1
|
Li F, Ma C, Lei S, Pan Y, Lin L, Pan C, Li Q, Geng F, Min D, Tang X. Gingipains may be one of the key virulence factors of Porphyromonas gingivalis to impair cognition and enhance blood-brain barrier permeability: An animal study. J Clin Periodontol 2024; 51:818-839. [PMID: 38414291 DOI: 10.1111/jcpe.13966] [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: 02/09/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
AIM Blood-brain barrier (BBB) disorder is one of the early findings in cognitive impairments. We have recently found that Porphyromonas gingivalis bacteraemia can cause cognitive impairment and increased BBB permeability. This study aimed to find out the possible key virulence factors of P. gingivalis contributing to the pathological process. MATERIALS AND METHODS C57/BL6 mice were infected with P. gingivalis or gingipains or P. gingivalis lipopolysaccharide (P. gingivalis LPS group) by tail vein injection for 8 weeks. The cognitive behaviour changes in mice, the histopathological changes in the hippocampus and cerebral cortex, the alternations of BBB permeability, and the changes in Mfsd2a and Cav-1 levels were measured. The mechanisms of Ddx3x-induced regulation on Mfsd2a by arginine-specific gingipain A (RgpA) in BMECs were explored. RESULTS P. gingivalis and gingipains significantly promoted mice cognitive impairment, pathological changes in the hippocampus and cerebral cortex, increased BBB permeability, inhibited Mfsd2a expression and up-regulated Cav-1 expression. After RgpA stimulation, the permeability of the BBB model in vitro increased, and the Ddx3x/Mfsd2a/Cav-1 regulatory axis was activated. CONCLUSIONS Gingipains may be one of the key virulence factors of P. gingivalis to impair cognition and enhance BBB permeability by the Ddx3x/Mfsd2a/Cav-1 axis.
Collapse
Affiliation(s)
- Fulong Li
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
- Center of Implantology, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Chunliang Ma
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Shuang Lei
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Li Lin
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Chunling Pan
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Qian Li
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Dongyu Min
- Traditional Chinese Medicine Experimental Center, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
- Key Laboratory of Ministry of Education for TCM Viscera State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xiaolin Tang
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| |
Collapse
|
2
|
Tiwari A, Elgrably B, Saar G, Vandoorne K. Multi-Scale Imaging of Vascular Pathologies in Cardiovascular Disease. Front Med (Lausanne) 2022; 8:754369. [PMID: 35071257 PMCID: PMC8766766 DOI: 10.3389/fmed.2021.754369] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/13/2021] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular disease entails systemic changes in the vasculature. The endothelial cells lining the blood vessels are crucial in the pathogenesis of cardiovascular disease. Healthy endothelial cells direct the blood flow to tissues as vasodilators and act as the systemic interface between the blood and tissues, supplying nutrients for vital organs, and regulating the smooth traffic of leukocytes into tissues. In cardiovascular diseases, when inflammation is sensed, endothelial cells adjust to the local or systemic inflammatory state. As the inflamed vasculature adjusts, changes in the endothelial cells lead to endothelial dysfunction, altered blood flow and permeability, expression of adhesion molecules, vessel wall inflammation, thrombosis, angiogenic processes, and extracellular matrix production at the endothelial cell level. Preclinical multi-scale imaging of these endothelial changes using optical, acoustic, nuclear, MRI, and multimodal techniques has progressed, due to technical advances and enhanced biological understanding on the interaction between immune and endothelial cells. While this review highlights biological processes that are related to changes in the cardiac vasculature during cardiovascular diseases, it also summarizes state-of-the-art vascular imaging techniques. The advantages and disadvantages of the different imaging techniques are highlighted, as well as their principles, methodologies, and preclinical and clinical applications with potential future directions. These multi-scale approaches of vascular imaging carry great potential to further expand our understanding of basic vascular biology, to enable early diagnosis of vascular changes and to provide sensitive diagnostic imaging techniques in the management of cardiovascular disease.
