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Prades-Sagarra E, Laarakker F, Dissy J, Lieuwes NG, Biemans R, Dubail M, Fouillade C, Yaromina A, Dubois LJ. Caffeic Acid Phenethyl Ester (CAPE), a natural polyphenol to increase the therapeutic window for lung adenocarcinomas. Radiother Oncol 2024; 190:110021. [PMID: 38000688 DOI: 10.1016/j.radonc.2023.110021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/16/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND PURPOSE Lung cancers are highly resistant to radiotherapy, necessitating the use of high doses, which leads to radiation toxicities such as radiation pneumonitis and fibrosis. Caffeic Acid Phenethyl Ester (CAPE) has been suggested to have anti-proliferative and pro-apoptotic effects in tumour cells, while radioprotective anti-inflammatory and anti-oxidant effects in the normal tissue. We investigated the radiosensitizing and radioprotective effects of CAPE in lung cancer cell lines and normal tissue in vitro and ex vivo, respectively. MATERIALS AND METHODS The cytotoxic and radiosensitizing effects of CAPE in lung cancer were investigated using viability and clonogenic survival assays. The radioprotective effects of CAPE were assessed in vitro and ex vivo using precision cut lung slices (PCLS). Potential underlying molecular mechanisms of CAPE focusing on cell cycle, cell metabolism, mitochondrial function and pro-inflammatory markers were investigated. RESULTS Treatment with CAPE decreased cell viability in a dose-dependent manner (IC50 57.6 ± 16.6 μM). Clonogenic survival assays showed significant radiosensitization by CAPE in lung adenocarcinoma lines (p < 0.05), while no differences were found in non-adenocarcinoma lines (p ≥ 0.13). Cell cycle analysis showed an increased S-phase (p < 0.05) after incubation with CAPE in the majority of cell lines. Metabolic profiling showed that CAPE shifted cellular respiration towards glycolysis (p < 0.01), together with mitochondrial membrane depolarization (p < 0.01). CAPE induced a decrease in NF-κB activity in adenocarcinomas and decreased pro-inflammatory gene expression in PCLS. CONCLUSION The combination of CAPE and radiotherapy may be a potentially effective approach to increase the therapeutic window in lung cancer patients.
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Affiliation(s)
- E Prades-Sagarra
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - F Laarakker
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - J Dissy
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - N G Lieuwes
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - R Biemans
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - M Dubail
- Institut Curie, Inserm U1021-CNRS UMR 3347, University Paris-Saclay, PSL University, Centre Universitaire, 91405 Orsay Cedex, France
| | - C Fouillade
- Institut Curie, Inserm U1021-CNRS UMR 3347, University Paris-Saclay, PSL University, Centre Universitaire, 91405 Orsay Cedex, France
| | - A Yaromina
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - L J Dubois
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands.
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Palaniappan P, Knudsen Y, Meyer S, Gianoli C, Schnürle K, Würl M, Bortfeldt J, Parodi K, Riboldi M. Multi-stage image registration based on list-mode proton radiographies for small animal proton irradiation: A simulation study. Z Med Phys 2023:S0939-3889(23)00045-4. [PMID: 37353464 DOI: 10.1016/j.zemedi.2023.04.003] [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: 09/21/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 06/25/2023]
Abstract
We present a multi-stage and multi-resolution deformable image registration framework for image-guidance at a small animal proton irradiation platform. The framework is based on list-mode proton radiographies acquired at different angles, which are used to deform a 3D treatment planning CT relying on normalized mutual information (NMI) or root mean square error (RMSE) in the projection domain. We utilized a mouse X-ray micro-CT expressed in relative stopping power (RSP), and obtained Monte Carlo simulations of proton images in list-mode for three different treatment sites (brain, head and neck, lung). Rigid transformations and controlled artificial deformation were applied to mimic position misalignments, weight loss and breathing changes. Results were evaluated based on the residual RMSE of RSP in the image domain including the comparison of extracted local features, i.e. between the reference micro-CT and the one transformed taking into account the calculated deformation. The residual RMSE of the RSP showed that the accuracy of the registration framework is promising for compensating rigid (>97% accuracy) and non-rigid (∼95% accuracy) transformations with respect to a conventional 3D-3D registration. Results showed that the registration accuracy is degraded when considering the realistic detector performance and NMI as a metric, whereas the RMSE in projection domain is rather insensitive. This work demonstrates the pre-clinical feasibility of the registration framework on different treatment sites and its use for small animal imaging with a realistic detector. Further computational optimization of the framework is required to enable the use of this tool for online estimation of the deformation.
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Affiliation(s)
- Prasannakumar Palaniappan
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany.
| | - Yana Knudsen
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sebastian Meyer
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Chiara Gianoli
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katrin Schnürle
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Matthias Würl
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jonathan Bortfeldt
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katia Parodi
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marco Riboldi
- Department of Medical Physics - Experimental Physics, Ludwig-Maximilians-Universität München, Munich, Germany
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3
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Jiang S, Zhou Y, Zou L, Chu L, Chu X, Ni J, Li Y, Guo T, Yang X, Zhu Z. Low- dose Apatinib promotes vascular normalization and hypoxia reduction and sensitizes radiotherapy in lung cancer. Cancer Med 2023; 12:4434-4445. [PMID: 36065943 PMCID: PMC9972072 DOI: 10.1002/cam4.5113] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND PURPOSE Abnormal vascular network of tumor can create a hypoxic microenvironment, and reduce radiotherapy sensitivity. Normalization of tumor vasculature can be a new therapeutic strategy for sensitizing radiotherapy. This study aimed to explore the effect of apatinib on vascular normalization, as well as the syngeneic effect with radiotherapy on lung cancer. MATERIALS AND METHODS Lewis lung carcinoma (LLC) xenograft-bearing female C57BL/6 mice were treated with different doses of apatinib (30, 60, and 120 mg/kg per day) and/or radiation therapy (8 Gy/1F) and then sacrificed to harvest tumor tissue for immunohistochemical test. Further 18 F-FMISO micro- PET in vivo explored the degree of hypoxia. RESULTS Immunohistochemistry of CD31 and alpha-smooth muscle actin (α-SMA) proved that low-dose apatinib can normalize vasculature in tumor, especially on Day 10. Tissue staining of hypoxyprobe-1 and 18 F-FMISO micro- PET in vivo showed that 60 mg/kg/day of apatinib significantly alleviates hypoxia. Moreover, this study further proved that low-dose apatinib (60 mg/kg/day) can enhance the radio-response of LLC xenograft mice. CONCLUSION Our data suggested that low- dose apatinib can successfully induce a vascular normalization window and function as a radio- sensitizer in the lung cancer xenografts model.
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Affiliation(s)
- Shanshan Jiang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yue Zhou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Liqing Zou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Li Chu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao Chu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianjiao Ni
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yida Li
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tiantian Guo
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xi Yang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Institute of Thoracic Oncology, Fudan University, Shanghai, China
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van Dijk RHW, Staut N, Wolfs CJA, Verhaegen F. A novel multichannel deep learning model for fast denoising of Monte Carlo dose calculations: preclinical applications. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. In preclinical radiotherapy with kilovolt (kV) x-ray beams, accurate treatment planning is needed to improve the translation potential to clinical trials. Monte Carlo based radiation transport simulations are the gold standard to calculate the absorbed dose distribution in external beam radiotherapy. However, these simulations are notorious for their long computation time, causing a bottleneck in the workflow. Previous studies have used deep learning models to speed up these simulations for clinical megavolt (MV) beams. For kV beams, dose distributions are more affected by tissue type than for MV beams, leading to steep dose gradients. This study aims to speed up preclinical kV dose simulations by proposing a novel deep learning pipeline. Approach. A deep learning model is proposed that denoises low precision (∼106 simulated particles) dose distributions to produce high precision (109 simulated particles) dose distributions. To effectively denoise the steep dose gradients in preclinical kV dose distributions, the model uses the novel approach to use the low precision Monte Carlo dose calculation as well as the Monte Carlo uncertainty (MCU) map and the mass density map as additional input channels. The model was trained on a large synthetic dataset and tested on a real dataset with a different data distribution. To keep model inference time to a minimum, a novel method for inference optimization was developed as well. Main results. The proposed model provides dose distributions which achieve a median gamma pass rate (3%/0.3 mm) of 98% with a lower bound of 95% when compared to the high precision Monte Carlo dose distributions from the test set, which represents a different dataset distribution than the training set. Using the proposed model together with the novel inference optimization method, the total computation time was reduced from approximately 45 min to less than six seconds on average. Significance. This study presents the first model that can denoise preclinical kV instead of clinical MV Monte Carlo dose distributions. This was achieved by using the MCU and mass density maps as additional model inputs. Additionally, this study shows that training such a model on a synthetic dataset is not only a viable option, but even increases the generalization of the model compared to training on real data due to the sheer size and variety of the synthetic dataset. The application of this model will enable speeding up treatment plan optimization in the preclinical workflow.
