The response of the KHT sarcoma to radiotherapy as measured by water proton NMR relaxation times: relationships with tumor volume and water content

Musculoskeletal tumors: how to use anatomic, functional, and metabolic MR techniques

Although the function of magnetic resonance (MR) imaging in the evaluation of musculoskeletal tumors has traditionally been to help identify the extent of disease prior to treatment, its role continues to evolve as new techniques emerge. Conventional pulse sequences remain heavily used and useful, but with the advent of chemical shift imaging, diffusion-weighted imaging, perfusion imaging and MR spectroscopy, additional quantitative metrics have become available that may help expand the role of MR imaging to include detection, characterization, and reliable assessment of treatment response. This review discusses a multiparametric approach to the evaluation of musculoskeletal tumors, with a focus on the utility and potential added value of various pulse sequences in helping establish a diagnosis, assess pretreatment extent, and evaluate a tumor in the posttreatment setting for recurrence and treatment response.

Measurement of proliferation activity in human melanoma xenografts by magnetic resonance imaging

Tumor proliferation may be predictive for malignant progression and response to fractionated therapy of cancer. The purpose of the present work was to investigate whether the proliferation activity of solid tumors can be assessed in vivo from the proton relaxation times, T1 and T2. Tumors of four amelanotic human melanoma xenograft lines were studied. Three parameters were used to represent tumor proliferation activity; the volume doubling time, Tvol, the potential doubling time, Tpot, and the fraction of cells in S-phase. Tvol was determined from volumetric growth data. Tpot and S-phase fraction were determined by flow cytometric analysis of tumor cells after bromodeoxyuridine (BrdU) incorporation in vivo. T1 and T2 were measured by 1H-MRI in vivo, using spin-echo pulse sequences. The proliferation parameters and relaxation times differed considerably among the tumor lines. Significant correlations were found between the proliferation parameters and the relaxation times, regardless of whether Tvol, Tpot, or S-phase fraction was considered. Tumors with short Tvol and Tpot and high S-phase fraction had long T1 and T2 compared to tumors with long Tvol and Tpot and low S-phase fraction. The elongated T1 and T2 of fast growing tumors were probably due to increased interstitial and/or intravascular water content. The present results suggest that in vivo spin-echo 1H-MRI can be used to discriminate between tumors of high and low proliferation activity.

Proton relaxation times and interstitial fluid pressure in human melanoma xenografts

The interstitial fluid pressure (IFP) and the proton spin-lattice and spin-spin relaxation times (T1 and T2) of some experimental tumours have been shown to be related to tumour water content. These observations have led to the hypothesis that magnetic resonance imaging (MRI) might be a clinically useful non-invasive method for assessment of tumour IFP. The purpose of the work reported here was to examine the general validity of this hypothesis. R-18 human melanoma xenografts grown intradermally in Balb/c nu/nu mice were used as the tumour model system. Median T1 and T2 were determined by spin-echo MRI using a 1.5-T clinical whole-body tomograph. IFP was measured using the wick-in-needle technique. No correlation was found between tumour IFP and fractional tumour water content. Moreover, there was no correlation between median T1 or T2 and IFP, suggesting that proton T1 and T2 values determined by MRI cannot be used clinically to assess tumour IFP and thereby to predict the uptake of macromolecular therapeutic agents.

Early detection of treatment response by diffusion-weighted 1H-NMR spectroscopy in a murine tumour in vivo

Nuclear magnetic resonance (NMR) non-invasively measures the apparent diffusion coefficient (ADC) of water, which is sensitive to the biophysical characteristics of tissue. Because anti-cancer treatment alters tumour pathophysiology, tumour ADC may be altered by treatment. In order to test this hypothesis, ADC was measured in s.c. implanted murine RIF-1 tumours before and up to 9 days after treatment with cyclophosphamide. A dose-dependent, reversible increase in tumour ADC was observed after cyclophosphamide treatment, which is consistent with an increase in the fraction of interstitial water due to treatment-induced cell death. Because tumour water ADC is increased substantially at a time when there is no change in tumour volume for a dose which produces minimal cell kill, its measurement could provide a novel means for early detection of response to anti-cancer therapy. If the changes in ADC observed in the present study are evident for commonly used anti-cancer therapies in different tumour types and specific to a therapeutic response, the approach could be broadly applicable as a response predictor since magnetic resonance imaging can be used to measure ADC in human tumours.