Collapse
Affiliation(s)
- Ashish Tiwari
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Betsalel Elgrably
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Galit Saar
- Biomedical Core Facility, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Katrien Vandoorne
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
3
|
Lu J, Mei Q, Hou X, Manaenko A, Zhou L, Liebeskind DS, Zhang JH, Li Y, Hu Q. Imaging Acute Stroke: From One-Size-Fit-All to Biomarkers. Front Neurol 2021; 12:697779. [PMID: 34630278 PMCID: PMC8497192 DOI: 10.3389/fneur.2021.697779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/30/2021] [Indexed: 12/27/2022] Open
Abstract
In acute stroke management, time window has been rigidly used as a guide for decades and the reperfusion treatment is only available in the first few limited hours. Recently, imaging-based selection of patients has successfully expanded the treatment window out to 16 and even 24 h in the DEFUSE 3 and DAWN trials, respectively. Recent guidelines recommend the use of imaging techniques to guide therapeutic decision-making and expanded eligibility in acute ischemic stroke. A tissue window is proposed to replace the time window and serve as the surrogate marker for potentially salvageable tissue. This article reviews the evolution of time window, addresses the advantage of a tissue window in precision medicine for ischemic stroke, and discusses both the established and emerging techniques of neuroimaging and their roles in defining a tissue window. We also emphasize the metabolic imaging and molecular imaging of brain pathophysiology, and highlight its potential in patient selection and treatment response prediction in ischemic stroke.
Collapse
Affiliation(s)
- Jianfei Lu
- Central Laboratory, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiyong Mei
- Department of Neurosurgery, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Xianhua Hou
- Department of Neurology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Anatol Manaenko
- National Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lili Zhou
- Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - David S. Liebeskind
- Neurovascular Imaging Research Core and University of California Los Angeles Stroke Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - John H. Zhang
- Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda, CA, United States
| | - Yao Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qin Hu
- Central Laboratory, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Sun H, Hu H, Liu C, Sun N, Duan C. Methods used for the measurement of blood-brain barrier integrity. Metab Brain Dis 2021; 36:723-735. [PMID: 33635479 DOI: 10.1007/s11011-021-00694-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/11/2021] [Indexed: 01/12/2023]
Abstract
The blood-brain barrier (BBB) comprises the interface between blood, brain and cerebrospinal fluid. Its primary function, which is mainly carried out by tight junctions, is to stabilize the tightly controlled microenvironment of the brain. To study the development and maintenance of the BBB, as well as various roles their intrinsic mechanisms that play in neurological disorders, suitable measurements are required to demonstrate integrity and functional changes at the interfaces between the blood and brain tissue. Markers and plasma proteins with different molecular weight (MW) are used to measure the permeability of BBB. In addition, the expression changes of tight-junction proteins form the basic structure of BBB, and imaging modalities are available to study the disruption of BBB. In the present review, above mentioned methods are depicted in details, together with the pros and cons as well as the differences between these methods, which maybe benefit research studies focused on the detection of BBB breakdown.
Collapse
Affiliation(s)
- Huixin Sun
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Huiling Hu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Chuanjie Liu
- Weihai City Key Laboratory of Autoimmunity, Weihai Central Hospital, Weihai, 264400, Shandong Province, China
| | - Nannan Sun
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China.
| | - Chaohui Duan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
| |
Collapse
|
5
|
Chang CY, Luo DZ, Pei JC, Kuo MC, Hsieh YC, Lai WS. Not Just a Bystander: The Emerging Role of Astrocytes and Research Tools in Studying Cognitive Dysfunctions in Schizophrenia. Int J Mol Sci 2021; 22:ijms22105343. [PMID: 34069523 PMCID: PMC8160762 DOI: 10.3390/ijms22105343] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 12/16/2022] Open
Abstract
Cognitive dysfunction is one of the core symptoms in schizophrenia, and it is predictive of functional outcomes and therefore useful for treatment targets. Rather than improving cognitive deficits, currently available antipsychotics mainly focus on positive symptoms, targeting dopaminergic/serotoninergic neurons and receptors in the brain. Apart from investigating the neural mechanisms underlying schizophrenia, emerging evidence indicates the importance of glial cells in brain structure development and their involvement in cognitive functions. Although the etiopathology of astrocytes in schizophrenia remains unclear, accumulated evidence reveals that alterations in gene expression and astrocyte products have been reported in schizophrenic patients. To further investigate the role of astrocytes in schizophrenia, we highlighted recent progress in the investigation of the effect of astrocytes on abnormalities in glutamate transmission and impairments in the blood–brain barrier. Recent advances in animal models and behavioral methods were introduced to examine schizophrenia-related cognitive deficits and negative symptoms. We also highlighted several experimental tools that further elucidate the role of astrocytes. Instead of focusing on schizophrenia as a neuron-specific disorder, an additional astrocytic perspective provides novel and promising insight into its causal mechanisms and treatment. The involvement of astrocytes in the pathogenesis of schizophrenia and other brain disorders is worth further investigation.