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Sforazzini F, Salome P, Moustafa M, Zhou C, Schwager C, Rein K, Bougatf N, Kudak A, Woodruff H, Dubois L, Lambin P, Debus J, Abdollahi A, Knoll M. Deep Learning-based Automatic Lung Segmentation on Multiresolution CT Scans from Healthy and Fibrotic Lungs in Mice. Radiol Artif Intell 2022; 4:e210095. [PMID: 35391764 PMCID: PMC8980878 DOI: 10.1148/ryai.210095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 06/02/2023]
Abstract
PURPOSE To develop a model to accurately segment mouse lungs with varying levels of fibrosis and investigate its applicability to mouse images with different resolutions. MATERIALS AND METHODS In this experimental retrospective study, a U-Net was trained to automatically segment lungs on mouse CT images. The model was trained (n = 1200), validated (n = 300), and tested (n = 154) on longitudinally acquired and semiautomatically segmented CT images, which included both healthy and irradiated mice (group A). A second independent group of 237 mice (group B) was used for external testing. The Dice score coefficient (DSC) and Hausdorff distance (HD) were used as metrics to quantify segmentation accuracy. Transfer learning was applied to adapt the model to high-spatial-resolution mouse micro-CT segmentation (n = 20; group C [n = 16 for training and n = 4 for testing]). RESULTS The trained model yielded a high median DSC in both test datasets: 0.984 (interquartile range [IQR], 0.977-0.988) in group A and 0.966 (IQR, 0.955-0.972) in group B. The median HD in both test datasets was 0.47 mm (IQR, 0-0.51 mm [group A]) and 0.31 mm (IQR, 0.30-0.32 mm [group B]). Spatially resolved quantification of differences toward reference masks revealed two hot spots close to the air-tissue interfaces, which are particularly prone to deviation. Finally, for the higher-resolution mouse CT images, the median DSC was 0.905 (IQR, 0.902-0.929) and the median 95th percentile of the HD was 0.33 mm (IQR, 2.61-2.78 mm). CONCLUSION The developed deep learning-based method for mouse lung segmentation performed well independently of disease state (healthy, fibrotic, emphysematous lungs) and CT resolution.Keywords: Deep Learning, Lung Fibrosis, Radiation Therapy, Segmentation, Animal Studies, CT, Thorax, Lung Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Lappas G, Wolfs CJA, Staut N, Lieuwes NG, Biemans R, van Hoof SJ, Dubois LJ, Verhaegen F. Automatic contouring of normal tissues with deep learning for preclinical radiation studies. Phys Med Biol 2022; 67. [PMID: 35061600 DOI: 10.1088/1361-6560/ac4da3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/21/2022] [Indexed: 02/05/2023]
Abstract
Objective.Delineation of relevant normal tissues is a bottleneck in image-guided precision radiotherapy workflows for small animals. A deep learning (DL) model for automatic contouring using standardized 3D micro cone-beam CT (μCBCT) volumes as input is proposed, to provide a fully automatic, generalizable method for normal tissue contouring in preclinical studies.Approach.A 3D U-net was trained to contour organs in the head (whole brain, left/right brain hemisphere, left/right eye) and thorax (complete lungs, left/right lung, heart, spinal cord, thorax bone) regions. As an important preprocessing step, Hounsfield units (HUs) were converted to mass density (MD) values, to remove the energy dependency of theμCBCT scanner and improve generalizability of the DL model. Model performance was evaluated quantitatively by Dice similarity coefficient (DSC), mean surface distance (MSD), 95th percentile Hausdorff distance (HD95p), and center of mass displacement (ΔCoM). For qualitative assessment, DL-generated contours (for 40 and 80 kV images) were scored (0: unacceptable, manual re-contouring needed - 5: no adjustments needed). An uncertainty analysis using Monte Carlo dropout uncertainty was performed for delineation of the heart.Main results.The proposed DL model and accompanying preprocessing method provide high quality contours, with in general median DSC > 0.85, MSD < 0.25 mm, HD95p < 1 mm and ΔCoM < 0.5 mm. The qualitative assessment showed very few contours needed manual adaptations (40 kV: 20/155 contours, 80 kV: 3/155 contours). The uncertainty of the DL model is small (within 2%).Significance.A DL-based model dedicated to preclinical studies has been developed for multi-organ segmentation in two body sites. For the first time, a method independent of image acquisition parameters has been quantitatively evaluated, resulting in sub-millimeter performance, while qualitative assessment demonstrated the high quality of the DL-generated contours. The uncertainty analysis additionally showed that inherent model variability is low.
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Affiliation(s)
- Georgios Lappas
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Cecile J A Wolfs
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Nick Staut
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,SmART Scientific Solutions BV, Maastricht, The Netherlands
| | - Natasja G Lieuwes
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Rianne Biemans
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | | | - Ludwig J Dubois
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Frank Verhaegen
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,SmART Scientific Solutions BV, Maastricht, The Netherlands
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Bertho A, Dos Santos M, Braga-Cohen S, Buard V, Paget V, Guipaud O, Tarlet G, Milliat F, François A. Preclinical Model of Stereotactic Ablative Lung Irradiation Using Arc Delivery in the Mouse: Is Fractionation Worthwhile? Front Med (Lausanne) 2022; 8:794324. [PMID: 35004768 PMCID: PMC8739220 DOI: 10.3389/fmed.2021.794324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Lung stereotactic body radiation therapy is characterized by a reduction in target volumes and the use of severely hypofractionated schedules. Preclinical modeling became possible thanks to rodent-dedicated irradiation devices allowing accurate beam collimation and focal lung exposure. Given that a great majority of publications use single dose exposures, the question we asked in this study was as follows: in incremented preclinical models, is it worth using fractionated protocols or should we continue focusing solely on volume limitation? The left lungs of C57BL/6JRj mice were exposed to ionizing radiation using arc therapy and 3 × 3 mm beam collimation. Three-fraction schedules delivered over a period of 1 week were used with 20, 28, 40, and 50 Gy doses per fraction. Lung tissue opacification, global histological damage and the numbers of type II pneumocytes and club cells were assessed 6 months post-exposure, together with the gene expression of several lung cells and inflammation markers. Only the administration of 3 × 40 Gy or 3 × 50 Gy generated focal lung fibrosis after 6 months, with tissue opacification visible by cone beam computed tomography, tissue scarring and consolidation, decreased club cell numbers and a reactive increase in the number of type II pneumocytes. A fractionation schedule using an arc-therapy-delivered three fractions/1 week regimen with 3 × 3 mm beam requires 40 Gy per fraction for lung fibrosis to develop within 6 months, a reasonable time lapse given the mouse lifespan. A comparison with previously published laboratory data suggests that, in this focal lung irradiation configuration, administering a Biological Effective Dose ≥ 1000 Gy should be recommended to obtain lung fibrosis within 6 months. The need for such a high dose per fraction challenges the appropriateness of using preclinical highly focused fractionation schedules in mice.
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Affiliation(s)
- Annaïg Bertho
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Morgane Dos Santos
- Laboratory of Radiobiology of Accidental Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Sarah Braga-Cohen
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Valérie Buard
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Vincent Paget
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Olivier Guipaud
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Georges Tarlet
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Fabien Milliat
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
| | - Agnès François
- Laboratory of Radiobiology of Medical Exposures, Institute for Radioprotection and Nuclear Safety (IRSN), Research Department in Radiobiology and Regenerative Medicine, Fontenay-aux-Roses, France
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8
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Lappas G, Staut N, Lieuwes NG, Biemans R, Wolfs CJ, van Hoof SJ, Dubois LJ, Verhaegen F. Inter-observer variability of organ contouring for preclinical studies with cone beam Computed Tomography imaging. Phys Imaging Radiat Oncol 2022; 21:11-17. [PMID: 35111981 PMCID: PMC8790504 DOI: 10.1016/j.phro.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 12/28/2022] Open
Abstract
Background and purpose In preclinical radiation studies, there is great interest in quantifying the radiation response of healthy tissues. Manual contouring has significant impact on the treatment-planning because of variation introduced by human interpretation. This results in inconsistencies when assessing normal tissue volumes. Evaluation of these discrepancies can provide a better understanding on the limitations of the current preclinical radiation workflow. In the present work, interobserver variability (IOV) in manual contouring of rodent normal tissues on cone-beam Computed Tomography, in head and thorax regions was evaluated. Materials and methods Two animal technicians performed manually (assisted) contouring of normal tissues located within the thorax and head regions of rodents, 20 cases per body site. Mean surface distance (MSD), displacement of center of mass (ΔCoM), DICE similarity coefficient (DSC) and the 95th percentile Hausdorff distance (HD95) were calculated between the contours of the two observers to evaluate the IOV. Results For the thorax organs, right lung had the lowest IOV (ΔCoM: 0.08 ± 0.04 mm, DSC: 0.96 ± 0.01, MSD:0.07 ± 0.01 mm, HD95:0.20 ± 0.03 mm) while spinal cord, the highest IOV (ΔCoM:0.5 ± 0.3 mm, DSC:0.81 ± 0.05, MSD:0.14 ± 0.03 mm, HD95:0.8 ± 0.2 mm). Regarding head organs, right eye demonstrated the lowest IOV (ΔCoM:0.12 ± 0.08 mm, DSC: 0.93 ± 0.02, MSD: 0.15 ± 0.04 mm, HD95: 0.29 ± 0.07 mm) while complete brain, the highest IOV (ΔCoM: 0.2 ± 0.1 mm, DSC: 0.94 ± 0.02, MSD: 0.3 ± 0.1 mm, HD95: 0.5 ± 0.1 mm). Conclusions Our findings reveal small IOV, within the sub-mm range, for thorax and head normal tissues in rodents. The set of contours can serve as a basis for developing an automated delineation method for e.g., treatment planning.
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Affiliation(s)
- Georgios Lappas
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Nick Staut
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | | | - Rianne Biemans
- SmART Scientific Solutions BV, Maastricht, the Netherlands
| | - Cecile J.A. Wolfs
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Stefan J. van Hoof
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | | | - Frank Verhaegen
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
- Corresponding author at: Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
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9
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Burkhardt R, Gora T, Fingerle AA, Sauter AP, Meurer F, Gassert FT, Dobiasch S, Schilling D, Feuchtinger A, Walch AK, Multhoff G, Herzen J, Noël PB, Rummeny EJ, Combs SE, Schmid TE, Pfeiffer F, Wilkens JJ. In-vivo X-ray dark-field computed tomography for the detection of radiation-induced lung damage in mice. Phys Imaging Radiat Oncol 2021; 20:11-16. [PMID: 34611553 PMCID: PMC8476771 DOI: 10.1016/j.phro.2021.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/22/2022] Open
Abstract
Radiation-induced lung damage was observed using X-ray dark-field tomography. In this pre-clinical study, mouse lungs were irradiated and subsequently imaged. We report increased sensitivity of X-ray dark-field tomography over absorption-based tomography.
