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Li H, Gong Q, Luo K. Biomarker-driven molecular imaging probes in radiotherapy. Theranostics 2024; 14:4127-4146. [PMID: 38994026 PMCID: PMC11234278 DOI: 10.7150/thno.97768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/23/2024] [Indexed: 07/13/2024] Open
Abstract
Background: Biomarker-driven molecular imaging has emerged as an integral part of cancer precision radiotherapy. The use of molecular imaging probes, including nanoprobes, have been explored in radiotherapy imaging to precisely and noninvasively monitor spatiotemporal distribution of biomarkers, potentially revealing tumor-killing mechanisms and therapy-induced adverse effects during radiation treatment. Methods: We summarized literature reports from preclinical studies and clinical trials, which cover two main parts: 1) Clinically-investigated and emerging imaging biomarkers associated with radiotherapy, and 2) instrumental roles, functions, and activatable mechanisms of molecular imaging probes in the radiotherapy workflow. In addition, reflection and future perspectives are proposed. Results: Numerous imaging biomarkers have been continuously explored in decades, while few of them have been successfully validated for their correlation with radiotherapeutic outcomes and/or radiation-induced toxicities. Meanwhile, activatable molecular imaging probes towards the emerging biomarkers have exhibited to be promising in animal or small-scale human studies for precision radiotherapy. Conclusion: Biomarker-driven molecular imaging probes are essential for precision radiotherapy. Despite very inspiring preliminary results, validation of imaging biomarkers and rational design strategies of probes await robust and extensive investigations. Especially, the correlation between imaging biomarkers and radiotherapeutic outcomes/toxicities should be established through multi-center collaboration involving a large cohort of patients.
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Affiliation(s)
- Haonan Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province and Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, 699 Jinyuan Xi Road, Jimei District, 361021 Xiamen, Fujian, China
| | - Kui Luo
- Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province and Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
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Bøgh N, Bertelsen LB, Rasmussen CW, Bech SK, Keller AK, Madsen MG, Harving F, Thorsen TH, Mieritz IK, Hansen ES, Wanders A, Laustsen C. Metabolic MRI With Hyperpolarized 13 C-Pyruvate for Early Detection of Fibrogenic Kidney Metabolism. Invest Radiol 2024:00004424-990000000-00225. [PMID: 38913443 DOI: 10.1097/rli.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVES Fibrosis is the final common pathway for chronic kidney disease and the best predictor for disease progression. Besides invasive biopsies, biomarkers for its detection are lacking. To address this, we used hyperpolarized 13 C-pyruvate MRI to detect the metabolic changes associated with fibrogenic activity of myofibroblasts. MATERIALS AND METHODS Hyperpolarized 13 C-pyruvate MRI was performed in 2 pig models of kidney fibrosis (unilateral ureteral obstruction and ischemia-reperfusion injury). The imaging data were correlated with histology, biochemical, and genetic measures of metabolism and fibrosis. The porcine experiments were supplemented with cell-line experiments to inform the origins of metabolic changes in fibrogenesis. Lastly, healthy and fibrotic human kidneys were analyzed for the metabolic alterations accessible with hyperpolarized 13 C-pyruvate MRI. RESULTS In the 2 large animal models of kidney fibrosis, metabolic imaging revealed alterations in amino acid metabolism and glycolysis. Conversion from hyperpolarized 13 C-pyruvate to 13 C-alanine decreased, whereas conversion to 13 C-lactate increased. These changes were shown to reflect profibrotic activity in cultured epithelial cells, macrophages, and fibroblasts, which are important precursors of myofibroblasts. Importantly, metabolic MRI using hyperpolarized 13 C-pyruvate was able to detect these changes earlier than fibrosis-sensitive structural imaging. Lastly, we found that the same metabolic profile is present in fibrotic tissue from human kidneys. This affirms the translational potential of metabolic MRI as an early indicator of fibrogenesis associated metabolism. CONCLUSIONS Our findings demonstrate the promise of hyperpolarized 13 C-pyruvate MRI for noninvasive detection of fibrosis development, which could enable earlier diagnosis and intervention for patients at risk of kidney fibrosis.
