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Wegner CS, Hauge A, Gaustad JV, Andersen LMK, Simonsen TG, Galappathi K, Rofstad EK. Dynamic contrast-enhanced MRI of the microenvironment of pancreatic adenocarcinoma xenografts. Acta Oncol 2017; 56:1754-1762. [PMID: 28661213 DOI: 10.1080/0284186x.2017.1343494] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with poor outcome. Resistance to treatment is associated with impaired vascularity, extensive hypoxia, and interstitial hypertension. In this study, the potential of dynamic contrast-enhanced (DCE)-MRI as a method for assessing the microvascular density (MVD), the fraction of hypoxic tissue, and the interstitial fluid pressure (IFP) of PDACs was investigated. MATERIAL AND METHODS Intramuscular BxPC-3, Capan-2, MIAPaCa-2, and Panc-1 PDAC xenografts were used as preclinical models of human PDACs. DCE-MRI with Gd-DOTA as contrast agent was conducted with a 7.05-T scanner, and the DCE-MRI series were analyzed voxelwise by using the Tofts pharmacokinetic model. Tumor MVD and hypoxia were measured in histological preparations by using pimonidazole as a hypoxia marker and CD31 as a marker of endothelial cells. IFP was measured with a Millar catheter. RESULTS Ktrans (the volume transfer constant of Gd-DOTA) increased with increasing MVD and decreased with increasing hypoxic fraction, but was not associated with IFP. Any association between ve (the fractional distribution volume of Gd-DOTA) and MVD, hypoxic fraction, or IFP could not be detected. CONCLUSIONS This study shows that DCE-MRI is a useful modality for assessing important features of the microenvironment of PDAC xenografts and thus provides the basis for future preclinical and clinical DCE-MRI investigations of PDAC.
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Affiliation(s)
- Catherine S. Wegner
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Anette Hauge
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Jon-Vidar Gaustad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Lise Mari K. Andersen
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Trude G. Simonsen
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Kanthi Galappathi
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Einar K. Rofstad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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Koyasu S, Tsuji Y, Harada H, Nakamoto Y, Nobashi T, Kimura H, Sano K, Koizumi K, Hamaji M, Togashi K. Evaluation of Tumor-associated Stroma and Its Relationship with Tumor Hypoxia Using Dynamic Contrast-enhanced CT and (18)F Misonidazole PET in Murine Tumor Models. Radiology 2015; 278:734-41. [PMID: 26393963 DOI: 10.1148/radiol.2015150416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To determine the relationship between the fractional interstitial volume (Fis), as calculated at dynamic contrast material-enhanced (DCE) computed tomography (CT), and tumor-associated stroma and to analyze its spatial relationship with tumor hypoxia in several xenograft tumor models. MATERIALS AND METHODS All animal experiments were approved by the animal research committee. Mice with three different xenograft tumors (U251, CFPAC-1, and BxPC-3; n = 6, n = 8, and n = 6, respectively) underwent DCE CT then hypoxia imaging with fluorine 18 ((18)F) fluoromisonidazole (FMISO) positron emission tomography (PET) within 24 hours. Immunohistochemical analysis was performed in harvested tumors to detect hypoxia markers and to quantify microvascular and stromal density. Two DCE CT parameters (amount of interstitial space associated with the amount of stroma [Fis] and flow velocity [Fv]) were identified and quantitatively validated by using immunohistochemistry. FMISO uptake within the tumor was also assessed in relation to DCE CT parameters. Imaging and immunohistochemical parameters were assessed by using the Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni correction, and Pearson correlation coefficient. RESULTS Almost no α-smooth muscle actin-positive cells were found in the U251 xenograft, while abundant stroma was found in the entire BxPC-3 xenograft and in the periphery of the CFPAC-1 xenograft. Quantitative analysis showed a significant correlation (R = 0.83, P < .0001) between Fis and stromal density. FMISO uptake had a negative correlation with Fis (R = -0.58, P < .0001) and Fv (R = -0.53, P < .0001). CONCLUSION DCE CT can be used to quantify parameters associated with tumor-associated stroma. Tumor hypoxia was Complementarily localized in tumor-associated stroma in these models.
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Affiliation(s)
- Sho Koyasu
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yoshihisa Tsuji
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hiroshi Harada
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yuji Nakamoto
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tomomi Nobashi
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hiroyuki Kimura
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kohei Sano
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Koji Koizumi
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masatsugu Hamaji
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kaori Togashi
- From the Departments of Diagnostic Imaging and Nuclear Medicine (S.K., Y.N., T.N., K.S., K.T.), Gastroenterology and Hepatology (Y.T.), and Radiation Oncology and Image-Applied Therapy (H.H.), Graduate School of Medicine, Division of Molecular Imaging, Radioisotope Research Center (H.K), Clinical Radiology Service, Kyoto University Hospital (K.K.); and Department of Bioartificial Organs, Institute for Frontier Medical Science (M.H.), Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Lund KV, Simonsen TG, Hompland T, Kristensen GB, Rofstad EK. Short-term pretreatment DCE-MRI in prediction of outcome in locally advanced cervical cancer. Radiother Oncol 2015; 115:379-85. [PMID: 25998804 DOI: 10.1016/j.radonc.2015.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/17/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE Several investigators have indicated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to provide biomarkers for personalized treatment of cervical carcinoma. However, some clinical studies have suggested that treatment failure is associated with low tumor signal enhancement, whereas others have reported associations between high signal enhancement and poor outcome. The purpose of this investigation was to clear up these conflicting reports and to provide a method for identifying biomarkers that easily can be implemented in routine DCE-MRI diagnostics. METHODS The study involved 85 patients (FIGO stage IB through IVA) treated with concurrent chemoradiotherapy. Low-enhancing tumor volume (LETV) and low-enhancing tumor fraction (LETF), defined as the volume and fractional volume of low-enhancing voxels, respectively, were calculated from signal intensities recorded within 1 min after contrast administration by using two methods reported to give conflicting conclusions. RESULTS Multivariate analysis involving tumor volume, lymph node status, FIGO stage, and LETV or LETF revealed that LETV and LETF provided independent prognostic information on treatment outcome, independent of the method of calculation. CONCLUSION Low signal enhancement is associated with poor prognosis in cervical carcinoma, and biomarkers predicting poor outcome can be provided by short-term DCE-MRI without advanced image analysis.