Background and Purpose Radiotherapy of thoracic tumours can lead to side effects in the lung, which may benefit from early diagnosis. We investigated the potential of X-ray dark-field computed tomography by a proof-of-principle murine study in a clinically relevant radiotherapeutic setting aiming at the detection of radiation-induced lung damage. Material and Methods Six mice were irradiated with 20 Gy to the entire right lung. Together with five unirradiated control mice, they were imaged using computed tomography with absorption and dark-field contrast before and 16 weeks post irradiation. Mean pixel values for the right and left lung were calculated for both contrasts, and the right-to-left-ratio R of these means was compared. Radiologists also assessed the tomograms acquired 16 weeks post irradiation. Sensitivity, specificity, inter- and intra-reader accuracy were evaluated. Results In absorption contrast the group-average of R showed no increase in the control group and increased by 7% (p = 0.005) in the irradiated group. In dark-field contrast, it increased by 2% in the control group and by 14% (p = 0.005) in the irradiated group. Specificity was 100% for both contrasts but sensitivity was almost four times higher using dark-field tomography. Two cases were missed by absorption tomography but were detected by dark-field tomography. Conclusions The applicability of X-ray dark-field computed tomography for the detection of radiation-induced lung damage was demonstrated in a pre-clinical mouse model. The presented results illustrate the differences between dark-field and absorption contrast and show that dark-field tomography could be advantageous in future clinical settings.
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Affiliation(s)
- Rico Burkhardt
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany.,Physics Department, Technical University of Munich, Garching, Germany
| | - Thomas Gora
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Alexander A Fingerle
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Andreas P Sauter
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Felix Meurer
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Florian T Gassert
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Sophie Dobiasch
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany
| | - Daniela Schilling
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany
| | - Annette Feuchtinger
- Abteilung Analytische Pathologie, Helmholtz Zentrum München, Neuherberg, Germany
| | - Axel K Walch
- Abteilung Analytische Pathologie, Helmholtz Zentrum München, Neuherberg, Germany
| | - Gabriele Multhoff
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany.,TranslaTUM, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Julia Herzen
- Physics Department, Technical University of Munich, Garching, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany.,Munich School of BioEngineering (MSB), Technical University of Munich, Garching, Germany
| | - Peter B Noël
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany
| | - Thomas E Schmid
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany
| | - Franz Pfeiffer
- Physics Department, Technical University of Munich, Garching, Germany.,Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany.,Munich School of BioEngineering (MSB), Technical University of Munich, Garching, Germany
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Physics Department, Technical University of Munich, Garching, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany
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10
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Wang X, Li W, Zhang K, Sun J, Yang J, Zhang A, Xu L. A Novel Local Tumor Progression Prediction Method for Multimode Ablation Treatment. IEEE Trans Biomed Eng 2021; 69:1386-1397. [PMID: 34591754 DOI: 10.1109/tbme.2021.3116607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The multimode ablation of liver cancer, which uses radio-frequency heating after a pre-freezing process to treat the tumor, has shown significantly improved therapeutic effects and enhanced anti-tumor immune response. Unlike open surgery, the ablated lesions remain in the body after treatment, so it is critical to assess the immediate outcome and to monitor disease status over time. Here we propose a novel tumor progression prediction method for simultaneous postoperative evaluation and prognosis analysis. METHODS We propose to leverage the intraoperative therapeutic information extracted from thermal dose distribution. For tumors with specific sensitivity reflected in medical images, different thermal doses implicitly indicate the degree of instant damage and long-term inhibition excited under specific ablation energy. We further propose a survival analysis framework for the multimode ablation treatment. It extracts carefully designed features from clinical, preoperative, intraoperative, and postoperative data, then uses random survival forest for feature selection and deep neural networks for survival prediction. RESULTS We evaluated the proposed methods using clinical data. The results show that our method outperforms the state-of-the-art survival analysis methods with a C-index of 0.8550.090. The thermal dose information contributes significantly to the prediction accuracy by taking up 21.7% of the overall feature importance. CONCLUSION The proposed methods have been demonstrated to be a powerful tool in tumor progression prediction of multimode ablation therapy. SIGNIFICANCE This kind of data-driven prognosis analysis may benefit personalized medicine and simplify the follow-up process.
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11
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Khan A, Markus A, Rittmann T, Albers J, Alves F, Hülsmann S, Dullin C. Simple low dose radiography allows precise lung volume assessment in mice. Sci Rep 2021; 11:4163. [PMID: 33602964 PMCID: PMC7893164 DOI: 10.1038/s41598-021-83319-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/08/2021] [Indexed: 02/07/2023] Open
Abstract
X-ray based lung function (XLF) as a planar method uses dramatically less X-ray dose than computed tomography (CT) but so far lacked the ability to relate its parameters to pulmonary air volume. The purpose of this study was to calibrate the functional constituents of XLF that are biomedically decipherable and directly comparable to that of micro-CT and whole-body plethysmography (WBP). Here, we developed a unique set-up for simultaneous assessment of lung function and volume using XLF, micro-CT and WBP on healthy mice. Our results reveal a strong correlation of lung volumes obtained from radiographic XLF and micro-CT and demonstrate that XLF is superior to WBP in sensitivity and precision to assess lung volumes. Importantly, XLF measurement uses only a fraction of the radiation dose and acquisition time required for CT. Therefore, the redefined XLF approach is a promising tool for preclinical longitudinal studies with a substantial potential of clinical translation.
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Affiliation(s)
- Amara Khan
- Translational Molecular Imaging, Max-Planck-Institute for Experimental Medicine, Hermann-Rein-Straße 3, 37075, Göttingen, Germany
| | - Andrea Markus
- Translational Molecular Imaging, Max-Planck-Institute for Experimental Medicine, Hermann-Rein-Straße 3, 37075, Göttingen, Germany
| | - Thomas Rittmann
- 4th Physical Institute - Solids and Nanostructures, University of Göttingen, Friedrich-Hund-Platz 1, 37077, Göttingen, Germany
| | - Jonas Albers
- Translational Molecular Imaging, Max-Planck-Institute for Experimental Medicine, Hermann-Rein-Straße 3, 37075, Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Frauke Alves
- Translational Molecular Imaging, Max-Planck-Institute for Experimental Medicine, Hermann-Rein-Straße 3, 37075, Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Clinic for Hematology and Medical Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Swen Hülsmann
- Clinic for Anesthesiology, University Medical Center Göttingen, Humboldtallee 23, 37073, Göttingen, Germany
| | - Christian Dullin
- Translational Molecular Imaging, Max-Planck-Institute for Experimental Medicine, Hermann-Rein-Straße 3, 37075, Göttingen, Germany.
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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12
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Burkhardt R, Gora T, Fingerle AA, Sauter AP, Meurer F, Umkehrer S, von Teuffenbach M, Kampfer S, Schilling D, Feuchtinger A, Walch AK, Rummeny E, Combs SE, Schmid TE, Pfeiffer F, Wilkens JJ, Herzen J. Early detection of radiation-induced lung damage with X-ray dark-field radiography in mice. Eur Radiol 2020; 31:4175-4183. [PMID: 33211140 PMCID: PMC8128748 DOI: 10.1007/s00330-020-07459-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/12/2020] [Accepted: 11/03/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Assessing the advantage of x-ray dark-field contrast over x-ray transmission contrast in radiography for the detection of developing radiation-induced lung damage in mice. METHODS Two groups of female C57BL/6 mice (irradiated and control) were imaged obtaining both contrasts monthly for 28 weeks post irradiation. Six mice received 20 Gy of irradiation to the entire right lung sparing the left lung. The control group of six mice was not irradiated. A total of 88 radiographs of both contrasts were evaluated for both groups based on average values for two regions of interest, covering (irradiated) right lung and healthy left lung. The ratio of these average values, R, was distinguished between healthy and damaged lungs for both contrasts. The time-point when deviations of R from healthy lung exceeded 3σ was determined and compared among contrasts. The Wilcoxon-Mann-Whitney test was used to test against the null hypothesis that there is no difference between both groups. A selection of 32 radiographs was assessed by radiologists. Sensitivity and specificity were determined in order to compare the diagnostic potential of both contrasts. Inter-reader and intra-reader accuracy were rated with Cohen's kappa. RESULTS Radiation-induced morphological changes of lung tissue caused deviations from the control group that were measured on average 10 weeks earlier with x-ray dark-field contrast than with x-ray transmission contrast. Sensitivity, specificity, and accuracy doubled using dark-field radiography. CONCLUSION X-ray dark-field radiography detects morphological changes of lung tissue associated with radiation-induced damage earlier than transmission radiography in a pre-clinical mouse model. KEY POINTS • Significant deviations from healthy lung due to irradiation were measured after 16 weeks with x-ray dark-field radiography (p = 0.004). • Significant deviations occur on average 10 weeks earlier for x-ray dark-field radiography in comparison to x-ray transmission radiography. • Sensitivity and specificity doubled when using x-ray dark-field radiography instead of x-ray transmission radiography.
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Affiliation(s)
- Rico Burkhardt
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany. .,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany. .,Physics Department, Technical University of Munich, Garching, Germany.
| | - Thomas Gora
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Alexander A Fingerle
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Andreas P Sauter
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Felix Meurer
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Stephan Umkehrer
- Chair of Biomedical Physics, Technical University of Munich, Garching, Germany
| | | | - Severin Kampfer
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Physics Department, Technical University of Munich, Garching, Germany
| | - Daniela Schilling
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany
| | - Annette Feuchtinger
- Abteilung Analytische Pathologie, Helmholtz Zentrum München, Neuherberg, Germany
| | - Axel K Walch
- Abteilung Analytische Pathologie, Helmholtz Zentrum München, Neuherberg, Germany
| | - Ernst Rummeny
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany
| | - Thomas E Schmid
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Neuherberg, Germany
| | - Franz Pfeiffer
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany.,Munich School of BioEngineering (MSB), Technical University of Munich, Garching, Germany
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Munich, Germany.,Physics Department, Technical University of Munich, Garching, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany
| | - Julia Herzen
- Physics Department, Technical University of Munich, Garching, Germany.,Chair of Biomedical Physics, Technical University of Munich, Garching, Germany.,Munich School of BioEngineering (MSB), Technical University of Munich, Garching, Germany
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13
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Use of a Luciferase-Expressing Orthotopic Rat Brain Tumor Model to Optimize a Targeted Irradiation Strategy for Efficacy Testing with Temozolomide. Cancers (Basel) 2020; 12:cancers12061585. [PMID: 32549357 PMCID: PMC7352586 DOI: 10.3390/cancers12061585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/29/2020] [Accepted: 06/11/2020] [Indexed: 01/04/2023] Open
Abstract
Glioblastoma multiforme (GBM) is a common and aggressive malignant brain cancer with a mean survival time of approximately 15 months after initial diagnosis. Currently, the standard-of-care (SOC) treatment for this disease consists of radiotherapy (RT) with concomitant and adjuvant temozolomide (TMZ). We sought to develop an orthotopic preclinical model of GBM and to optimize a protocol for non-invasive monitoring of tumor growth, allowing for determination of the efficacy of SOC therapy using a targeted RT strategy combined with TMZ. A strong correlation (r = 0.80) was observed between contrast-enhanced (CE)-CT-based volume quantification and bioluminescent (BLI)-integrated image intensity when monitoring tumor growth, allowing for BLI imaging as a substitute for CE-CT. An optimized parallel-opposed single-angle RT beam plan delivered on average 96% of the expected RT dose (20, 30 or 60 Gy) to the tumor. Normal tissue on the ipsilateral and contralateral sides of the brain were spared 84% and 99% of the expected dose, respectively. An increase in median survival time was demonstrated for all SOC regimens compared to untreated controls (average 5.2 days, p < 0.05), but treatment was not curative, suggesting the need for novel treatment options to increase therapeutic efficacy.