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Affiliation(s)
- Nikolaj Bøgh
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (N.B., L.B.B., C.W.R., S.K.B., T.H.T., I.K.M., E.S.S.H., C.L.); Department of Urology, Aarhus University Hospital, Aarhus, Denmark (A.K.K., M.G.M.); and Department of Pathology, Aalborg University Hospital, Aalborg, Denmark (F.H., A.W.)
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Arponen O, Wodtke P, Gallagher FA, Woitek R. Hyperpolarised 13C-MRI using 13C-pyruvate in breast cancer: A review. Eur J Radiol 2023; 167:111058. [PMID: 37666071 DOI: 10.1016/j.ejrad.2023.111058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
Tumour metabolism can be imaged with a novel imaging technique termed hyperpolarised carbon-13 (13C)-MRI using probes, i.e., endogenously found molecules that are labeled with 13C. Hyperpolarisation of the 13C label increases the sensitivity to a level that allows dynamic imaging of the distribution and metabolism of the probes. Dynamic imaging of [1-13C]pyruvate metabolism is of particular biological interest in cancer because of the Warburg effect resulting in the intratumoural accumulation of [1-13C]pyruvate and conversion to [1-13C]lactate. Numerous preclinical studies in breast cancer and other tumours have shown that hyperpolarised 13C-pyruvate has potential for metabolic phenotyping and response assessment at earlier timepoints than the current clinical imaging techniques allow. The clinical feasibility of hyperpolarised 13C-MRI after the injection of pyruvate in patients with breast cancer has now been demonstrated, with increased 13C-label exchange between pyruvate and lactate present in higher grade tumours with associated increased expression of the monocarboxylate transporter 1 (MCT1), the transmembrane transporter mediating intracellular pyruvate uptake, and lactate dehydrogenase (LDH) as the enzyme catalysing the conversion of pyruvate to lactate. Furthermore, a study in patients with breast cancer undergoing neoadjuvant chemotherapy suggested that early changes in 13C-label exchange can distinguish between patients who reach pathologic complete response (pCR) and those who do not. This review summarises the current literature on preclinical and clinical research on hyperpolarised 13C-MRI with [1-13C]-pyruvate in breast cancer imaging.
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Affiliation(s)
- Otso Arponen
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom.
| | - Pascal Wodtke
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Center, Cambridge, United Kingdom
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Center, Cambridge, United Kingdom
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Center, Cambridge, United Kingdom; Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Danube Private University, Krems, Austria
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4
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Deen SS, Rooney C, Shinozaki A, McGing J, Grist JT, Tyler DJ, Serrão E, Gallagher FA. Hyperpolarized Carbon 13 MRI: Clinical Applications and Future Directions in Oncology. Radiol Imaging Cancer 2023; 5:e230005. [PMID: 37682052 PMCID: PMC10546364 DOI: 10.1148/rycan.230005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/16/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
Hyperpolarized carbon 13 MRI (13C MRI) is a novel imaging approach that can noninvasively probe tissue metabolism in both normal and pathologic tissues. The process of hyperpolarization increases the signal acquired by several orders of magnitude, allowing injected 13C-labeled molecules and their downstream metabolites to be imaged in vivo, thus providing real-time information on kinetics. To date, the most important reaction studied with hyperpolarized 13C MRI is exchange of the hyperpolarized 13C signal from injected [1-13C]pyruvate with the resident tissue lactate pool. Recent preclinical and human studies have shown the role of several biologic factors such as the lactate dehydrogenase enzyme, pyruvate transporter expression, and tissue hypoxia in generating the MRI signal from this reaction. Potential clinical applications of hyperpolarized 13C MRI in oncology include using metabolism to stratify tumors by grade, selecting therapeutic pathways based on tumor metabolic profiles, and detecting early treatment response through the imaging of shifts in metabolism that precede tumor structural changes. This review summarizes the foundations of hyperpolarized 13C MRI, presents key findings from human cancer studies, and explores the future clinical directions of the technique in oncology. Keywords: Hyperpolarized Carbon 13 MRI, Molecular Imaging, Cancer, Tissue Metabolism © RSNA, 2023.