Detection of necrosis in human tumour xenografts by proton magnetic resonance imaging

Tumours with necrotic regions have an inadequate blood supply and are expected to differ from well-vascularised tumours in response to treatment. The purpose of the present work was to investigate whether proton magnetic resonance imaging (MRI) might be used to detect necrotic regions in tumours. MR images and histological sections from individual tumours of three different amelanotic human melanoma xenograft lines (BEX-t, HUX-t, SAX-t) were analysed in pairs. MRI was performed at 1.5 T using two spin-echo pulse sequences, one with a repetition time (TR) of 600 ms and echo times (TEs) of 20, 40, 60 and 80 ms and the other with a TR of 2000 ms and TEs of 20, 40, 60 and 80 ms. Spin-lattice relaxation time (T1), spin-spin relaxation time (T2) and proton density (N0) were calculated for each volume element corresponding to a pixel. Synthetic MR images, pure T1, T2 and N0 images and spin-echo images with chosen values for TR and TE were generated from these data. T1, T2 and N0 distributions of tumour subregions, corresponding to necrotic regions and regions of viable tissue as defined by histological criteria, were also generated. T1 and T2 were significantly shorter in the necrotic regions than in the regions of viable tissue in all tumours. These differences were sufficiently large to allow the generation of synthetic spin-echo images showing clear contrast between necrosis and viable tissue. Maximum contrast was achieved with TRs within the range 2800-4000 ms and TEs within the range 160-200 ms. Necrotic tissue could also be distinguished from viable tissue in pure T1 and T2 images. Consequently, the possibility exists that MRI might be used for detection of necrotic regions in tumours and hence for prediction of tumour treatment response.

Non-invasive monitoring of tissue response to radiotherapy by localised proton spin-lattice relaxation time in mice

Proton spin-lattice relaxation time T1 of the localised tumour portion and its neighbouring portion of tumour-bearing mice legs is successively observed before and after radiotherapy by applying the previously proposed magnetic focusing method. Changes in T1 values are also compared with the histological radiation effects. For un-irradiated tumours, T1 increases gradually with tumour growth. T1 of the tumour portion shows significant decrease after radiotherapy. The decrease in the T1 values of the tumour clearly depends on the single radiation dose of 30, 45 and 60 Gy, respectively. A rapid decrease in the T1 values of the tumour occurs prior to the decrease in tumour volume. These decreases in the T1 values of the tumour after radiotherapy correspond positively to the increase of the histological radiation effects. After the reduction in the T1 values of the irradiated tumour portion, a successive increase in T1 values is observed and suggests local recurrence of the tumour. These results show that localised T1 relaxation time is a good reflection of the tissue response to radiotherapy.

MRI of human tumor xenografts in vivo: proton relaxation times and extracellular tumor volume

Proton T1 and T2 differ substantially between tumors, but the tumor properties causing heterogeneity in T1 and T2 have not been fully recognized. The purpose of the study reported here was to investigate whether differences in T1 and T2 between tumors are mainly a consequence of differences in the fractional volume of the extracellular compartment. The study was performed using a single human tumor xenograft line showing large naturally occurring intratumor heterogeneity in the size of the extracellular compartment. The size of the extracellular compartment was calculated from the volume and the density of the tumor cells. Cell volume was measured by an electronic particle counter. Cell density was determined by stereological analysis of histological preparations. T1 and T2 were measured by MRI in vivo both in the absence and presence of Gd-DTPA. Two spin-echo pulse sequences were used, one with a repetition time (TR) of 600 ms and echo times (TEs) of 20, 40, 60, and 80 ms and the other with a TR of 2,000 ms and TEs of 20, 40, 60, and 80 ms. Measurements of T1 and T2 in the presence of Gd-DTPA were performed in a state of semi-equilibrium between uptake and clearance of Gd-DTPA. MR-images and histological preparations of tumor subregions homogeneous in extracellular volume were analysed in pairs. The extracellular volume differed between tumor subregions from 5 to 70%. T1 and T2 measured in the absence of Gd-DTPA differed between tumor subregions by a factor of approximately 1.5 and increased with increasing extracellular volume. The relative decrease in T1 caused by Gd-DTPA, represented by (T1 control-T1 Gd-DTPA)/T1 control, also increased with increasing extracellular volume.(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo relaxation time measurements on a murine tumor model--prolongation of T1 after photodynamic therapy