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14
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Bertho A, Dos Santos M, Buard V, Paget V, Guipaud O, Tarlet G, Milliat F, François A. Preclinical Model of Stereotactic Ablative Lung Irradiation Using Arc Delivery in the Mouse: Effect of Beam Size Changes and Dose Effect at Constant Collimation. Int J Radiat Oncol Biol Phys 2020; 107:548-562. [PMID: 32278852 DOI: 10.1016/j.ijrobp.2020.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Stereotactic body radiation therapy is a therapeutic option offered to high surgical risk patients with lung cancer. Focal lung irradiation in mice is a new preclinical model to help understand the development of lung damage in this context. Here we developed a mouse model of lung stereotactic therapy using arc delivery and monitored the development of lung damage while varying the beam size and dose delivered. METHODS AND MATERIALS C57BL/6JRj mice were exposed to 90 Gy focal irradiation on the left lung using 1-mm diameter, 3 × 3 mm2, 7 × 7 mm2, or 10 × 10 mm2 beam collimation for beam size effect and using 3 × 3 mm2 beam collimation delivering 20 to 120 Gy for dose effect. Long-term lung damage was monitored with micro-computed tomography imaging with anatomopathologic and gene expression measurements in the injured patch and the ipsilateral and contralateral lungs. RESULTS Both 1-mm diameter and 3 × 3 mm2 beam collimation allow long-term studies, but only 3-mm beam collimation generates lung fibrosis when delivering 90 Gy. Dose-effect studies with constant 3-mm beam collimation revealed a dose of 60 Gy as the minimum to obtain lung fibrosis 6 months postexposure. Lung fibrosis development was associated with club cell depletion and increased type II pneumocyte numbers. Lung injury developed with ipsilateral and contralateral consequences such as parenchymal thickening and gene expression modifications. CONCLUSIONS Arc therapy allows long-term studies and dose escalation without lethality. In our dose-delivery conditions, dose-effect studies revealed that 3 × 3 mm2 beam collimation to a minimum single dose of 60 Gy enables preclinical models for the assessment of lung injury within a 6-month period. This model of lung tissue fibrosis in a time length compatible with mouse life span may offer good prospects for future mechanistic studies.
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Affiliation(s)
- Annaïg Bertho
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Morgane Dos Santos
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Accidentelles, Fontenay-aux-Roses, France
| | - Valérie Buard
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Vincent Paget
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Olivier Guipaud
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Georges Tarlet
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Fabien Milliat
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Agnès François
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France.
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15
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Radiosafe micro-computed tomography for longitudinal evaluation of murine disease models. Sci Rep 2019; 9:17598. [PMID: 31772203 PMCID: PMC6879529 DOI: 10.1038/s41598-019-53876-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/04/2019] [Indexed: 02/08/2023] Open
Abstract
Implementation of in vivo high-resolution micro-computed tomography (µCT), a powerful tool for longitudinal analysis of murine lung disease models, is hampered by the lack of data on cumulative low-dose radiation effects on the investigated disease models. We aimed to measure radiation doses and effects of repeated µCT scans, to establish cumulative radiation levels and scan protocols without relevant toxicity. Lung metastasis, inflammation and fibrosis models and healthy mice were weekly scanned over one-month with µCT using high-resolution respiratory-gated 4D and expiration-weighted 3D protocols, comparing 5-times weekly scanned animals with controls. Radiation dose was measured by ionization chamber, optical fiberradioluminescence probe and thermoluminescent detectors in a mouse phantom. Dose effects were evaluated by in vivo µCT and bioluminescence imaging read-outs, gold standard endpoint evaluation and blood cell counts. Weekly exposure to 4D µCT, dose of 540-699 mGy/scan, did not alter lung metastatic load nor affected healthy mice. We found a disease-independent decrease in circulating blood platelets and lymphocytes after repeated 4D µCT. This effect was eliminated by optimizing a 3D protocol, reducing dose to 180-233 mGy/scan while maintaining equally high-quality images. We established µCT safety limits and protocols for weekly repeated whole-body acquisitions with proven safety for the overall health status, lung, disease process and host responses under investigation, including the radiosensitive blood cell compartment.
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16
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Giuranno L, Ient J, De Ruysscher D, Vooijs MA. Radiation-Induced Lung Injury (RILI). Front Oncol 2019; 9:877. [PMID: 31555602 PMCID: PMC6743286 DOI: 10.3389/fonc.2019.00877] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Abstract
Radiation pneumonitis (RP) and radiation fibrosis (RF) are two dose-limiting toxicities of radiotherapy (RT), especially for lung, and esophageal cancer. It occurs in 5-20% of patients and limits the maximum dose that can be delivered, reducing tumor control probability (TCP) and may lead to dyspnea, lung fibrosis, and impaired quality of life. Both physical and biological factors determine the normal tissue complication probability (NTCP) by Radiotherapy. A better understanding of the pathophysiological sequence of radiation-induced lung injury (RILI) and the intrinsic, environmental and treatment-related factors may aid in the prevention, and better management of radiation-induced lung damage. In this review, we summarize our current understanding of the pathological and molecular consequences of lung exposure to ionizing radiation, and pharmaceutical interventions that may be beneficial in the prevention or curtailment of RILI, and therefore enable a more durable therapeutic tumor response.
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Affiliation(s)
- Lorena Giuranno
- Department of Radiotherapy, GROW School for Oncology Maastricht University Medical Centre, Maastricht, Netherlands
| | - Jonathan Ient
- Department of Radiotherapy, GROW School for Oncology Maastricht University Medical Centre, Maastricht, Netherlands
| | - Dirk De Ruysscher
- Department of Radiotherapy, GROW School for Oncology Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marc A Vooijs
- Department of Radiotherapy, GROW School for Oncology Maastricht University Medical Centre, Maastricht, Netherlands
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17
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Micro cone beam computed tomography for sensitive assessment of radiation-induced late lung toxicity in preclinical models. Radiother Oncol 2019; 138:17-24. [DOI: 10.1016/j.radonc.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 11/20/2022]
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18
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Spiegelberg L, van Hoof SJ, Biemans R, Lieuwes NG, Marcus D, Niemans R, Theys J, Yaromina A, Lambin P, Verhaegen F, Dubois LJ. Evofosfamide sensitizes esophageal carcinomas to radiation without increasing normal tissue toxicity. Radiother Oncol 2019; 141:247-255. [PMID: 31431383 PMCID: PMC6913516 DOI: 10.1016/j.radonc.2019.06.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Esophageal cancer incidence is increasing and is rarely curable. Hypoxic tumor areas cause resistance to conventional therapies, making them susceptible for treatment with hypoxia-activated prodrugs (HAPs). We investigated in vivo whether the HAP evofosfamide (TH-302) could increase the therapeutic ratio by sensitizing esophageal carcinomas to radiotherapy without increasing normal tissue toxicity. MATERIALS AND METHODS To assess therapeutic efficacy, growth of xenografted esophageal squamous cell (OE21) or adeno (OE19) carcinomas was monitored after treatment with TH-302 (50 mg/kg, QD5) and irradiation (sham or 10 Gy). Short- and long-term toxicity was assessed in a gut mucosa and lung fibrosis irradiation model, sensitive to acute and late radiation injury respectively. Mice were injected with TH-302 (50 mg/kg, QD5) and the abdominal area (sham, 8 or 10 Gy) or the upper part of the right lung (sham, 20 Gy) was irradiated. Damage to normal tissues was assessed 84 hours later by histology and blood plasma citrulline levels (gut) and for up to 1 year by non-invasive micro CT imaging (lung). RESULTS The combination treatment of TH-302 with radiotherapy resulted in significant tumor growth delay in OE19 (P = 0.02) and OE21 (P = 0.03) carcinomas, compared to radiotherapy only. Irradiation resulted in a dose-dependent decrease of crypt survival (P < 0.001), mucosal surface area (P < 0.01) and citrulline levels (P < 0.001) in both tumor and non-tumor bearing animals. On the long-term, irradiation increased CT density in the lung, indicating fibrosis, over time. TH-302 did not influence the radiation-induced short-term and long-term toxicity, confirmed by histological evaluation. CONCLUSION The combination of TH-302 and radiotherapy might be a promising approach to improve the therapeutic index for esophageal cancer patients.
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Affiliation(s)
- Linda Spiegelberg
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Stefan J van Hoof
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Rianne Biemans
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Natasja G Lieuwes
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Damiënne Marcus
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Raymon Niemans
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Jan Theys
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Ala Yaromina
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Philippe Lambin
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands
| | - Frank Verhaegen
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Ludwig J Dubois
- Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, the Netherlands.