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Affiliation(s)
- Surrin S Deen
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Catriona Rooney
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Ayaka Shinozaki
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Jordan McGing
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - James T Grist
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Damian J Tyler
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Eva Serrão
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Ferdia A Gallagher
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
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5
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Chaumeil M, Guglielmetti C, Qiao K, Tiret B, Ozen M, Krukowski K, Nolan A, Paladini MS, Lopez C, Rosi S. Hyperpolarized 13C metabolic imaging detects long-lasting metabolic alterations following mild repetitive traumatic brain injury. RESEARCH SQUARE 2023:rs.3.rs-3166656. [PMID: 37645937 PMCID: PMC10462249 DOI: 10.21203/rs.3.rs-3166656/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Career athletes, active military, and head trauma victims are at increased risk for mild repetitive traumatic brain injury (rTBI), a condition that contributes to the development of epilepsy and neurodegenerative diseases. Standard clinical imaging fails to identify rTBI-induced lesions, and novel non-invasive methods are needed. Here, we evaluated if hyperpolarized 13C magnetic resonance spectroscopic imaging (HP 13C MRSI) could detect long-lasting changes in brain metabolism 3.5 months post-injury in a rTBI mouse model. Our results show that this metabolic imaging approach can detect changes in cortical metabolism at that timepoint, whereas multimodal MR imaging did not detect any structural or contrast alterations. Using Machine Learning, we further show that HP 13C MRSI parameters can help classify rTBI vs. Sham and predict long-term rTBI-induced behavioral outcomes. Altogether, our study demonstrates the potential of metabolic imaging to improve detection, classification and outcome prediction of previously undetected rTBI.
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Affiliation(s)
| | | | - Kai Qiao
- University of California, San Francisco
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Woitek R, Brindle KM. Hyperpolarized Carbon-13 MRI in Breast Cancer. Diagnostics (Basel) 2023; 13:2311. [PMID: 37443703 DOI: 10.3390/diagnostics13132311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
One of the hallmarks of cancer is metabolic reprogramming, including high levels of aerobic glycolysis (the Warburg effect). Pyruvate is a product of glucose metabolism, and 13C-MR imaging of the metabolism of hyperpolarized (HP) [1-13C]pyruvate (HP 13C-MRI) has been shown to be a potentially versatile tool for the clinical evaluation of tumor metabolism. Hyperpolarization of the 13C nuclear spin can increase the sensitivity of detection by 4-5 orders of magnitude. Therefore, following intravenous injection, the location of hyperpolarized 13C-labeled pyruvate in the body and its subsequent metabolism can be tracked using 13C-MRI. Hyperpolarized [13C]urea and [1,4-13C2]fumarate are also likely to translate to the clinic in the near future as tools for imaging tissue perfusion and post-treatment tumor cell death, respectively. For clinical breast imaging, HP 13C-MRI can be combined with 1H-MRI to address the need for detailed anatomical imaging combined with improved functional tumor phenotyping and very early identification of patients not responding to standard and novel neoadjuvant treatments. If the technical complexity of the hyperpolarization process and the relatively high associated costs can be reduced, then hyperpolarized 13C-MRI has the potential to become more widely available for large-scale clinical trials.
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Affiliation(s)
- Ramona Woitek
- Research Centre for Medical Image Analysis and AI, Danube Private University, 3500 Krems, Austria
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, UK
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge CB2 0RE, UK
- Department of Biochemistry, University of Cambridge, Cambridge CB2 1QW, UK
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Chetta P, Sriram R, Zadra G. Lactate as Key Metabolite in Prostate Cancer Progression: What Are the Clinical Implications? Cancers (Basel) 2023; 15:3473. [PMID: 37444583 PMCID: PMC10340474 DOI: 10.3390/cancers15133473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Advanced prostate cancer represents the fifth leading cause of cancer death in men worldwide. Although androgen-receptor signaling is the major driver of the disease, evidence is accumulating that disease progression is supported by substantial metabolic changes. Alterations in de novo lipogenesis and fatty acid catabolism are consistently reported during prostate cancer development and progression in association with androgen-receptor signaling. Therefore, the term "lipogenic phenotype" is frequently used to describe the complex metabolic rewiring that occurs in prostate cancer. However, a new scenario has emerged in which lactate may play a major role. Alterations in oncogenes/tumor suppressors, androgen signaling, hypoxic conditions, and cells in the tumor microenvironment can promote aerobic glycolysis in prostate cancer cells and the release of lactate in the tumor microenvironment, favoring immune evasion and metastasis. As prostate cancer is composed of metabolically heterogenous cells, glycolytic prostate cancer cells or cancer-associated fibroblasts can also secrete lactate and create "symbiotic" interactions with oxidative prostate cancer cells via lactate shuttling to sustain disease progression. Here, we discuss the multifaceted role of lactate in prostate cancer progression, taking into account the influence of the systemic metabolic and gut microbiota. We call special attention to the clinical opportunities of imaging lactate accumulation for patient stratification and targeting lactate metabolism.