Collapse
Affiliation(s)
- Chia-Yuan Chang
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan; (C.-Y.C.); (D.-Z.L.); (J.-C.P.); (Y.-C.H.)
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei 10617, Taiwan;
| | - Da-Zhong Luo
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan; (C.-Y.C.); (D.-Z.L.); (J.-C.P.); (Y.-C.H.)
| | - Ju-Chun Pei
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan; (C.-Y.C.); (D.-Z.L.); (J.-C.P.); (Y.-C.H.)
| | - Ming-Che Kuo
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei 10617, Taiwan;
- Department of Neurology, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Yi-Chen Hsieh
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan; (C.-Y.C.); (D.-Z.L.); (J.-C.P.); (Y.-C.H.)
| | - Wen-Sung Lai
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan; (C.-Y.C.); (D.-Z.L.); (J.-C.P.); (Y.-C.H.)
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei 10617, Taiwan;
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei 10617, Taiwan
- Correspondence: ; Tel.: +886-2-3366-3112; Fax: +886-2-3362-9909
| |
Collapse
|
6
|
Automated Assessment of Hematoma Volume of Rodents Subjected to Experimental Intracerebral Hemorrhagic Stroke by Bayes Segmentation Approach. Transl Stroke Res 2019; 11:789-798. [PMID: 31836961 DOI: 10.1007/s12975-019-00754-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/01/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
Simulating a clinical condition of intracerebral hemorrhage (ICH) in animals is key to research on the development and testing of diagnostic or treatment strategies for this high-mortality disease. In order to study the mechanism, pathology, and treatment for hemorrhagic stroke, various animal models have been developed. Measurement of hematoma volume is an important assessment parameter to evaluate post-ICH outcomes. However, due to tissue preservation conditions and variables in digitization, quantification of hematoma volume is usually labor intensive and sometimes even subjective. The objective of this study is to develop an automated method that can accurately and efficiently obtain unbiased cerebral hematoma volume. We developed an application (MATLAB program) that can delineate the brain slice from the background and use the Hue information in the Hue/Saturation/Value (HSV) color space to segment the hematoma region. The segmentation threshold of Hue is calculated based on the Bayes classifier theorem so that the minimum error is mathematically ensured and automated processing is enabled. To validate the developed method, we compared the outcomes from the developed method with the hemoglobin content by the spectrophotometric assay method. The results were linearly correlated with statistical significance. The method was also validated by digital phantoms with an error less than 5% compared with the ground truth from the phantoms. Hematoma volumes yielded by the automated processing and those obtained by the operator's manual operation are highly correlated. This automated segmentation approach can be potentially used to quantify hemorrhagic outcomes in rodent stroke models in an unbiased and efficient way.
Collapse
|
7
|
Abstract
The global population is ageing at an accelerating speed. The ability to perform working memory tasks together with rapid processing becomes increasingly difficult with increases in age. With increasing national average life spans and a rise in the prevalence of age-related disease, it is pertinent to discuss the unique perspectives that can be gained from imaging the aged brain. Differences in structure, function, blood flow, and neurovascular coupling are present in both healthy aged brains and in diseased brains and have not yet been explored to their full depth in contemporary imaging studies. Imaging methods ranging from optical imaging to magnetic resonance imaging (MRI) to newer technologies such as photoacoustic tomography each offer unique advantages and challenges in imaging the aged brain. This paper will summarize first the importance and challenges of imaging the aged brain and then offer analysis of potential imaging modalities and their representative applications. The potential breakthroughs in brain imaging are also envisioned.