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Ghita M, Dunne VL, McMahon SJ, Osman SO, Small DM, Weldon S, Taggart CC, McGarry CK, Hounsell AR, Graves EE, Prise KM, Hanna GG, Butterworth KT. Preclinical Evaluation of Dose-Volume Effects and Lung Toxicity Occurring In and Out-of-Field. Int J Radiat Oncol Biol Phys 2019; 103:1231-1240. [PMID: 30552964 DOI: 10.1016/j.ijrobp.2018.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study was to define the dose and dose-volume relationship of radiation-induced pulmonary toxicities occurring in and out-of-field in mouse models of early inflammatory and late fibrotic response. MATERIALS AND METHODS Early radiation-induced inflammation and fibrosis were investigated in C3H/NeJ and C57BL/6J mice, respectively. Animals were irradiated with 20 Gy delivered to the upper region of the right lung as a single fraction or as 3 consecutive fractions using the Small Animal Radiation Research Platform (Xstrahl Inc, Camberley, UK). Cone beam computed tomography was performed for image guidance before irradiation and to monitor late toxicity. Histologic sections were examined for neutrophil and macrophage infiltration as markers of early inflammatory response and type I collagen staining as a marker of late-occurring fibrosis. Correlation was evaluated with the dose-volume histogram parameters calculated for individual mice and changes in the observed cone beam computed tomography values. RESULTS Mean lung dose and the volume receiving over 10 Gy (V10) showed significant correlation with late responses for single and fractionated exposures in directly targeted volumes. Responses observed outside the target volume were attributed to nontargeted effects and showed no dependence on either mean lung dose or V10. CONCLUSIONS Quantitative assessment of normal tissue response closely correlates early and late pulmonary response with clinical parameters, demonstrating this approach as a potential tool to facilitate clinical translation of preclinical studies. Out-of-field effects were observed but did not correlate with dosimetric parameters, suggesting that nontargeted effects may have a role in driving toxicities outside the treatment field.
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Affiliation(s)
- Mihaela Ghita
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom.
| | - Victoria L Dunne
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Stephen J McMahon
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Sarah O Osman
- Northern Ireland Cancer Centre, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Donna M Small
- Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Sinead Weldon
- Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Clifford C Taggart
- Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Conor K McGarry
- Northern Ireland Cancer Centre, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Alan R Hounsell
- Northern Ireland Cancer Centre, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Edward E Graves
- Department of Radiation Oncology, Stanford Cancer Center, Stanford University, Stanford, California
| | - Kevin M Prise
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Gerard G Hanna
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom; Northern Ireland Cancer Centre, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Northern Ireland, United Kingdom
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20
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Evolution of the Supermodel: Progress in Modelling Radiotherapy Response in Mice. Clin Oncol (R Coll Radiol) 2019; 31:272-282. [PMID: 30871751 DOI: 10.1016/j.clon.2019.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022]
Abstract
Mouse models are essential tools in cancer research that have been used to understand the genetic basis of tumorigenesis, cancer progression and to test the efficacies of anticancer treatments including radiotherapy. They have played a critical role in our understanding of radiotherapy response in tumours and normal tissues and continue to evolve to better recapitulate the underlying biology of humans. In addition, recent developments in small animal irradiators have significantly improved in vivo irradiation techniques, allowing previously unimaginable experimental approaches to be explored in the laboratory. The combination of contemporary mouse models with small animal irradiators represents a major step forward for the radiobiology field in being able to much more accurately replicate clinical exposure scenarios. As radiobiology studies become ever more sophisticated in reflecting developments in the clinic, it is increasingly important to understand the basis and potential limitations of extrapolating data from mice to humans. This review provides an overview of mouse models and small animal radiotherapy platforms currently being used as advanced radiobiological research tools towards improving the translational power of preclinical studies.
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21
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Farese AM, Bennett AW, Gibbs AM, Hankey KG, Prado K, Jackson W, MacVittie TJ. Efficacy of Neulasta or Neupogen on H-ARS and GI-ARS Mortality and Hematopoietic Recovery in Nonhuman Primates After 10-Gy Irradiation With 2.5% Bone Marrow Sparing. HEALTH PHYSICS 2019; 116:339-353. [PMID: 30281533 PMCID: PMC6349470 DOI: 10.1097/hp.0000000000000878] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
A nonhuman primate model of acute, partial-body, high-dose irradiation with minimal (2.5%) bone marrow sparing was used to assess endogenous gastrointestinal and hematopoietic recovery and the ability of Neulasta (pegylated granulocyte colony-stimulating factor) or Neupogen (granulocyte colony-stimulating factor) to enhance recovery from myelosuppression when administered at an increased interval between exposure and initiation of treatment. A secondary objective was to assess the effect of Neulasta or Neupogen on mortality and morbidity due to the hematopoietic acute radiation syndrome and concomitant gastrointestinal acute radiation syndrome. Nonhuman primates were exposed to 10.0 Gy, 6 MV, linear accelerator-derived photons delivered at 0.80 Gy min. All nonhuman primates received subject-based medical management. Nonhuman primates were dosed daily with control article (5% dextrose in water), initiated on day 1 postexposure; Neulasta (300 μg kg), administered on days 1, 8, and 15 or days 3, 10, and 17 postexposure; or Neupogen (10 μg kg), administered daily postexposure following its initiation on day 1 or day 3 until neutrophil recovery (absolute neutrophil count ≥1,000 cells μL for 3 consecutive days). Mortality in the irradiated cohorts suggested that administration of Neulasta or Neupogen on either schedule did not affect mortality due to gastrointestinal acute radiation syndrome or mitigate mortality due to hematopoietic acute radiation syndrome (plus gastrointestinal damage). Following 10.0 Gy partial-body irradiation with 2.5% bone marrow sparing, the mean duration of neutropenia (absolute neutrophil count <500 cells μL) was 22.4 d in the control cohort vs. 13.0 and 15.3 d in the Neulasta day 1, 8, 15 and day 3, 10, 17 cohorts, relative to 16.2 and 17.4 d in the Neupogen cohorts initiated on day 1 and day 3, respectively. The absolute neutrophil count nadirs were 48 cells μL in the controls; 117 cells μL and 40 cells μL in the Neulasta days 1, 8, and 15 or days 3, 10, and 17 cohorts, respectively; and 75 cells μL and 37 cells μL in the Neupogen day 1 and day 3 cohorts, respectively. Therefore, the earlier administration of Neulasta or Neupogen was more effective in this model of marginal 2.5% bone marrow sparing. The approximate 2.5% bone marrow sparing may approach the threshold for efficacy of the lineage-specific medical countermeasure. The partial-body irradiation with 2.5% bone marrow sparing model can be used to assess medical countermeasure efficacy in the context of the concomitant gastrointestinal and hematopoietic acute radiation syndrome sequelae.
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Affiliation(s)
- Ann M. Farese
- University of Maryland School of Medicine, Baltimore, MD
| | | | | | - Kim G. Hankey
- University of Maryland School of Medicine, Baltimore, MD
| | - Karl Prado
- University of Maryland Medical System, Department of Radiation Oncology, Baltimore, MD
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22
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Ghita M, Dunne V, Hanna GG, Prise KM, Williams JP, Butterworth KT. Preclinical models of radiation-induced lung damage: challenges and opportunities for small animal radiotherapy. Br J Radiol 2019; 92:20180473. [PMID: 30653332 DOI: 10.1259/bjr.20180473] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Despite a major paradigm shift in radiotherapy planning and delivery over the past three decades with continuing refinements, radiation-induced lung damage (RILD) remains a major dose limiting toxicity in patients receiving thoracic irradiations. Our current understanding of the biological processes involved in RILD which includes DNA damage, inflammation, senescence and fibrosis, is based on clinical observations and experimental studies in mouse models using conventional radiation exposures. Whilst these studies have provided vital information on the pulmonary radiation response, the current implementation of small animal irradiators is enabling refinements in the precision and accuracy of dose delivery to mice which can be applied to studies of RILD. This review presents the current landscape of preclinical studies in RILD using small animal irradiators and highlights the challenges and opportunities for the further development of this emerging technology in the study of normal tissue damage in the lung.
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Affiliation(s)
- Mihaela Ghita
- 1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Northern Ireland, UK
| | - Victoria Dunne
- 1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Northern Ireland, UK
| | - Gerard G Hanna
- 1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Northern Ireland, UK.,2 Northern Ireland Cancer Centre, Belfast City Hospital , Belfast , Northern Ireland, UK
| | - Kevin M Prise
- 1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Northern Ireland, UK
| | - Jaqueline P Williams
- 3 University of Rochester Medical Centre, University of Rochester , Rochester , USA
| | - Karl T Butterworth
- 1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Northern Ireland, UK
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Integrating Small Animal Irradiators withFunctional Imaging for Advanced Preclinical Radiotherapy Research. Cancers (Basel) 2019; 11:cancers11020170. [PMID: 30717307 PMCID: PMC6406472 DOI: 10.3390/cancers11020170] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 12/16/2022] Open
Abstract
Translational research aims to provide direct support for advancing novel treatment approaches in oncology towards improving patient outcomes. Preclinical studies have a central role in this process and the ability to accurately model biological and physical aspects of the clinical scenario in radiation oncology is critical to translational success. The use of small animal irradiators with disease relevant mouse models and advanced in vivo imaging approaches offers unique possibilities to interrogate the radiotherapy response of tumors and normal tissues with high potential to translate to improvements in clinical outcomes. The present review highlights the current technology and applications of small animal irradiators, and explores how these can be combined with molecular and functional imaging in advanced preclinical radiotherapy research.
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24
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Lavigne J, Suissa A, Verger N, Dos Santos M, Benadjaoud M, Mille-Hamard L, Momken I, Soysouvanh F, Buard V, Guipaud O, Paget V, Tarlet G, Milliat F, François A. Lung Stereotactic Arc Therapy in Mice: Development of Radiation Pneumopathy and Influence of HIF-1α Endothelial Deletion. Int J Radiat Oncol Biol Phys 2019; 104:279-290. [PMID: 30703512 DOI: 10.1016/j.ijrobp.2019.01.081] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/10/2019] [Accepted: 01/21/2019] [Indexed: 01/24/2023]
Abstract
PURPOSE Stereotactic body radiation therapy offers good lung local tumor control by the administration of a high dose per fraction in small volumes. Stereotactic body radiation therapy preclinical modeling is now possible, and our aim was to develop a model of focal irradiation of the mouse lung and to investigate the impact of conditional hypoxia-inducible factor 1α (HIF-1α) deletion in the endothelium on radiation-induced tissue damage. METHODS AND MATERIALS The Small Animal Radiation Research Platform was used to create a mouse model of focal irradiation of the lung using arc therapy. HIF-1α conditional deletion was obtained by crossing mice expressing Cre recombinase under the endothelial promoter VE-cadherin (VECad-Cre+/+ mice) with HIF-1α floxed mice. RESULTS Lung stereotactic arc therapy allows thoracic wall sparing and long-term studies. However, isodose curves showed that neighboring organs received significant doses of radiation, as revealed by ipsilateral lung acute red hepatization and major gene expression level modifications. Conditional HIF-1α deletion reduced acute lung edema and tended to diminish neutrophil infiltrate, but it had no impact on long-term global tissue damage. CONCLUSIONS Arc therapy for focal high-dose irradiation of mouse lung is an efficient model for long-term studies. However, irradiation may have a strong impact on the structure and function of neighboring organs, which must be considered. HIF-1α conditional deletion has no beneficial impact on lung damage in this irradiation schedule.
