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Qin W, Chandra J, Abourehab MAS, Gupta N, Chen ZS, Kesharwani P, Cao HL. New opportunities for RGD-engineered metal nanoparticles in cancer. Mol Cancer 2023; 22:87. [PMID: 37226188 DOI: 10.1186/s12943-023-01784-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023] Open
Abstract
The advent of nanotechnology has opened new possibilities for bioimaging. Metal nanoparticles (such as gold, silver, iron, copper, etc.) hold tremendous potential and offer enormous opportunities for imaging and diagnostics due to their broad optical characteristics, ease of manufacturing technique, and simple surface modification. The arginine-glycine-aspartate (RGD) peptide is a three-amino acid sequence that seems to have a considerably greater ability to adhere to integrin adhesion molecules that exclusively express on tumour cells. RGD peptides act as the efficient tailoring ligand with a variety of benefits including non-toxicity, greater precision, rapid clearance, etc. This review focuses on the possibility of non-invasive cancer imaging using metal nanoparticles with RGD assistance.
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Affiliation(s)
- Wei Qin
- Xi'an Key Laboratory of Basic and Translation of Cardiovascular Metabolic Disease, College of Pharmacy, Xi'an Medical University, Xi'an, 710021, China
| | - Jyoti Chandra
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Mohammed A S Abourehab
- Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Neelima Gupta
- Dr. Harisingh Gour Vishwavidyalaya (A Central University), Sagar, Madhya Pradesh, 470003, India
| | - Zhe-Sheng Chen
- Institute for Biotechnology, College of Pharmacy and Health Sciences, St. John's University, Queens, New York, 11439, USA
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical science, Chennai, India.
| | - Hui-Ling Cao
- Xi'an Key Laboratory of Basic and Translation of Cardiovascular Metabolic Disease, College of Pharmacy, Xi'an Medical University, Xi'an, 710021, China.
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Molecular MRI-Based Monitoring of Cancer Immunotherapy Treatment Response. Int J Mol Sci 2023; 24:ijms24043151. [PMID: 36834563 PMCID: PMC9959624 DOI: 10.3390/ijms24043151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Immunotherapy constitutes a paradigm shift in cancer treatment. Its FDA approval for several indications has yielded improved prognosis for cases where traditional therapy has shown limited efficiency. However, many patients still fail to benefit from this treatment modality, and the exact mechanisms responsible for tumor response are unknown. Noninvasive treatment monitoring is crucial for longitudinal tumor characterization and the early detection of non-responders. While various medical imaging techniques can provide a morphological picture of the lesion and its surrounding tissue, a molecular-oriented imaging approach holds the key to unraveling biological effects that occur much earlier in the immunotherapy timeline. Magnetic resonance imaging (MRI) is a highly versatile imaging modality, where the image contrast can be tailored to emphasize a particular biophysical property of interest using advanced engineering of the imaging pipeline. In this review, recent advances in molecular-MRI based cancer immunotherapy monitoring are described. Next, the presentation of the underlying physics, computational, and biological features are complemented by a critical analysis of the results obtained in preclinical and clinical studies. Finally, emerging artificial intelligence (AI)-based strategies to further distill, quantify, and interpret the image-based molecular MRI information are discussed in terms of perspectives for the future.
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You J, Pan C, Park K, Li A, Du C. In vivo detection of tumor boundary using ultrahigh-resolution optical coherence angiography and fluorescence imaging. JOURNAL OF BIOPHOTONICS 2020; 13:e201960091. [PMID: 31778294 PMCID: PMC7446292 DOI: 10.1002/jbio.201960091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/22/2019] [Accepted: 11/17/2019] [Indexed: 06/01/2023]
Abstract
Accurate detection of early tumor margin is of great preclinical and clinical implications for predicting the survival rate of subjects and assessing the response of tumor microenvironment to chemotherapy or radiation therapy. Here, we report a multimodality optical imaging study on in vivo detection of tumor boundary by analyzing neoangiogenesis of tumor microenvironment (microangiography), microcirculatory blood flow (optical Doppler tomography) and tumor proliferation (green fluorescent protein [GFP] fluorescence). Microangiography demonstrates superior sensitivity (77.7 ± 6.4%) and specificity (98.2 ± 1.7%) over other imaging technologies (eg, optical coherence tomography) for tumor margin detection. Additionally, we report longitudinal in vivo imaging of tumor progression and show that the abrupt tumor cell proliferation did not occur until local capillary density and cerebral blood flow reached their peak approximately 2 weeks after tumor implantation. The unique capability of longitudinal multimodality imaging of tumor angiogenesis may provide new insights in tumor biology and in vivo assessment of the treatment effects on anti-angiogenesis therapy for brain cancer.