Collapse
Affiliation(s)
- Hannah Humayun
- Photoacoustic Imaging Laboratory, Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Junjie Yao
- Photoacoustic Imaging Laboratory, Department of Biomedical Engineering, Duke University, Durham, NC, USA
| |
Collapse
|
8
|
Coolens C, Driscoll B, Foltz W, Svistoun I, Sinno N, Chung C. Unified platform for multimodal voxel-based analysis to evaluate tumour perfusion and diffusion characteristics before and after radiation treatment evaluated in metastatic brain cancer. Br J Radiol 2019; 92:20170461. [PMID: 30235004 DOI: 10.1259/bjr.20170461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE: Early changes in tumour behaviour following stereotactic radiosurgery) are potential biomarkers of response. To-date quantitative model-based measures of dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI parameters have shown widely variable findings, which may be attributable to variability in image acquisition, post-processing and analysis. Big data analytic approaches are needed for the automation of computationally intensive modelling calculations for every voxel, independent of observer interpretation. METHODS: This unified platform is a voxel-based, multimodality architecture that brings complimentary solute transport processes such as perfusion and diffusion into a common framework. The methodology was tested on synthetic data and digital reference objects and consequently evaluated in patients who underwent volumetric DCE-CT, DCE-MRI and DWI-MRI scans before and after treatment. Three-dimensional pharmacokinetic parameter maps from both modalities were compared as well as the correlation between apparent diffusion coefficient (ADC) values and the extravascular, extracellular volume (Ve). Comparison of histogram parameters was done via Bland-Altman analysis, as well as Student's t-test and Pearson's correlation using two-sided analysis. RESULTS: System testing on synthetic Tofts model data and digital reference objects recovered the ground truth parameters with mean relative percent error of 1.07 × 10-7 and 5.60 × 10-4 respectively. Direct voxel-to-voxel Pearson's analysis showed statistically significant correlations between CT and MR which peaked at Day 7 for Ktrans (R = 0.74, p <= 0.0001). Statistically significant correlations were also present between ADC and Ve derived from both DCE-MRI and DCE-CT with highest median correlations found at Day 3 between median ADC and Ve,MRI values (R = 0.6, p < 0.01) The strongest correlation to DCE-CT measurements was found with DCE-MRI analysis using voxelwise T10 maps (R = 0.575, p < 0.001) instead of assigning a fixed T10 value. CONCLUSION: The unified implementation of multiparametric transport modelling allowed for more robust and timely observer-independent data analytics. Utility of a common analysis platform has shown higher correlations between pharmacokinetic parameters obtained from different modalities than has previously been reported. ADVANCES IN KNOWLEDGE: Utility of a common analysis platform has shown statistically higher correlations between pharmacokinetic parameters obtained from different modalities than has previously been reported.