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Affiliation(s)
- Jérémy Lavigne
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France; Sorbonne Université, Collège Doctoral, Paris, France
| | - Alexandra Suissa
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Nicolas Verger
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Morgane Dos Santos
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Accidentelles, Fontenay-aux-Roses, France
| | - Mohamedamine Benadjaoud
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Fontenay-aux-Roses, France
| | - Laurence Mille-Hamard
- Unité de Biologie Intégrative des Adaptations à l'Exercice, Université Évry-Val-d'Essonne, Université Paris-Saclay, Evry, France
| | - Iman Momken
- Unité de Biologie Intégrative des Adaptations à l'Exercice, Université Évry-Val-d'Essonne, Université Paris-Saclay, Evry, France
| | - Frédéric Soysouvanh
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France; Sorbonne Université, Collège Doctoral, Paris, France
| | - Valérie Buard
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Olivier Guipaud
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Vincent Paget
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Georges Tarlet
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Fabien Milliat
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France
| | - Agnès François
- Institut de Radioprotection et de Sûreté Nucléaire, Service de Recherche en Radiobiologie et en Médecine régénérative, Laboratoire de Radiobiologie des expositions Médicales, Fontenay-aux-Roses, France.
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25
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Persoon L, Hoof SV, van der Kruijssen F, Granton P, Sanchez Rivero A, Beunk H, Dubois L, Doosje JW, Verhaegen F. A novel data management platform to improve image-guided precision preclinical biological research. Br J Radiol 2018; 92:20180455. [PMID: 30260242 DOI: 10.1259/bjr.20180455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: Preclinical biological research is mandatory for developing new drugs to investigate the toxicity and efficacy of the drug. In this paper, the focus is on radiobiological research as an example of advanced preclinical biological research. In radiobiology, recent technological advances have produced novel research platforms which can precisely irradiate targets in animals and use advanced onboard image-guidance, mimicking the clinical radiotherapy environment. These platforms greatly facilitate complex research combining several agents simultaneously (in our example, radiation and non-radiation agents). Since these modern platform can produce a large amount of wide-ranging data, one of the main impediments in preclinical research platforms is a proper data management system for preclinical studies. METHODS: A preclinical data management system, inspired by current radiotherapy clinical data management systems was designed. The system was designed with InterSystems technology, i.e. a programmable Enterprise Service Bus solution. New DICOM animal imaging standards are used such as DICOM suppl. 187 for storing small animal acquisition context and the DICOM second generation course model. RESULTS: A small animal big data warehouse environment for research is designed to work with modern image-guided precision research platforms. Its modular design includes (1) a study workflow manager, (2) a data manager, and (3) a storage manager. The system provides interfaces to, e.g. preclinical treatment planning systems and data analysis plug-ins, and guides the user efficiently through the many steps involved in preclinical research. The system manages various data source locations, and arranges access to the data centrally. CONCLUSION: A novel preclinical data management system can be designed to improve preclinical workflow, facilitate data exchange between researchers, and support translation to clinical trials. ADVANCES IN KNOWLEDGE: A preclinical data management system such as the one proposed here would greatly benefit preparation, execution and analysis of biological experiments, and will eventually facilitate translation to clinical trials.
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Affiliation(s)
- Lucas Persoon
- 1 Healthcare department, ICT Group N.V , Eindhoven , Netherlands
| | | | | | | | | | - Harold Beunk
- 1 Healthcare department, ICT Group N.V , Eindhoven , Netherlands
| | - Ludwig Dubois
- 3 Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastricht , Netherlands
| | | | - Frank Verhaegen
- 2 Smart Scientific Solutions B.V , Maastricht , Netherlands.,3 Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastricht , Netherlands
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26
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Sievert W, Stangl S, Steiger K, Multhoff G. Improved Overall Survival of Mice by Reducing Lung Side Effects After High-Precision Heart Irradiation Using a Small Animal Radiation Research Platform. Int J Radiat Oncol Biol Phys 2018; 101:671-679. [DOI: 10.1016/j.ijrobp.2018.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/14/2017] [Accepted: 02/07/2018] [Indexed: 12/27/2022]
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Verhaegen F, Dubois L, Gianolini S, Hill MA, Karger CP, Lauber K, Prise KM, Sarrut D, Thorwarth D, Vanhove C, Vojnovic B, Weersink R, Wilkens JJ, Georg D. ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges. Radiother Oncol 2018; 126:471-478. [PMID: 29269093 DOI: 10.1016/j.radonc.2017.11.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Abstract
Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations. This report discusses the combination of precision irradiation systems, small animal imaging (CT, MRI, PET, SPECT, bioluminescence) systems, image registration, treatment planning, and data processing. It also provides guidelines for reporting on studies.
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Affiliation(s)
- Frank Verhaegen
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | - Ludwig Dubois
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | | | - Mark A Hill
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, UK
| | - Christian P Karger
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg, Germany; National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Kirsten Lauber
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University of Munich, Germany
| | - Kevin M Prise
- Centre for Cancer Research & Cell Biology, Queen's University Belfast, UK
| | - David Sarrut
- Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, France
| | - Daniela Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - Christian Vanhove
- Institute Biomedical Technology (IBiTech), Medical Imaging and Signal Processing (MEDISIP), Ghent University, Belgium
| | - Boris Vojnovic
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, UK
| | - Robert Weersink
- Department of Radiation Oncology, University of Toronto, Department of Radiation Medicine, Princess Margaret Hospital, Canada
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich, Klinikum rechts der Isar, Germany
| | - Dietmar Georg
- Division of Medical Radiation Physics, Department of Radiation Oncology and Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
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Tang C, Hobbs B, Amer A, Li X, Behrens C, Canales JR, Cuentas EP, Villalobos P, Fried D, Chang JY, Hong DS, Welsh JW, Sepesi B, Court L, Wistuba II, Koay EJ. Development of an Immune-Pathology Informed Radiomics Model for Non-Small Cell Lung Cancer. Sci Rep 2018; 8:1922. [PMID: 29386574 PMCID: PMC5792427 DOI: 10.1038/s41598-018-20471-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/09/2018] [Indexed: 12/17/2022] Open
Abstract
With increasing use of immunotherapy agents, pretreatment strategies for identifying responders and non-responders is useful for appropriate treatment assignment. We hypothesize that the local immune micro-environment of NSCLC is associated with patient outcomes and that these local immune features exhibit distinct radiologic characteristics discernible by quantitative imaging metrics. We assembled two cohorts of NSCLC patients treated with definitive surgical resection and extracted quantitative parameters from pretreatment CT imaging. The excised primary tumors were then quantified for percent tumor PDL1 expression and density of tumor-infiltrating lymphocyte (via CD3 count) utilizing immunohistochemistry and automated cell counting. Associating these pretreatment radiomics parameters with tumor immune parameters, we developed an immune pathology-informed model (IPIM) that separated patients into 4 clusters (designated A-D) utilizing 4 radiomics features. The IPIM designation was significantly associated with overall survival in both training (5 year OS: 61%, 41%, 50%, and 91%, for clusters A-D, respectively, P = 0.04) and validation (5 year OS: 55%, 72%, 75%, and 86%, for clusters A-D, respectively, P = 0.002) cohorts and immune pathology (all P < 0.05). Specifically, we identified a favorable outcome group characterized by low CT intensity and high heterogeneity that exhibited low PDL1 and high CD3 infiltration, suggestive of a favorable immune activated state. We have developed a NSCLC radiomics signature based on the immune micro-environment and patient outcomes. This manuscript demonstrates model creation and validation in independent cohorts.
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Affiliation(s)
- Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Brian Hobbs
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ahmed Amer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiao Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carmen Behrens
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jaime Rodriguez Canales
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Edwin Parra Cuentas
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pamela Villalobos
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Fried
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joe Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James W Welsh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Boris Sepesi
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laurence Court
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eugene J Koay
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Vaniqui A, Schyns LEJR, Almeida IP, van der Heyden B, van Hoof SJ, Verhaegen F. The impact of dual energy CT imaging on dose calculations for pre-clinical studies. Radiat Oncol 2017; 12:181. [PMID: 29157265 PMCID: PMC5696722 DOI: 10.1186/s13014-017-0922-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the feasibility of using dual-energy CT (DECT) for tissue segmentation and kilovolt (kV) dose calculations in pre-clinical studies and assess potential dose calculation accuracy gain. METHODS Two phantoms and an ex-vivo mouse were scanned in a small animal irradiator with two distinct energies. Tissue segmentation was performed with the single-energy CT (SECT) and DECT methods. A number of different material maps was used. Dose calculations were performed to verify the impact of segmentations on the dose accuracy. RESULTS DECT showed better overall results in comparison to SECT. Higher number of DECT segmentation media resulted in smaller dose differences in comparison to the reference. Increasing the number of materials in the SECT method yielded more instability. Both modalities showed a limit to which adding more materials with similar characteristics ceased providing better segmentation results, and resulted in more noise in the material maps and the dose distributions. The effect was aggravated with a decrease in beam energy. For the ex-vivo specimen, the choice of only one high dense bone for the SECT method resulted in large volumes of tissue receiving high doses. For the DECT method, the choice of more than one kind of bone resulted in lower dose values for the different tissues occupying the same volume. For the organs at risk surrounded by bone, the doses were lower when using the SECT method in comparison to DECT, due to the high absorption of the bone. SECT material segmentation may lead to an underestimation of the dose to OAR in the proximity of bone. CONCLUSIONS The DECT method enabled the selection of a higher number of materials thereby increasing the accuracy in dose calculations. In phantom studies, SECT performed best with three materials and DECT with seven for the phantom case. For irradiations in preclinical studies with kV photon energies, the use of DECT segmentation combined with the choice of a low-density bone is recommended.