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Affiliation(s)
- Jiang You
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Chelsea Pan
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Kicheon Park
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Ang Li
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Congwu Du
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
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5
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Urbano N, Scimeca M, Bonfiglio R, Bonanno E, Schillaci O. New advance in breast cancer pathology and imaging. Future Oncol 2019; 15:2707-2722. [DOI: 10.2217/fon-2019-0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The improvement of knowledge concerning the pathology of breast cancer could provide the rationale for the development of new imaging diagnostic protocols. Indeed, as for the microcalcifications, new histopathological markers can be used as target for in vivo early detection of breast cancer lesions by using molecular imaging techniques such as positron emission tomography. Specifically, the mutual contribution of these medical specialties can ‘nourish’ the dream of a personalized medicine that takes into account the intrinsic variability of breast cancer. In this review, we report the main discoveries concerning breast cancer pathology highlighting the possible cooperation between the departments of anatomic pathology and imaging diagnostics.
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Affiliation(s)
- Nicoletta Urbano
- Nuclear Medicine, Policlinico ‘Tor Vergata,’ viale Oxford, 81, Rome, 00133, Italy
| | - Manuel Scimeca
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS San Raffaele, Via di Val Cannuta 247, 00166, Rome, Italy
- Fondazione Umberto Veronesi (FUV), Piazza Velasca 5, 20122 Milano (Mi), Italy
| | - Rita Bonfiglio
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
| | - Elena Bonanno
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- Neuromed Group, ‘Diagnostica Medica’ & ‘Villa dei Platani', Via Errico Carmelo, 2, 83100 Avellino AV, Italy
| | - Orazio Schillaci
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS Neuromed, Pozzilli, Italy
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6
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Gabriele P, Malinverni G, Moroni GL, Gatti M, Regge D, Versari A, Serafini D, Fraternali A, Salvo D. The Impact of 18F-deoxyglucose Positron Emission Tomography on Tumor Staging, Treatment Strategy and Treatment Planning for Radiotherapy in a Department of Radiation Oncology. TUMORI JOURNAL 2018; 90:579-85. [PMID: 15762360 DOI: 10.1177/030089160409000608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background The study analyzed the potential contribution of positron emission tomography (PET) in patient selection for radiotherapy and in radiation therapy planning. Methods Eighty-seven patients with a histological cancer diagnosis were accrued for the study from December 2000 to December 2001. Demographic characteristics included a median age of 54 years and male/female ratio of 51/36. All patients staged by conventional workup who were candidates for radiotherapy had PET imaging and were allocated to a conventional “pre/post-PET stage”. The treatment protocol and the shape and/or size of the portals was directly related to PET results. We examined 26 lung cancers, 15 gastrointestinal tumors, 22 genitourinary cancers and 24 hematologic malignancies. Results In the lung cancer group, the stage was modified in 10/26 patients (38.5%) by PET, with a change in management in 13 (50%) and a change in radiotherapy planning in 6 (23.1%). In the hematological group, stage was modified by PET in 8/24 cases (33.3%), with a change in treatment strategy in 9 (37.5%) and a change in radiotherapy planning in 3 (12.5%). In the gastrointestinal group, the stage was modified by PET in 2/15 cases (13.4%), with a change inn treatment strategy in 4 (26.7%) and a change in the decision for radiotherapy in 8 (no radiotherapy in 53.3%). In the mixed group (genitourinary, breast and other), the stage was modified by PET in 6/22 cases (27.3%), with a change in treatment strategy in 11 (50%) and a very low rate of change in radiotherapy planning. Conclusions PET contributed to a modification of stage in 26/87 patients (30%), to a changing in treatment strategy in 37/87 (42.5%), and to a substantial change of the shape and/or size of radiotherapy portals in 13/43 (30%) who underwent radiotherapy.
