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deSouza NM, Choudhury A, Greaves M, O’Connor JPB, Hoskin PJ. Imaging hypoxia in endometrial cancer: How and why should it be done? Front Oncol 2022; 12:1020907. [PMID: 36439503 PMCID: PMC9682004 DOI: 10.3389/fonc.2022.1020907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2023] Open
Affiliation(s)
- Nandita M. deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Imaging, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Ananya Choudhury
- Radiation Oncology, The Christie National Health Service (NHS) Foundation Trust Manchester, Manchester, United Kingdom
- The Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Mel Greaves
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
| | - James P. B. O’Connor
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Imaging, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
- The Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Peter J. Hoskin
- The Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Radiation Oncology, Mount Vernon Cancer Centre, Northwood, United Kingdom
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Tran WT, Childs C, Probst H, Farhat G, Czarnota GJ. Imaging Biomarkers for Precision Medicine in Locally Advanced Breast Cancer. J Med Imaging Radiat Sci 2018; 49:342-351. [DOI: 10.1016/j.jmir.2017.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 09/18/2017] [Indexed: 12/19/2022]
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Kousi E, O'Flynn EAM, Borri M, Morgan VA, deSouza NM, Schmidt MA. Pre-treatment functional MRI of breast cancer: T2* evaluation at 3 T and relationship to dynamic contrast-enhanced and diffusion-weighted imaging. Magn Reson Imaging 2018; 52:53-61. [PMID: 29859948 DOI: 10.1016/j.mri.2018.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Baseline T2* relaxation time has been proposed as an imaging biomarker in cancer, in addition to Dynamic Contrast-Enhanced (DCE) MRI and diffusion-weighted imaging (DWI) parameters. The purpose of the current work is to investigate sources of error in T2* measurements and the relationship between T2* and DCE and DWI functional parameters in breast cancer. METHODS Five female volunteers and thirty-two women with biopsy proven breast cancer were scanned at 3 T, with Research Ethics Committee approval. T2* values of the normal breast were acquired from high-resolution, low-resolution and fat-suppressed gradient-echo sequences in volunteers, and compared. In breast cancer patients, pre-treatment T2*, DCE MRI and DWI were performed at baseline. Pathologically complete responders at surgery and non-responders were identified and compared. Principal component analysis (PCA) and cluster analysis (CA) were performed. RESULTS There were no significant differences between T2* values from high-resolution, low-resolution and fat-suppressed datasets (p > 0.05). There were not significant differences between baseline functional parameters in responders and non-responders (p > 0.05). However, there were differences in the relationship between T2* and contrast-agent uptake in responders and non-responders. Voxels of similar characteristics were grouped in 5 clusters, and large intra-tumoural variations of all parameters were demonstrated. CONCLUSION Breast T2* measurements at 3 T are robust, but spatial resolution should be carefully considered. T2* of breast tumours at baseline is unrelated to DCE and DWI parameters and contribute towards describing functional heterogeneity of breast tumours.
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Affiliation(s)
- Evanthia Kousi
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom.
| | - Elizabeth A M O'Flynn
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
| | - Marco Borri
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
| | - Veronica A Morgan
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
| | - Nandita M deSouza
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
| | - Maria A Schmidt
- CR-UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
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Hectors SJCG, Jacobs I, Moonen CTW, Strijkers GJ, Nicolay K. MRI methods for the evaluation of high intensity focused ultrasound tumor treatment: Current status and future needs. Magn Reson Med 2015; 75:302-17. [PMID: 26096859 DOI: 10.1002/mrm.25758] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/14/2015] [Accepted: 04/10/2015] [Indexed: 01/17/2023]
Abstract
Thermal ablation with high intensity focused ultrasound (HIFU) is an emerging noninvasive technique for the treatment of solid tumors. HIFU treatment of malignant tumors requires accurate treatment planning, monitoring and evaluation, which can be facilitated by performing the procedure in an MR-guided HIFU system. The MR-based evaluation of HIFU treatment is most often restricted to contrast-enhanced T1 -weighted imaging, while it has been shown that the non-perfused volume may not reflect the extent of nonviable tumor tissue after HIFU treatment. There are multiple studies in which more advanced MRI methods were assessed for their suitability for the evaluation of HIFU treatment. While several of these methods seem promising regarding their sensitivity to HIFU-induced tissue changes, there is still ample room for improvement of MRI protocols for HIFU treatment evaluation. In this review article, we describe the major acute and delayed effects of HIFU treatment. For each effect, the MRI methods that have been-or could be-used to detect the associated tissue changes are described. In addition, the potential value of multiparametric MRI for the evaluation of HIFU treatment is discussed. The review ends with a discussion on future directions for the MRI-based evaluation of HIFU treatment.