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Affiliation(s)
- Paolo Chetta
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA;
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Giorgia Zadra
- Institute of Molecular Genetics, National Research Council (IGM-CNR), 27100 Pavia, Italy
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Guglielmetti C, Cordano C, Najac C, Green AJ, Chaumeil MM. Imaging immunomodulatory treatment responses in a multiple sclerosis mouse model using hyperpolarized 13C metabolic MRI. COMMUNICATIONS MEDICINE 2023; 3:71. [PMID: 37217574 DOI: 10.1038/s43856-023-00300-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND In recent years, the ability of conventional magnetic resonance imaging (MRI), including T1 contrast-enhanced (CE) MRI, to monitor high-efficacy therapies and predict long-term disability in multiple sclerosis (MS) has been challenged. Therefore, non-invasive methods to improve MS lesions detection and monitor therapy response are needed. METHODS We studied the combined cuprizone and experimental autoimmune encephalomyelitis (CPZ-EAE) mouse model of MS, which presents inflammatory-mediated demyelinated lesions in the central nervous system as commonly seen in MS patients. Using hyperpolarized 13C MR spectroscopy (MRS) metabolic imaging, we measured cerebral metabolic fluxes in control, CPZ-EAE and CPZ-EAE mice treated with two clinically-relevant therapies, namely fingolimod and dimethyl fumarate. We also acquired conventional T1 CE MRI to detect active lesions, and performed ex vivo measurements of enzyme activities and immunofluorescence analyses of brain tissue. Last, we evaluated associations between imaging and ex vivo parameters. RESULTS We show that hyperpolarized [1-13C]pyruvate conversion to lactate is increased in the brain of untreated CPZ-EAE mice when compared to the control, reflecting immune cell activation. We further demonstrate that this metabolic conversion is significantly decreased in response to the two treatments. This reduction can be explained by increased pyruvate dehydrogenase activity and a decrease in immune cells. Importantly, we show that hyperpolarized 13C MRS detects dimethyl fumarate therapy, whereas conventional T1 CE MRI cannot. CONCLUSIONS In conclusion, hyperpolarized MRS metabolic imaging of [1-13C]pyruvate detects immunological responses to disease-modifying therapies in MS. This technique is complementary to conventional MRI and provides unique information on neuroinflammation and its modulation.
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Affiliation(s)
- Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Christian Cordano
- Department of Neurology, Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, CA, USA
| | - Chloé Najac
- Department of Radiology, C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Ari J Green
- Department of Neurology, Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, CA, USA
- Department of Ophthalmology, University of California at San Francisco, CA, San Francisco, USA
| | - Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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Sejersen S, Rasmussen CW, Bøgh N, Kjaergaard U, Hansen ESS, Schulte RF, Laustsen C. Considering whole-body metabolism in hyperpolarized MRI through 13 C breath analysis-An alternative way to quantification and normalization? Magn Reson Med 2023; 90:664-672. [PMID: 37094025 DOI: 10.1002/mrm.29669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Hyperpolarized [1-13 C]pyruvate MRI is an emerging clinical tool for metabolic imaging. It has the potential for absolute quantitative metabolic imaging. However, the method itself is not quantitative, limiting comparison of images across both time and between individuals. Here, we propose a simple signal normalization to the whole-body oxidative metabolism to overcome this limitation. THEORY AND METHODS A simple extension of the model-free ratiometric analysis of hyperpolarized [1-13 C]pyruvate MRI is presented, using the expired 13 CO2 in breath for normalization. The proposed framework was investigated in two porcine cohorts (N = 11) subjected to local renal hypoperfusion defects and subsequent [1-13 C]pyruvate MRI. A breath sample was taken before the [1-13 C]pyruvate injection and 5 min after. The raw MR signal from both the healthy and intervened kidney in the two cohorts was normalized using the 13 CO2 in the expired air. RESULTS 13 CO2 content in the expired air was significantly different between the two cohorts. Normalization to this reduced the coefficients of variance in the aerobic metabolic sensitive pathways by 25% for the alanine/pyruvate ratio, and numerical changes were observed in the bicarbonate/pyruvate ratio. The lactate/pyruvate ratio was largely unaltered (<2%). CONCLUSION Our results indicate that normalizing the hyperpolarized 13 C-signal ratios by the 13 CO2 content in expired air can reduce variation as well as improve specificity of the method by normalizing the metabolic readout to the overall metabolic status of the individual. The method is a simple and cheap extension to the hyperpolarized 13 C exam.