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Affiliation(s)
- Pietro Gabriele
- Radiation Therapy Unit, Institute for Cancer Research and Treatment (IRCC), Candiolo (TO), Italy
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7
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Scimeca M, Urbano N, Bonfiglio R, Schillaci O, Bonanno E. Management of oncological patients in the digital era: anatomic pathology and nuclear medicine teamwork. Future Oncol 2018; 14:1013-1015. [PMID: 29623724 DOI: 10.2217/fon-2017-0698] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Manuel Scimeca
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCCS San Raffaele, Via di Val Cannuta 247, Rome 00166, Italy.,OrchideaLab S.r.l., Via del Grecale 6, Morlupo, Rome (RM) 000674, Italy
| | | | - Rita Bonfiglio
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy
| | - Orazio Schillaci
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCCS Neuromed, Pozzilli 860777, Italy
| | - Elena Bonanno
- Department of Experimental Medicine & Surgery, University 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCSS Neuromed Lab. 'Diagnostica Medica' & 'Villa dei Platani', Avellino 83100, Italy
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8
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Lazzeroni M, Uhrdin J, Carvalho S, van Elmpt W, Lambin P, Dasu A, Wersäll P, Toma-Dasu I. Evaluation of third treatment week as temporal window for assessing responsiveness on repeated FDG-PET-CT scans in Non-Small Cell Lung Cancer patients. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Uehara T, Watanabe M, Suzuki H, Furusawa Y, Arano Y. Amino acid transport system - A substrate predicts the therapeutic effects of particle radiotherapy. PLoS One 2017; 12:e0173096. [PMID: 28245294 PMCID: PMC5330493 DOI: 10.1371/journal.pone.0173096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 02/15/2017] [Indexed: 11/19/2022] Open
Abstract
L-[methyl-11C]Methionine (11C-Met) is useful for estimating the therapeutic efficacy of particle radiotherapy at early stages of the treatment. Given the short half-life of 11C, the development of longer-lived 18F- and 123I-labeled probes that afford diagnostic information similar to 11C-Met, are being sought. Tumor uptake of 11C-Met is involved in many cellular functions such as amino acid transport System-L, protein synthesis, and transmethylation. Among these processes, since the energy-dependent intracellular functions involved with 11C-Met are more reflective of the radiotherapeutic effects, we evaluated the activity of the amino acid transport System-A as an another energy-dependent cellular function in order to estimate radiotherapeutic effects. In this study, using a carbon-ion beam as the radiation source, the activity of System-A was evaluated by a specific System-A substrate, alpha-[1-14C]-methyl-aminoisobutyric acid (14C-MeAIB). Cellular growth and the accumulation of 14C-MeAIB or 14C-Met were evaluated over time in vitro in cultured human salivary gland (HSG) tumor cells (3-Gy) or in vivo in murine xenografts of HSG tumors (6- or 25-Gy) before and after irradiation with the carbon-ion beam. Post 3-Gy irradiation, in vitro accumulation of 14C-Met and 14C-MeAIB decreased over a 5-day period. In xenografts of HSG tumors in mice, tumor re-growth was observed in vivo on day-10 after a 6-Gy irradiation dose, but no re-growth was detected after the 25-Gy irradiation dose. Consistent with the growth results, the in vivo tumor accumulation of 14C-MeAIB did not decrease after the 6-Gy irradiation dose, whereas a significant decrease was observed after the 25-Gy irradiation dose. These results indicate that the activity of energy dependent System-A transporter may reflect the therapeutic efficacy of carbon-ion radiotherapy and suggests that longer half-life radionuclide-labeled probes for System-A may also provide widely available probes to evaluate the effects of particle radiotherapy on tumors at early stage of the treatment.
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Affiliation(s)
- Tomoya Uehara
- Department of Molecular Imaging and Radiotherapy, Graduate School of Pharmaceutical Science, Chiba University, Chiba, Japan
- * E-mail:
| | - Mariko Watanabe
- Department of Molecular Imaging and Radiotherapy, Graduate School of Pharmaceutical Science, Chiba University, Chiba, Japan
| | - Hiroyuki Suzuki
- Department of Molecular Imaging and Radiotherapy, Graduate School of Pharmaceutical Science, Chiba University, Chiba, Japan
| | - Yoshiya Furusawa
- National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Yasushi Arano
- Department of Molecular Imaging and Radiotherapy, Graduate School of Pharmaceutical Science, Chiba University, Chiba, Japan
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10
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Koch M, de Jong JS, Glatz J, Symvoulidis P, Lamberts LE, Adams ALL, Kranendonk MEG, Terwisscha van Scheltinga AGT, Aichler M, Jansen L, de Vries J, Lub-de Hooge MN, Schröder CP, Jorritsma-Smit A, Linssen MD, de Boer E, van der Vegt B, Nagengast WB, Elias SG, Oliveira S, Witkamp AJ, Mali WPTM, Van der Wall E, Garcia-Allende PB, van Diest PJ, de Vries EGE, Walch A, van Dam GM, Ntziachristos V. Threshold Analysis and Biodistribution of Fluorescently Labeled Bevacizumab in Human Breast Cancer. Cancer Res 2016; 77:623-631. [PMID: 27879266 DOI: 10.1158/0008-5472.can-16-1773] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/06/2016] [Accepted: 10/24/2016] [Indexed: 11/16/2022]
Abstract
In vivo tumor labeling with fluorescent agents may assist endoscopic and surgical guidance for cancer therapy as well as create opportunities to directly observe cancer biology in patients. However, malignant and nonmalignant tissues are usually distinguished on fluorescence images by applying empirically determined fluorescence intensity thresholds. Here, we report the development of fSTREAM, a set of analytic methods designed to streamline the analysis of surgically excised breast tissues by collecting and statistically processing hybrid multiscale fluorescence, color, and histology readouts toward precision fluorescence imaging. fSTREAM addresses core questions of how to relate fluorescence intensity to tumor tissue and how to quantitatively assign a normalized threshold that sufficiently differentiates tumor tissue from healthy tissue. Using fSTREAM we assessed human breast tumors stained in vivo with fluorescent bevacizumab at microdose levels. Showing that detection of such levels is achievable, we validated fSTREAM for high-resolution mapping of the spatial pattern of labeled antibody and its relation to the underlying cancer pathophysiology and tumor border on a per patient basis. We demonstrated a 98% sensitivity and 79% specificity when using labeled bevacizumab to outline the tumor mass. Overall, our results illustrate a quantitative approach to relate fluorescence signals to malignant tissues and improve the theranostic application of fluorescence molecular imaging. Cancer Res; 77(3); 623-31. ©2016 AACR.