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Affiliation(s)
- Ana Vaniqui
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Lotte E J R Schyns
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Isabel P Almeida
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Brent van der Heyden
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Stefan J van Hoof
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Frank Verhaegen
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.
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Dunne V, Ghita M, Small DM, Coffey CBM, Weldon S, Taggart CC, Osman SO, McGarry CK, Prise KM, Hanna GG, Butterworth KT. Inhibition of ataxia telangiectasia related-3 (ATR) improves therapeutic index in preclinical models of non-small cell lung cancer (NSCLC) radiotherapy. Radiother Oncol 2017; 124:475-481. [PMID: 28697853 DOI: 10.1016/j.radonc.2017.06.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/13/2017] [Accepted: 06/22/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE To evaluate the impact of ATR inhibition using AZD6738 in combination with radiotherapy on the response of non-small cell lung cancer (NSCLC) tumour models and a murine model of radiation induced fibrosis. MATERIALS AND METHODS AZD6738 was evaluated as a monotherapy and in combination with radiation in vitro and in vivo using A549 and H460 NSCLC models. Radiation induced pulmonary fibrosis was evaluated by cone beam computed tomography (CBCT) and histological staining. RESULTS AZD6738 specifically inhibits ATR kinase and enhanced radiobiological response in NSCLC models but not in human bronchial epithelial cells (HBECs) in vitro. Significant tumour growth delay was observed in cell line derived xenografts (CDXs) of H460 cells (p<0.05) which were less significant in A549 cells. Combination of AZD6738 with radiotherapy showed no significant change in lung tissue density by CBCT (p>0.5) and histological scoring of radiation induced fibrosis (p>0.5). CONCLUSION Inhibition of ATR with AZD6738 in combination with radiotherapy increases tumour growth delay without observable augmentation of late radiation induced toxicity further underpinning translation towards clinical evaluation in NSCLC.
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Affiliation(s)
- Victoria Dunne
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - Mihaela Ghita
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - Donna M Small
- Centre for Experimental Medicine, Queen's University Belfast, UK
| | | | - Sinead Weldon
- Centre for Experimental Medicine, Queen's University Belfast, UK
| | | | - Sarah O Osman
- Northern Ireland Cancer Centre, Queen's University Belfast, UK
| | - Conor K McGarry
- Northern Ireland Cancer Centre, Queen's University Belfast, UK
| | - Kevin M Prise
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK
| | - Gerard G Hanna
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK; Northern Ireland Cancer Centre, Queen's University Belfast, UK
| | - Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK.
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Perez JR, Lee S, Ybarra N, Maria O, Serban M, Jeyaseelan K, Wang LM, Seuntjens J, Naqa IE. A comparative analysis of longitudinal computed tomography and histopathology for evaluating the potential of mesenchymal stem cells in mitigating radiation-induced pulmonary fibrosis. Sci Rep 2017; 7:9056. [PMID: 28831189 PMCID: PMC5567327 DOI: 10.1038/s41598-017-09021-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/19/2017] [Indexed: 12/19/2022] Open
Abstract
Radiation-induced pulmonary fibrosis (RIPF) is a debilitating side effect that occurs in up to 30% of thoracic irradiations in breast and lung cancer patients. RIPF remains a major limiting factor to dose escalation and an obstacle to applying more promising new treatments for cancer cure. Limited treatment options are available to mitigate RIPF once it occurs, but recently, mesenchymal stem cells (MSCs) and a drug treatment stimulating endogenous stem cells (GM-CSF) have been investigated for their potential in preventing this disease onset. In a pre-clinical rat model, we contrasted the application of longitudinal computed tomography (CT) imaging and classical histopathology to quantify RIPF and to evaluate the potential of MSCs in mitigating RIPF. Our results on histology demonstrate promises when MSCs are injected endotracheally (but not intravenously). While our CT analysis highlights the potential of GM-CSF treatment. Advantages and limitations of both analytical methods are contrasted in the context of RIPF.
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Affiliation(s)
- Jessica R Perez
- McGill University, Biomedical Engineering, Montreal, H4A 3J1, Canada. .,McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada.
| | - Sangkyu Lee
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | - Norma Ybarra
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | - Ola Maria
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | - Monica Serban
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | | | - Li Ming Wang
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | - Jan Seuntjens
- McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada
| | - Issam El Naqa
- McGill University, Biomedical Engineering, Montreal, H4A 3J1, Canada.,McGill University Health Centre, Medical Physics Unit, Montreal, H4A 3J1, Canada.,University of Michigan, Radiation Oncology, Ann Arbor, MI, 48103-4943, USA
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De Ruysscher D, Granton PV, Lieuwes NG, van Hoof S, Wollin L, Weynand B, Dingemans AM, Verhaegen F, Dubois L. Nintedanib reduces radiation-induced microscopic lung fibrosis but this cannot be monitored by CT imaging: A preclinical study with a high precision image-guided irradiator. Radiother Oncol 2017; 124:482-487. [PMID: 28774597 DOI: 10.1016/j.radonc.2017.07.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/14/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nintedanib has anti-fibrotic and anti-inflammatory activity and is approved for the treatment of idiopathic pulmonary fibrosis. The aim of this study was to noninvasively assess the efficacy of nintedanib in a mouse model of partial lung irradiation to prevent radiation-induced lung damage (RILD). METHODS 266 C57BL/6 adult male mice were irradiated with a single radiation dose (0, 4, 8, 12, 16 or 20Gy) using parallel-opposed fields targeting the upper right lung using a precision image-guided small animal irradiator sparing heart and spine based on micro-CT images. One week post irradiation, mice were randomized across nintedanib daily oral gavage treatment (0, 30 or 60mg/kg). CT density analysis of the lungs was performed on monthly acquired micro-CT images. After 39weeks, lungs were processed to evaluate the fibrotic phenotype. RESULTS Although the CT density increase correlated with the radiation dose, nintedanib did not influence this relationship. Immunohistochemical analysis confirmed the ability of nintedanib to reduce the microscopic fibrotic phenotype, in particular interstitial edema, interstitial and perivascular fibrosis and inflammation, and vasculitis. CONCLUSIONS Nintedanib reduces radiation-induced lung fibrosis after partial lung irradiation without adverse effects, however, noninvasive CT imaging measuring electron density cannot be applied for monitoring its effects.
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Affiliation(s)
- Dirk De Ruysscher
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands; Department of Radiation Oncology, KU Leuven, Belgium
| | - Patrick Vincent Granton
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Natasja Gaby Lieuwes
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Stefan van Hoof
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Lutz Wollin
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | | | - Anne-Marie Dingemans
- Department of Pulmonology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Frank Verhaegen
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Ludwig Dubois
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands.
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Longitudinal microcomputed tomography-derived biomarkers for lung metastasis detection in a syngeneic mouse model: added value to bioluminescence imaging. J Transl Med 2017; 97:24-33. [PMID: 27869796 DOI: 10.1038/labinvest.2016.114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 09/30/2016] [Accepted: 09/30/2016] [Indexed: 01/22/2023] Open
Abstract
With more patients dying from metastasis than from primary cancers, metastasis is a very important area in cancer research. Investigators thereby heavily rely on animal models of metastasis to common organs such as the lung to improve our insight into the pathogenesis and to research novel therapeutic approaches to combat metastasis. In this experimental context, novel tools that allow longitudinal monitoring of lung metastasis in individual animals are highly needed. We have therefore evaluated for the first time microcomputed tomography (μCT) as a very efficient and crossvalidated means to noninvasively and repeatedly monitor metastasis to the lung in individual, free-breathing syngeneic mice. Two individual clones of KLN205 cancer cells were intravenously injected in syngeneic DBA/2 mice and lung metastasis was monitored weekly during 3 weeks using μCT, and was compared with the current gold standard histology and bioluminescence imaging (BLI). μCT enabled us to visualize diffuse tumor morphology and also to extract four different biomarkers that quantify not only tumor load but also aerated space in the lung as a marker of vital lung capacity and potential compensatory mechanisms. Complementary to BLI, applying this novel μCT-based approach enabled us to unravel sensitively and efficiently differences in metastatic potential between two cellular clones. In conclusion, μCT and BLI offer biomarkers that describe different and complementary aspects of lung metastasis, underlining the importance of multimodality follow-up. The added value of μCT findings is important to better assess lung metastasis and host/lung response in preclinical studies, which will be valuable for translational applications.
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Ford E, Emery R, Huff D, Narayanan M, Schwartz J, Cao N, Meyer J, Rengan R, Zeng J, Sandison G, Laramore G, Mayr N. An image-guided precision proton radiation platform for preclinicalin vivoresearch. Phys Med Biol 2016; 62:43-58. [DOI: 10.1088/1361-6560/62/1/43] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Ford E, Deye J. Current Instrumentation and Technologies in Modern Radiobiology Research—Opportunities and Challenges. Semin Radiat Oncol 2016; 26:349-55. [DOI: 10.1016/j.semradonc.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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A survey of changing trends in modelling radiation lung injury in mice: bringing out the good, the bad, and the uncertain. J Transl Med 2016; 96:936-49. [PMID: 27479087 DOI: 10.1038/labinvest.2016.76] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 05/10/2016] [Accepted: 06/04/2016] [Indexed: 12/22/2022] Open
Abstract
Within this millennium there has been resurgence in funding and research dealing with animal models of radiation-induced lung injury to identify and establish predictive biomarkers and effective mitigating agents that are applicable to humans. Most have been performed on mice but there needs to be assurance that the emphasis on such models is not misplaced. We therefore considered it timely to perform a comprehensive appraisal of the literature dealing with radiation lung injury of mice and to critically evaluate the validity and clinical relevance of the research. A total of 357 research papers covering the period of 1970-2015 were extensively reviewed. Whole thorax irradiation (WTI) has become the most common treatment for studying lung injury in mice and distinct trends were seen with regard to the murine strain, radiation dose, intended pathology investigated, length of study, and assays. Recently, the C57BL/6 strain has been increasingly used in the majority of these studies with the notion that they are susceptible to pulmonary fibrosis. Nonetheless, many of these investigations depend on animal survival as the primary end point and neglect the importance of radiation pneumonitis and the anomaly of lethal pleural effusions. A relatively large variation in survival times of C5BL/6 mice is also seen among different institutions pointing to the need for standardization of radiation treatments and environmental conditions. An analysis of mitigating drug treatments is complicated by the fact that the majority of studies are limited to the C57BL/6 strain with a premature termination of the experiments and do not establish whether the treatment actually prevents or simply delays the progression of radiation injury. This survey of the literature has pointed to several improvements that need to be considered in establishing a reliable preclinical murine model of radiation lung injury. The lethality end point should also be used cautiously and with greater emphasis on other assays such as non-invasive lung functional and imaging monitoring in order to quantify specific pulmonary injury that can be better extrapolated to radiation toxicity encountered in our own species.