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Affiliation(s)
- Steffen Sejersen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Camilla W Rasmussen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Uffe Kjaergaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Esben S S Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Gamliel A, Shaul D, Gomori JM, Katz‐Brull R. Signal enhancement of hyperpolarized 15 N sites in solution-increase in solid-state polarization at 3.35 T and prolongation of relaxation in deuterated water mixtures. NMR IN BIOMEDICINE 2022; 35:e4787. [PMID: 35704397 PMCID: PMC9787933 DOI: 10.1002/nbm.4787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Hyperpolarized 15 N sites have been found to be promising for generating long-lived hyperpolarized states in solution, and present a promising approach for utilizing dissolution-dynamic nuclear polarization (dDNP)-driven hyperpolarized MRI for imaging in biology and medicine. Specifically, 15 N sites with directly bound protons were shown to be useful when dissolved in D2 O. The purpose of the current study was to further characterize and increase the visibility of such 15 N sites in solutions that mimic an intravenous injection during the first cardiac pass in terms of their H2 O:D2 O composition. The T1 values of hyperpolarized 15 N in [15 N2 ]urea and [15 N]NH4 Cl demonstrated similar dependences on the H2 O:D2 O composition of the solution, with a T1 of about 140 s in 100% D2 O, about twofold shortening in 90% and 80% D2 O, and about threefold shortening in 50% D2 O. [13 C]urea was found to be a useful solid-state 13 C marker for qualitative monitoring of the 15 N polarization process in a commercial pre-clinical dDNP device. Adding trace amounts of Gd3+ to the polarization formulation led to higher solid-state polarization of [13 C]urea and to higher polarization levels of [15 N2 ]urea in solution.
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Affiliation(s)
- Ayelet Gamliel
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
| | - David Shaul
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
| | - J. Moshe Gomori
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
| | - Rachel Katz‐Brull
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
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11
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Agarwal S, Decavel-Bueff E, Wang YH, Qin H, Santos RD, Evans MJ, Sriram R. Defining the Magnetic Resonance Features of Renal Lesions and Their Response to Everolimus in a Transgenic Mouse Model of Tuberous Sclerosis Complex. Front Oncol 2022; 12:851192. [PMID: 35814396 PMCID: PMC9260108 DOI: 10.3389/fonc.2022.851192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Tuberous sclerosis complex (TSC) is an inherited genetic disorder characterized by mutations in TSC1 or TSC2 class of tumor suppressers which impact several organs including the kidney. The renal manifestations are usually in the form of angiomyolipoma (AML, in 80% of the cases) and cystadenomas. mTOR inhibitors such as rapamycin and everolimus have shown efficacy in reducing the renal tumor burden. Early treatment prevents the progression of AML; however, the tumors regrow upon cessation of therapy implying a lifelong need for monitoring and management of this morbid disease. There is a critical need for development of imaging strategies to monitor response to therapy and progression of disease which will also facilitate development of newer targeted therapy. In this study we evaluated the potential of multiparametric 1H magnetic resonance imaging (mpMRI) to monitor tumor response to therapy in a preclinical model of TSC, the transgenic mouse A/J Tsc2+/-. We found 2-dimensional T2-weighted sequence with 0.5 mm slice thickness to be optimal for detecting renal lesions as small as 0.016 mm3. Baseline characterization of lesions with MRI to assess physiological parameters such as cellularity and perfusion is critical for distinguishing between cystic and solid lesions. Everolimus treatment for three weeks maintained tumor growth at 36% from baseline, while control tumors displayed steady growth and were 70% larger than baseline at the end of therapy. Apparent diffusion coefficient, T1 values and normalized T2 intensity changes were also indictive of response to treatment. Our results indicate that standardization and implementation of improved MR imaging protocols will significantly enhance the utility of mpMRI in determining the severity and composition of renal lesions for better treatment planning.