Collapse
Affiliation(s)
- Catherine Coolens
- 1 Department of Medical Physics, Princess Margaret Cancer Center and University Health Network , Toronto, ON , Canada.,2 Department of Radiation Oncology, University of Toronto , Toronto, ON , Canada.,3 Department of Biomaterials and Biomedical Engineering, University of Toronto , Toronto, ON , Canada.,4 TECHNA Institute, University Health Network , Toronto, ON , Canada
| | - Brandon Driscoll
- 1 Department of Medical Physics, Princess Margaret Cancer Center and University Health Network , Toronto, ON , Canada
| | - Warren Foltz
- 1 Department of Medical Physics, Princess Margaret Cancer Center and University Health Network , Toronto, ON , Canada.,2 Department of Radiation Oncology, University of Toronto , Toronto, ON , Canada
| | - Igor Svistoun
- 1 Department of Medical Physics, Princess Margaret Cancer Center and University Health Network , Toronto, ON , Canada
| | - Noha Sinno
- 1 Department of Medical Physics, Princess Margaret Cancer Center and University Health Network , Toronto, ON , Canada.,3 Department of Biomaterials and Biomedical Engineering, University of Toronto , Toronto, ON , Canada
| | - Caroline Chung
- 4 TECHNA Institute, University Health Network , Toronto, ON , Canada.,5 Department of Radiation Oncology, MD Anderson Cancer Center , Houston, TX , USA
| |
Collapse
|
9
|
Laviña B. Brain Vascular Imaging Techniques. Int J Mol Sci 2016; 18:ijms18010070. [PMID: 28042833 PMCID: PMC5297705 DOI: 10.3390/ijms18010070] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/13/2016] [Accepted: 12/26/2016] [Indexed: 12/13/2022] Open
Abstract
Recent major improvements in a number of imaging techniques now allow for the study of the brain in ways that could not be considered previously. Researchers today have well-developed tools to specifically examine the dynamic nature of the blood vessels in the brain during development and adulthood; as well as to observe the vascular responses in disease situations in vivo. This review offers a concise summary and brief historical reference of different imaging techniques and how these tools can be applied to study the brain vasculature and the blood-brain barrier integrity in both healthy and disease states. Moreover, it offers an overview on available transgenic animal models to study vascular biology and a description of useful online brain atlases.
Collapse
Affiliation(s)
- Bàrbara Laviña
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden.
| |
Collapse
|
10
|
Coolens C, Driscoll B, Foltz W, Pellow C, Menard C, Chung C. Comparison of Voxel-Wise Tumor Perfusion Changes Measured With Dynamic Contrast-Enhanced (DCE) MRI and Volumetric DCE CT in Patients With Metastatic Brain Cancer Treated with Radiosurgery. ACTA ACUST UNITED AC 2016; 2:325-333. [PMID: 30042966 PMCID: PMC6037934 DOI: 10.18383/j.tom.2016.00178] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Dynamic contrast-enhanced (DCE)-MRI metrics are evaluated against volumetric DCE-CT quantitative parameters as a standard for tracer-kinetic validation using a common 4-dimensional temporal dynamic analysis platform in tumor perfusion measurements following stereotactic radiosurgery (SRS) for brain metastases. Patients treated with SRS as part of Research Ethics Board-approved clinical trials underwent volumetric DCE-CT and DCE-MRI at baseline, then at 7 and 21 days after SRS. Temporal dynamic analysis was used to create 3-dimensional pharmacokinetic parameter maps for both modalities. Individual vascular input functions were selected for DCE-CT and a population function was used for DCE-MRI. Semiquantitative and pharmacokinetic DCE parameters were assessed using a modified Tofts model within each tumor at every time point for both modalities for characterization of perfusion and capillary permeability, as well as their dependency on precontrast relaxation times (TRs), T10, and input function. Direct voxel-to-voxel Pearson analysis showed statistically significant correlations between CT and magnetic resonance which peaked at day 7 for Ktrans (R = 0.74, P ≤ .0001). The strongest correlation to DCE-CT measurements was found with DCE-MRI analysis using voxel-wise T10 maps (R = 0.575, P < .001) instead of assigning a fixed T10 value. Comparison of histogram features showed statistically significant correlations between modalities over all tumors for median Ktrans (R = 0.42, P = .01), median area under the enhancement curve (iAUC90) (R = 0.55, P < .01), and median iAUC90 skewness (R = 0.34, P = .03). Statistically significant, strong correlations were found for voxel-wise Ktrans, iAUC90, and ve values between DCE-CT and DCE-MRI. For DCE-MRI, the implementation of voxel-wise T10 maps plays a key role in ensuring the accuracy of heterogeneous pharmacokinetic maps.
Collapse
Affiliation(s)
- Catherine Coolens
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario, Canada.,TECHNA Institute, University Health Network, Toronto, Ontario, Canada; and
| | - Brandon Driscoll
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada
| | - Warren Foltz
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Carly Pellow
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada
| | - Cynthia Menard
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Montreal Hospital, Montreal, QC, Canada
| | - Caroline Chung
- Radiation Medicine Program, Princess Margaret Cancer Center and University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,TECHNA Institute, University Health Network, Toronto, Ontario, Canada; and
| |
Collapse
|