by using hyperpolarized carbon 13 (13C) MRI to monitor the exchange of the hyperpolarized 13C label between injected [1-13C]pyruvate and tumor lactate and bicarbonate. Materials and Methods In this prospective study, seven treatment-naive patients (age [mean ± SD], 60 years ± 11; five men) with GBM were imaged at 3 T by using a dual-tuned 13C-hydrogen 1 head coil. Hyperpolarized [1-13C]pyruvate was injected, and signal was acquired by using a dynamic MRI spiral sequence. Metabolism was assessed within the tumor, in the normal-appearing brain parenchyma (NABP), and in healthy volunteers by using paired or unpaired t tests and a Wilcoxon signed rank test. The Spearman ρ correlation coefficient was used to correlate metabolite labeling with lactate dehydrogenase A (LDH-A) expression and some immunohistochemical markers. The Benjamini-Hochberg procedure was used to correct for multiple comparisons. Results The bicarbonate-to-pyruvate (BP) ratio was lower in the tumor than in the contralateral NABP (P < .01). The tumor lactate-to-pyruvate (LP) ratio was not different from that in the NABP (P = .38). The LP and BP ratios in the NABP were higher than those observed previously in healthy volunteers (P < .05). Tumor lactate and bicarbonate signal intensities were strongly correlated with the pyruvate signal intensity (ρ = 0.92, P < .001, and ρ = 0.66, P < .001, respectively), and the LP ratio was weakly correlated with LDH-A expression in biopsy samples (ρ = 0.43, P = .04). Conclusion Hyperpolarized 13C MRI demonstrated variation in lactate labeling in GBM, both within and between tumors. In contrast, bicarbonate labeling was consistently lower in tumors than in the surrounding NABP. Keywords: Hyperpolarized 13C MRI, Glioblastoma, Metabolism, Cancer, MRI, Neuro-oncology Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Fulvio Zaccagna
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Mary A. McLean
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - James T. Grist
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Joshua Kaggie
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Richard Mair
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Frank Riemer
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ramona Woitek
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Andrew B. Gill
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Surrin Deen
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Charlie J. Daniels
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Stephan Ursprung
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Rolf F. Schulte
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Kieren Allinson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Anita Chhabra
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Marie-Christine Laurent
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Matthew Locke
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Amy Frary
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Sarah Hilborne
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ilse Patterson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Bruno D. Carmo
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Rhys Slough
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ian Wilkinson
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Bristi Basu
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - James Wason
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Jonathan H. Gillard
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Tomasz Matys
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Colin Watts
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Stephen J. Price
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Thomas Santarius
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Martin J. Graves
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Sarah Jefferies
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Kevin M. Brindle
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
| | - Ferdia A. Gallagher
- From the Departments of Radiology (F.Z., J.T.G., J.K., F.R., R.W.,
A.B.G., S.D., C.J.D., S.U., M.C.L., M.L., A.F., S.H., J.H.G., T.M., M.J.G.,
F.A.G.), Clinical Neurosciences (R.M., C.W., S.J.P., T.S.), and Medicine (I.W.),
University of Cambridge School of Clinical Medicine, Cambridge, England; Cancer
Research UK Cambridge Institute (M.A.M., S.U., K.M.B.), Medical Research Council
Biostatistics Unit (J.W.), and Department of Biochemistry (K.M.B.), University
of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, England;
Department of Biomedical Imaging and Image-guided Therapy, Medical University of
Vienna, Vienna, Austria (R.W.); GE Healthcare, Munich, Germany (R.F.S.);
Department of Pathology (K.A.), Cambridge Cancer Trials Centre (A.C.),
Department of Radiology (I.P., B.D.C., R.S.), and Department of Oncology (B.B.,
S.J.), Cambridge University Hospitals National Health Service Foundation Trust,
Cambridge, England; and Population Health Sciences Institute, Newcastle
University, Newcastle upon Tyne, England (J.W.)
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