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Affiliation(s)
- Shubhangi Agarwal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Emilie Decavel-Bueff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Yung-Hua Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Michael J. Evans
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA, United States
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Renuka Sriram,
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12
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Fiedorowicz M, Wieteska M, Rylewicz K, Kossowski B, Piątkowska-Janko E, Czarnecka AM, Toczylowska B, Bogorodzki P. Hyperpolarized 13C tracers: Technical advancements and perspectives for clinical applications. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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13
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Qin H, Tang S, Riselli AM, Bok RA, Delos Santos R, van Criekinge M, Gordon JW, Aggarwal R, Chen R, Goddard G, Zhang CT, Chen A, Reed G, Ruscitto DM, Slater J, Sriram R, Larson PEZ, Vigneron DB, Kurhanewicz J. Clinical translation of hyperpolarized 13 C pyruvate and urea MRI for simultaneous metabolic and perfusion imaging. Magn Reson Med 2021; 87:138-149. [PMID: 34374471 PMCID: PMC8616838 DOI: 10.1002/mrm.28965] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/30/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Purpose The combined hyperpolarized (HP) 13C pyruvate and urea MRI has provided a simultaneous assessment of glycolytic metabolism and tissue perfusion for improved cancer diagnosis and therapeutic evaluation in preclinical studies. This work aims to translate this dual‐probe HP imaging technique to clinical research. Methods A co‐polarization system was developed where [1‐13C]pyruvic acid (PA) and [13C, 15N2]urea in water solution were homogeneously mixed and polarized on a 5T SPINlab system. Physical and chemical characterizations and toxicology studies of the combined probe were performed. Simultaneous metabolic and perfusion imaging was performed on a 3T clinical MR scanner by alternatively applying a multi‐slice 2D spiral sequence for [1‐13C]pyruvate and its downstream metabolites and a 3D balanced steady‐state free precession (bSSFP) sequence for [13C, 15N2]urea. Results The combined PA/urea probe has a glass‐formation ability similar to neat PA and can generate nearly 40% liquid‐state 13C polarization for both pyruvate and urea in 3‐4 h. A standard operating procedure for routine on‐site production was developed and validated to produce 40 mL injection product of approximately 150 mM pyruvate and 35 mM urea. The toxicology study demonstrated the safety profile of the combined probe. Dynamic metabolite‐specific imaging of [1‐13C]pyruvate, [1‐13C]lactate, [1‐13C]alanine, and [13C, 15N2]urea was achieved with adequate spatial (2.6 mm × 2.6 mm) and temporal resolution (4.2 s), and urea images showed reduced off‐resonance artifacts due to the JCN coupling. Conclusion The reported technical development and translational studies will lead to the first‐in‐human dual‐agent HP MRI study and mark the clinical translation of the first HP 13C MRI probe after pyruvate.
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Affiliation(s)
- Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Andrew M Riselli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Mark van Criekinge
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Rahul Aggarwal
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Rui Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | | | - Albert Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | - Galen Reed
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | - James Slater
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
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14
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Matsumoto S. [1. Hyperpolarized 13C MRI: Current Status and Prospects of Post-nuclear Medicine]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:753-759. [PMID: 34305064 DOI: 10.6009/jjrt.2021_jsrt_77.7.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shingo Matsumoto
- Laboratory of Magnetic Resonance Engineering, Faculty of Information Science and Technology, Hokkaido University
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15
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Abhyankar N, Szalai V. Challenges and Advances in the Application of Dynamic Nuclear Polarization to Liquid-State NMR Spectroscopy. J Phys Chem B 2021; 125:5171-5190. [PMID: 33960784 PMCID: PMC9871957 DOI: 10.1021/acs.jpcb.0c10937] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Nuclear magnetic resonance (NMR) spectroscopy is a powerful method to study the molecular structure and dynamics of materials. The inherently low sensitivity of NMR spectroscopy is a consequence of low spin polarization. Hyperpolarization of a spin ensemble is defined as a population difference between spin states that far exceeds what is expected from the Boltzmann distribution for a given temperature. Dynamic nuclear polarization (DNP) can overcome the relatively low sensitivity of NMR spectroscopy by using a paramagnetic matrix to hyperpolarize a nuclear spin ensemble. Application of DNP to NMR can result in sensitivity gains of up to four orders of magnitude compared to NMR without DNP. Although DNP NMR is now more routinely utilized for solid-state (ss) NMR spectroscopy, it has not been exploited to the same degree for liquid-state samples. This Review will consider challenges and advances in the application of DNP NMR to liquid-state samples. The Review is organized into four sections: (i) mechanisms of DNP NMR relevant to hyperpolarization of liquid samples; (ii) applications of liquid-state DNP NMR; (iii) available detection schemes for liquid-state samples; and (iv) instrumental challenges and outlook for liquid-state DNP NMR.