RIF tumors implanted on mice feet were investigated for changes in relaxation times (T1 and T2) after photodynamic therapy (PDT). Photodynamic therapy was performed using Photofrin II as the photosensitizer and laser light at 630 nm. A home-built proton solenoid coil in the balanced configuration was used to accommodate the tumors, and the relaxation times were measured before, immediately after, and up to several hours after therapy. Several control experiments were performed untreated tumors, tumors treated with Photofrin II alone, or tumors treated with laser light alone. Significant increases in T1s of water protons were observed after PDT treatment. In all experiments, 31P spectra were recorded before and after the therapy to study the tumor status and to confirm the onset of PDT. These studies show significant prolongation of T1s after the PDT treatment. The spin-spin relaxation measurements, on the other hand, did not show such prolongation in T2 values after PDT treatment.

Magnetic resonance imaging of human melanoma xenografts in vivo: proton spin-lattice and spin-spin relaxation times versus fractional tumour water content and fraction of necrotic tumour tissue

Proton nuclear magnetic resonance (1H-nmr) imaging is used routinely in clinical oncology to provide macroscopic anatomical information, whereas its potential to provide physiological information about tumours is not well explored. To evaluate the potential usefulness of 1H-nmr imaging in the prediction of tumour treatment resistance caused by unfavourable microenvironmental conditions, possible correlations between proton spin-lattice and spin-spin relaxation times (T1 and T2) and physiological parameters of the tumour microenvironment were investigated. Tumours from six human melanoma xenograft lines were included in the study. 1H-nmr imaging was performed at 1.5 T using spin-echo pulse sequences. T1- and T2-distributions were generated from the images. Fractional tumour water content and the fraction of necrotic tumour tissue were measured immediately after 1H-nmr imaging. Significant correlations across tumour lines were found for T1 and T2 versus fractional tumour water content (p < 0.001) as well as for T1 and T2 versus fraction of necrotic tumour tissue (p < 0.05). Tumours with high fractional water contents had high values of T1 and T2, probably caused by free water in the tumour interstitium. Fractional water content is correlated to interstitial fluid pressure in tumours, high interstitial fluid pressure being indicative of high vascular resistance. Tumours with high fractional water contents are thus expected to show regions with radiobiologically hypoxic cells as well as poor intravascular and interstitial transport of many therapeutic agents. T1 and T2 decreased with increasing fraction of necrotic tumour tissue, perhaps because complexed paramagnetic ions were released during development of necrosis. Viable tumour cells adjacent to necrotic regions are usually chronically hypoxic. Tumours with high fractions of necrotic tissue are thus expected to contain significant proportions of radiobiologically hypoxic cells. Consequently, quantitative 1H-nmr imaging has the potential to be developed as an efficient clinical tool in prediction of tumour treatment resistance caused by hypoxia and/or transport barriers for therapeutic agents. However, much work remains to be done before this potential can be adequately evaluated. One problem is that high fractional tumour water contents result in longer T1 and T2 whereas high fractions of necrotic tumour tissue result in shorter T1 and T2; i.e. the two parameters which are indicative of treatment resistance contribute in opposite directions. Another problem is that the correlations for T1 and T2 versus fraction of necrotic tumour tissue are not particularly strong.