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Affiliation(s)
- Kjersti V Lund
- Department of Radiation Biology, Institute for Cancer Research, Norway; Department of Radiology and Nuclear Medicine, Norway
| | - Trude G Simonsen
- Department of Radiation Biology, Institute for Cancer Research, Norway
| | - Tord Hompland
- Department of Radiation Biology, Institute for Cancer Research, Norway
| | - Gunnar B Kristensen
- Department of Gynecological Cancer, Norway; Institute for Cancer Genetics and Informatics, Oslo University Hospital, Norway; Institute for Clinical Medicine, University of Oslo, Norway
| | - Einar K Rofstad
- Department of Radiation Biology, Institute for Cancer Research, Norway.
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Øvrebø KM, Ellingsen C, Hompland T, Rofstad EK. Dynamic contrast-enhanced magnetic resonance imaging of the metastatic potential of tumors: a preclinical study of cervical carcinoma and melanoma xenografts. Acta Oncol 2013; 52:604-11. [PMID: 22671573 DOI: 10.3109/0284186x.2012.689851] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Gadolinium diethylene-triamine penta-acetic acid (Gd-DTPA)-based dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been suggested to be a useful non-invasive method for providing biomarkers for personalized cancer treatment. In this preclinical study, we investigated whether Gd-DTPA-based DCE-MRI may have the potential to differentiate between poorly and highly metastatic tumors. MATERIAL AND METHODS CK-160 cervical carcinoma and V-27 melanoma xenografts were used as tumor models. Fifty-six tumors were imaged, and parametric images of K(trans) (the volume transfer constant of Gd-DTPA) and v(e) (the fractional distribution volume of Gd-DTPA) were produced by pharmacokinetic analysis of the DCE-MRI series. The host mice were examined for lymph node metastases immediately after the DCE-MRI. RESULTS Highly metastatic tumors showed lower values for median K(trans) than poorly metastatic tumors (p = 0.00033, CK-160; p < 0.00001, V-27). Median v(e) was lower for highly than for poorly metastatic V-27 tumors (p = 0.047), but did not differ significantly between metastatic and non-metastatic CK-160 tumors (p > 0.05). CONCLUSION This study supports the clinical attempts to establish DCE-MRI as a method for providing biomarkers for tumor aggressiveness and suggests that tumors showing low K(trans) and low ve values may have high probability of lymphogenous metastatic dissemination.
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Affiliation(s)
- Kirsti Marie Øvrebø
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital,
Oslo, Norway
| | - Christine Ellingsen
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital,
Oslo, Norway
| | - Tord Hompland
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital,
Oslo, Norway
| | - Einar K. Rofstad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital,
Oslo, Norway
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De Bruyne S, Van Damme N, Smeets P, Ferdinande L, Ceelen W, Mertens J, Van de Wiele C, Troisi R, Libbrecht L, Laurent S, Geboes K, Peeters M. Value of DCE-MRI and FDG-PET/CT in the prediction of response to preoperative chemotherapy with bevacizumab for colorectal liver metastases. Br J Cancer 2012; 106:1926-33. [PMID: 22596235 PMCID: PMC3388560 DOI: 10.1038/bjc.2012.184] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: The purpose of this study was to assess the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) for evaluation of response to chemotherapy and bevacizumab and for prediction of progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) with potentially resectable liver lesions. Methods: A total of 19 mCRC patients were treated with FOLFOX/FOLFIRI and bevacizumab followed by surgery. Dynamic contrast-enhanced magnetic resonance imaging and FDG-PET/CT were performed before treatment and after cycle 5. PET results were quantified by calculating maximum standardised uptake value (SUVmax) whereas area under the enhancement curve (AUC), initial AUC (iAUC) and the endothelial transfer constant (Ktrans) were used to quantify DCE-MRI. Pathological analysis of the resection specimen was performed, including measurement of microvessel density (MVD) and proliferation index. Results: Both AUC and iAUC were significantly decreased following bevacizumab therapy (median change of 22% (P=0.002) and 40% (P=0.001) for AUC and iAUC, respectively). Progression-free survival benefit was shown for patients with >40% reduction in Ktrans (P=0.019). In the group of radiological responders, the median baseline SUVmax was 3.77 (IQR: 2.88–5.60) compared with 7.20 (IQR: 4.67–8.73) in nonresponders (P=0.021). A higher follow-up SUVmax was correlated with worse PFS (P=0.012). Median MVD was 10.9. Progression-free survival was significantly shorter in patients with an MVD greater than 10, compared with patients with lower MVD (10 months compared with 16 months, P=0.016). Conclusion: High relative decrease in Ktrans, low follow-up SUVmax and low MVD are favourable prognostic factors for mCRC patients treated with bevacizumab before surgery.
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Affiliation(s)
- S De Bruyne
- Department of Respiratory Medicine, Ghent University Hospital, Belgium
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