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Affiliation(s)
- Nandita Abhyankar
- Institute for Research in Electronics and Applied Physics, University of Maryland, College Park, MD 20742, USA
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Veronika Szalai
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
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16
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Vaeggemose M, F. Schulte R, Laustsen C. Comprehensive Literature Review of Hyperpolarized Carbon-13 MRI: The Road to Clinical Application. Metabolites 2021; 11:metabo11040219. [PMID: 33916803 PMCID: PMC8067176 DOI: 10.3390/metabo11040219] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/02/2023] Open
Abstract
This review provides a comprehensive assessment of the development of hyperpolarized (HP) carbon-13 metabolic MRI from the early days to the present with a focus on clinical applications. The status and upcoming challenges of translating HP carbon-13 into clinical application are reviewed, along with the complexity, technical advancements, and future directions. The road to clinical application is discussed regarding clinical needs and technological advancements, highlighting the most recent successes of metabolic imaging with hyperpolarized carbon-13 MRI. Given the current state of hyperpolarized carbon-13 MRI, the conclusion of this review is that the workflow for hyperpolarized carbon-13 MRI is the limiting factor.
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Affiliation(s)
- Michael Vaeggemose
- GE Healthcare, 2605 Brondby, Denmark;
- MR Research Centre, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Correspondence:
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17
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Mattei F, Andreone S, Mencattini A, De Ninno A, Businaro L, Martinelli E, Schiavoni G. Oncoimmunology Meets Organs-on-Chip. Front Mol Biosci 2021; 8:627454. [PMID: 33842539 PMCID: PMC8032996 DOI: 10.3389/fmolb.2021.627454] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/04/2021] [Indexed: 01/04/2023] Open
Abstract
Oncoimmunology represents a biomedical research discipline coined to study the roles of immune system in cancer progression with the aim of discovering novel strategies to arm it against the malignancy. Infiltration of immune cells within the tumor microenvironment is an early event that results in the establishment of a dynamic cross-talk. Here, immune cells sense antigenic cues to mount a specific anti-tumor response while cancer cells emanate inhibitory signals to dampen it. Animals models have led to giant steps in this research context, and several tools to investigate the effect of immune infiltration in the tumor microenvironment are currently available. However, the use of animals represents a challenge due to ethical issues and long duration of experiments. Organs-on-chip are innovative tools not only to study how cells derived from different organs interact with each other, but also to investigate on the crosstalk between immune cells and different types of cancer cells. In this review, we describe the state-of-the-art of microfluidics and the impact of OOC in the field of oncoimmunology underlining the importance of this system in the advancements on the complexity of tumor microenvironment.
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Affiliation(s)
- Fabrizio Mattei
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Sara Andreone
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Arianna Mencattini
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.,Interdisciplinary Center for Advanced Studies on Lab-on-Chip and Organ-on-Chip Applications (ICLOC), University of Rome Tor Vergata, Rome, Italy
| | - Adele De Ninno
- Institute for Photonics and Nanotechnologies, Italian National Research Council, Rome, Italy
| | - Luca Businaro
- Institute for Photonics and Nanotechnologies, Italian National Research Council, Rome, Italy
| | - Eugenio Martinelli
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.,Interdisciplinary Center for Advanced Studies on Lab-on-Chip and Organ-on-Chip Applications (ICLOC), University of Rome Tor Vergata, Rome, Italy
| | - Giovanna Schiavoni
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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