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Affiliation(s)
- Stefanie J C G Hectors
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Igor Jacobs
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gustav J Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Heijmen L, ter Voert EEGW, Oyen WJG, Punt CJA, van Spronsen DJ, Heerschap A, de Geus-Oei LF, van Laarhoven HWM. Multimodality imaging to predict response to systemic treatment in patients with advanced colorectal cancer. PLoS One 2015; 10:e0120823. [PMID: 25831053 PMCID: PMC4382283 DOI: 10.1371/journal.pone.0120823] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/06/2015] [Indexed: 12/15/2022] Open
Abstract
Aim Aim of this study was to investigate the potential of 18F-FDG PET, diffusion weighted imaging (DWI) and susceptibility-weighted (T2*) MRI to predict response to systemic treatment in patients with colorectal liver metastases. The predictive values of pretreatment measurements and of early changes one week after start of therapy, were evaluated. Methods Imaging was performed prior to and one week after start of first line chemotherapy in 39 patients with colorectal liver metastases. 18F-FDG PET scans were performed on a PET/CT scanner and DWI and T2* were performed on a 1.5T MR scanner. The maximum standardized uptake values (SUV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) and T2* value were assessed in the same lesions. Up to 5 liver metastases per patient were analyzed. Outcome measures were progression free survival (PFS), overall survival (OS) and size response. Results Pretreatment, high SUVmax, high TLG, low ADC and high T2* were associated with a shorter OS. Low pretreatment ADC value was associated with shorter PFS. After 1 week a significant drop in SUVmax and rise in ADC were observed. The drop in SUV was correlated with the rise in ADC (r=-0.58, p=0.002). Neither change in ADC nor in SUV was predictive of PFS or OS. T2* did not significantly change after start of treatment. Conclusion Pretreatment SUVmax, TLG, ADC, and T2* values in colorectal liver metastases are predictive of patient outcome. Despite sensitivity of DWI and 18F-FDG PET for early treatment effects, change in these parameters was not predictive of long term outcome.
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Affiliation(s)
- Linda Heijmen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
| | - Edwin E. G. W. ter Voert
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wim J. G. Oyen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Cornelis J. A. Punt
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Li XS, Fan HX, Fang H, Song YL, Zhou CW. Value of R2* obtained from T2*-weighted imaging in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy. J Magn Reson Imaging 2015; 42:681-8. [PMID: 25581675 DOI: 10.1002/jmri.24837] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/11/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To prospectively investigate the value of R2* in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy. METHODS Sixty-five patients with biopsy-proven cervical squamous carcinoma were enrolled in our study. All these subjects underwent multi-echo T2*-weighted MR imaging on a 3.0 Tesla MR scanner, and tumor R2* was calculated. The patients were divided into the responders and the nonresponders according to treatment effect. Tumor R2* values of these two groups were compared. The relationship between tumor R2* and prognosis after therapy was analyzed. RESULTS The responder group had lower R2* value than the nonresponder group (P = 0.02). The area under the receiver operating characteristics curve for tumor R2* in discriminating responders from nonresponders was 0.769. A cutoff value of 23.87 Hz for tumor R2* resulted in a sensitivity of 78.3% and a specificity of 67.6%. The low R2* group (≤28.37 Hz) had longer median progression-free survival period and overall survival period (P = 0.01, 0.03). Multivariate analysis showed that tumor R2* was a significant prognostic factor for progression-free survival and overall survival (adjusted hazards ratio = 5.34, 4.78; P = 0.02, 0.01). CONCLUSION R2* value obtained from T2*-weighted imaging, as an imaging biomarker, may be an important predictor for the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy.