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37
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[Small animal image-guided radiotherapy: A new era for preclinical studies]. Cancer Radiother 2016; 20:43-53. [PMID: 26856635 DOI: 10.1016/j.canrad.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 12/11/2022]
Abstract
Preclinical external beam radiotherapy irradiations used to be delivered with a static broad beam. To promote the transfer from animal to man, the preclinical treatment techniques dedicated to the animal have been optimized to be similar to those delivered to patients in clinical practice. In this context, preclinical irradiators have been developed. Due to the small sizes of the animals, and the irradiation beams, the scaling to the small animal dimensions involves specific problems. Reducing the size and energy of the irradiation beams require very high technical performance, especially for the mechanical stability of the irradiator and the spatial resolution of the imaging system. In addition, the determination of the reference absorbed dose rate must be conducted with a specific methodology and suitable detectors. To date, three systems are used for preclinical studies in France. The aim of this article is to present these new irradiators dedicated to small animals from a physicist point of view, including the commissioning and the quality control.
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38
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Gan GN, Altunbas C, Morton JJ, Eagles J, Backus J, Dzingle W, Raben D, Jimeno A. Radiation dose uncertainty and correction for a mouse orthotopic and xenograft irradiation model. Int J Radiat Biol 2015; 92:50-6. [PMID: 26689828 DOI: 10.3109/09553002.2016.1114189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE In animal irradiation models, reported dose can vary significantly from the actual doses delivered. We describe an effective method for in vivo dose verification. MATERIALS AND METHODS Mice bearing commercially-available cell line or patient-derived tumor cell orthotopic or flank xenografts were irradiated using a 160 kVp, 25 mA X-ray source. Entrance dose was evaluated using optically-stimulated luminescence dosimeters (OSLD) and exit dose was assessed using radiochromic film dosimetry. RESULTS Tumor position within the irradiation field was validated using external fiducial markers. The average entrance dose in orthotopic tumors from 10 OSLDs placed on two different animal irradiation days was 514 ± 37 cGy (range: 437-545). Exit dose measurements taken from seven radiochromic films on two separate days were 341 ± 21 cGy (a 34% attenuation). Flank tumor irradiation doses measured by OSLD were 368 ± 9 cGy compared to exit doses of 330 cGy measured by radiochromic film. CONCLUSION Variations related to the irradiation model can lead to significant under or overdosing in vivo which can affect tumor control and/or biologic endpoints that are dose-dependent. We recommend that dose measurements be determined empirically based on the mouse model and irradiator used and dose compensation adjustments performed to ensure correct and appropriate doses.
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Affiliation(s)
- Gregory N Gan
- a Division of Radiation Oncology, Internal Medicine , University of New Mexico School of Medicine , Albuquerque , NM , USA ;,b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA
| | - Cem Altunbas
- b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA
| | - John J Morton
- c Division of Medical Oncology, Department of Medicine , University of Colorado School of Medicine , Aurora , CO , USA
| | - Justin Eagles
- c Division of Medical Oncology, Department of Medicine , University of Colorado School of Medicine , Aurora , CO , USA
| | - Jennifer Backus
- b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA
| | - Wayne Dzingle
- b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA
| | - David Raben
- b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA
| | - Antonio Jimeno
- c Division of Medical Oncology, Department of Medicine , University of Colorado School of Medicine , Aurora , CO , USA ;,d Charles C. Gates Center for Stem Cell Biology, University of Colorado School of Medicine , Aurora , CO , USA ;,e Department of Otolaryngology , University of Colorado School of Medicine , Aurora , CO , USA
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Ghobadi G, Wiegman EM, Langendijk JA, Widder J, Coppes RP, van Luijk P. A new CT-based method to quantify radiation-induced lung damage in patients. Radiother Oncol 2015; 117:4-8. [DOI: 10.1016/j.radonc.2015.07.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/16/2015] [Accepted: 07/16/2015] [Indexed: 12/25/2022]
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Zhu H, Yang X, Ding Y, Liu J, Lu J, Zhan L, Qin Q, Zhang H, Chen X, Yang Y, Yang Y, Liu Z, Yang M, Zhou X, Cheng H, Sun X. Recombinant human endostatin enhances the radioresponse in esophageal squamous cell carcinoma by normalizing tumor vasculature and reducing hypoxia. Sci Rep 2015; 5:14503. [PMID: 26412785 PMCID: PMC4585975 DOI: 10.1038/srep14503] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 08/26/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to investigate the effect of recombinant human endostatin (rh-Endo) in combination with radiation therapy (RT) on esophageal squamous cell carcinoma (ESCC) and explore the potential mechanisms. ECA109-bearing nude mice were administered RT and/or rh-Endo treatment. Tumor volume, survival, hypoxia and vascular parameters were recorded during the treatment schedule and follow-up as measures of treatment response. ESCC cell lines (ECA109 and TE13) and human umbilical vein endothelial cells (HUVECs) were developed to investigate the outcomes and toxicities of rh-Endo and RT in vitro. Hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were also evaluated. In vivo studies of ECA109-bearing xenografts showed that rh-Endo improved the radioresponse, with normalization of tumor vasculature and a reduction in hypoxia. In vitro studies showed that rh-Endo did not radiosensitize ESCC cell lines but did affect endothelial cells with a time- and dose-dependent manner. Studies of the molecular mechanism indicated that the improved radioresponse might be due to crosstalk between cancer cells and endothelial cells involving HIF and VEGF expression. Our data suggest that rh-Endo may be a potential anti-angiogenic agent in ESCC especially when combined with RT. The improved radioresponse arises from normalization of tumor vasculature and a reduction in hypoxia.
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Affiliation(s)
- Hongcheng Zhu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xi Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuqiong Ding
- Department of Radiation Oncology, Changzhou Cancer Hospital of Soochow University, Changzhou 213001, China
| | - Jia Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jing Lu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Liangliang Zhan
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qin Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiaochen Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuehua Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yan Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zheming Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Meiling Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xifa Zhou
- Department of Radiation Oncology, Changzhou Cancer Hospital of Soochow University, Changzhou 213001, China
| | - Hongyan Cheng
- Department of General Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xinchen Sun
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Balvert M, van Hoof SJ, Granton PV, Trani D, den Hertog D, Hoffmann AL, Verhaegen F. A framework for inverse planning of beam-on times for 3D small animal radiotherapy using interactive multi-objective optimisation. Phys Med Biol 2015; 60:5681-98. [DOI: 10.1088/0031-9155/60/14/5681] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Vande Velde G, De Langhe E, Poelmans J, Bruyndonckx P, d'Agostino E, Verbeken E, Bogaerts R, Lories R, Himmelreich U. Longitudinal in vivo microcomputed tomography of mouse lungs: No evidence for radiotoxicity. Am J Physiol Lung Cell Mol Physiol 2015; 309:L271-9. [PMID: 26024893 DOI: 10.1152/ajplung.00098.2015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/28/2015] [Indexed: 12/21/2022] Open
Abstract
Before microcomputed tomography (micro-CT) can be exploited to its full potential for longitudinal monitoring of transgenic and experimental mouse models of lung diseases, radiotoxic side effects such as inflammation or fibrosis must be considered. We evaluated dose and potential radiotoxicity to the lungs for long-term respiratory-gated high-resolution micro-CT protocols. Free-breathing C57Bl/6 mice underwent four different retrospectively respiratory gated micro-CT imaging schedules of repeated scans during 5 or 12 wk, followed by ex vivo micro-CT and detailed histological and biochemical assessment of lung damage. Radiation exposure, dose, and absorbed dose were determined by ionization chamber, thermoluminescent dosimeter measurements and Monte Carlo calculations. Despite the relatively large radiation dose delivered per micro-CT acquisition, mice did not show any signs of radiation-induced lung damage or fibrosis when scanned weekly during 5 and up to 12 wk. Doubling the scanning frequency and once tripling the radiation dose as to mimic the instant repetition of a failed scan also stayed without detectable toxicity after 5 wk of scanning. Histological analyses confirmed the absence of radiotoxic damage to the lungs, thereby demonstrating that long-term monitoring of mouse lungs using high-resolution micro-CT is safe. This opens perspectives for longitudinal monitoring of (transgenic) mouse models of lung diseases and therapeutic response on an individual basis with high spatial and temporal resolution, without concerns for radiation toxicity that could potentially influence the readout of micro-CT-derived lung biomarkers. This work further supports the introduction of micro-CT for routine use in the preclinical pulmonary research field where postmortem histological approaches are still the gold standard.
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Affiliation(s)
- Greetje Vande Velde
- Biomedical MRI Unit/MoSAIC, Department Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - Ellen De Langhe
- Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Division of Rheumatology, University Hospitals Leuven, Flanders, Belgium
| | - Jennifer Poelmans
- Biomedical MRI Unit/MoSAIC, Department Imaging & Pathology, KU Leuven, Leuven, Belgium
| | | | - Emiliano d'Agostino
- SB Dosimetry and Calibration, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre, SCK·CEN, Mol, Belgium
| | - Erik Verbeken
- Translational Cell and Tissue Research, Department Imaging and Pathology, KU Leuven, Leuven, Belgium; and
| | - Ria Bogaerts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Rik Lories
- Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Division of Rheumatology, University Hospitals Leuven, Flanders, Belgium;
| | - Uwe Himmelreich
- Biomedical MRI Unit/MoSAIC, Department Imaging & Pathology, KU Leuven, Leuven, Belgium
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