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Affiliation(s)
- Xiang Sheng Li
- Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China
| | - Hong Xia Fan
- Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China
| | - Hong Fang
- Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China
| | - Yun Long Song
- Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China
| | - Chun Wu Zhou
- Department of Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Tumor oxygen measurements and personalized medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 765:195-201. [PMID: 22879033 DOI: 10.1007/978-1-4614-4989-8_27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Tumor hypoxia is probably the most important not yet measurable factor that predicts the outcome of cancer therapy. Hypoxic tumors are resistant to radiation, chemotherapy, and surgery. They signal tumor cells to grow, invade, survive cytotoxic-factor assault, and increase metastatic activity. Therapies aimed at reversing hypoxia-related treatment resistance or normalizing hypoxia are proven effective with level 1 evidence. The weak link remains the lack of satisfactory methods of measurement of tumor oxygenation.
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Ter Voert EGW, Heijmen L, de Wilt JHW, Bussink J, Punt CJA, van Laarhoven HWM, Heerschap A. Reproducibility and biological basis of in vivo T(2)* magnetic resonance imaging of liver metastasis of colorectal cancer. Magn Reson Med 2012; 70:1145-52. [PMID: 23165899 DOI: 10.1002/mrm.24543] [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] [Received: 07/07/2012] [Revised: 09/29/2012] [Accepted: 10/05/2012] [Indexed: 11/06/2022]
Abstract
In this study, the reproducibility of T2* MR imaging in colorectal liver metastases was assessed and T2* values were correlated with the expression of the hypoxia-related markers GLUT-1 and CA-IX as well as the relative vascular area, and the vessel density in resected tumors. The reproducibility of T2* was analyzed in 18 patients with in total 22 colorectal liver metastases using the Bland and Altman method for the 16th, 50th, and 84th percentile values. Immunohistochemical staining was performed on 17 resected tumors obtained from 16 patients. The median T2* of all liver metastases was 25.0 ± 5.6 ms vs. 23.0 ± 4.1 ms (median ± st.dev.) in normal liver. The coefficient of repeatability was 11.2 ms and the limits of agreement were -13.2 ms and 9.1 ms for median T2* values. On average, T2* showed fair reproducibility. No correlations between T2* values, hypoxia- and vascularity-related markers were observed.
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Affiliation(s)
- E G W Ter Voert
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Jiang L, Weatherall PT, McColl RW, Tripathy D, Mason RP. Blood oxygenation level-dependent (BOLD) contrast magnetic resonance imaging (MRI) for prediction of breast cancer chemotherapy response: A pilot study. J Magn Reson Imaging 2012; 37:1083-92. [DOI: 10.1002/jmri.23891] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 09/14/2012] [Indexed: 12/28/2022] Open
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Prevos R, Smidt ML, Tjan-Heijnen VCG, van Goethem M, Beets-Tan RG, Wildberger JE, Lobbes MBI. Pre-treatment differences and early response monitoring of neoadjuvant chemotherapy in breast cancer patients using magnetic resonance imaging: a systematic review. Eur Radiol 2012; 22:2607-16. [PMID: 22983282 DOI: 10.1007/s00330-012-2653-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/17/2012] [Accepted: 08/22/2012] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To assess whether magnetic resonance imaging (MRI) can identify pre-treatment differences or monitor early response in breast cancer patients receiving neoadjuvant chemotherapy. METHODS PubMed, Cochrane library, Medline and Embase databases were searched for publications until January 1, 2012. After primary selection, studies were selected based on predefined inclusion/exclusion criteria. Two reviewers assessed study contents using an extraction form. RESULTS In 15 studies, which were mainly underpowered and of heterogeneous study design, 31 different parameters were studied. Most frequently studied parameters were tumour diameter or volume, K(trans), K(ep), V(e), and apparent diffusion coefficient (ADC). Other parameters were analysed in only two or less studies. Tumour diameter, volume, and kinetic parameters did not show any pre-treatment differences between responders and non-responders. In two studies, pre-treatment differences in ADC were observed between study groups. At early response monitoring significant and non-significant changes for all parameters were observed for most of the imaging parameters. CONCLUSIONS Evidence on distinguishing responders and non-responders to neoadjuvant chemotherapy using pre-treatment MRI, as well as using MRI for early response monitoring, is weak and based on underpowered study results and heterogeneous study design. Thus, the value of breast MRI for response evaluation has not yet been established. KEY POINTS Few well-validated pre-treatment MR parameters exist that identify responders and non-responders. Eligible studies showed heterogeneous study designs which hampered pooling of data. Confounders and technical variations of MRI accuracy are not studied adequately. Value of MRI for response evaluation needs to be established further.
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Affiliation(s)
- R Prevos
- Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
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