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Affiliation(s)
- Maximilian Koch
- Chair for Biological Imaging, Technical University of Munich, München, Germany.,Institute for Biological and Medical Imaging, Helmholtz Zentrum München, München, Germany
| | - Johannes S de Jong
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jürgen Glatz
- Chair for Biological Imaging, Technical University of Munich, München, Germany.,Institute for Biological and Medical Imaging, Helmholtz Zentrum München, München, Germany
| | - Panagiotis Symvoulidis
- Chair for Biological Imaging, Technical University of Munich, München, Germany.,Institute for Biological and Medical Imaging, Helmholtz Zentrum München, München, Germany
| | - Laetitia E Lamberts
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arthur L L Adams
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Anton G T Terwisscha van Scheltinga
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Hospital and Clinical Pharmacy, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Michaela Aichler
- Research Unit Analytical Pathology, Helmholtz Zentrum München, München, Germany
| | - Liesbeth Jansen
- Department of Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jakob de Vries
- Department of Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Marjolijn N Lub-de Hooge
- Hospital and Clinical Pharmacy, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Carolien P Schröder
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annelies Jorritsma-Smit
- Hospital and Clinical Pharmacy, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Matthijs D Linssen
- Hospital and Clinical Pharmacy, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Esther de Boer
- Department of Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Wouter B Nagengast
- Department of Gastroenterology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sjoerd G Elias
- Julius Center for Health Sciences and Primary Care, Cell Biology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sabrina Oliveira
- Department of Biology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Arjen J Witkamp
- Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Willem P T M Mali
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elsken Van der Wall
- Department of Medical Oncology, Utrecht University, University Medical Center Utrecht, Utrecht, the Netherlands
| | - P Beatriz Garcia-Allende
- Chair for Biological Imaging, Technical University of Munich, München, Germany.,Institute for Biological and Medical Imaging, Helmholtz Zentrum München, München, Germany
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Axel Walch
- Research Unit Analytical Pathology, Helmholtz Zentrum München, München, Germany
| | - Gooitzen M van Dam
- Department of Surgery, University of Groningen, University Medical Center Groningen, the Netherlands.,Department of Nuclear Medicine and Molecular Imaging and Intensive Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Vasilis Ntziachristos
- Chair for Biological Imaging, Technical University of Munich, München, Germany. .,Institute for Biological and Medical Imaging, Helmholtz Zentrum München, München, Germany
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Muhanna N, Cui L, Chan H, Burgess L, Jin CS, MacDonald TD, Huynh E, Wang F, Chen J, Irish JC, Zheng G. Multimodal Image-Guided Surgical and Photodynamic Interventions in Head and Neck Cancer: From Primary Tumor to Metastatic Drainage. Clin Cancer Res 2015; 22:961-70. [PMID: 26463705 DOI: 10.1158/1078-0432.ccr-15-1235] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/24/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The low survival rate of head and neck cancer (HNC) patients is attributable to late disease diagnosis and high recurrence rate. Current HNC staging has inadequate accuracy and low sensitivity for effective diagnosis and treatment management. The multimodal porphyrin lipoprotein-mimicking nanoparticle (PLP), intrinsically capable of positron emission tomography (PET), fluorescence imaging, and photodynamic therapy (PDT), shows great potential to enhance the accuracy of HNC staging and potentially HNC management. EXPERIMENTAL DESIGN Using a clinically relevant VX-2 buccal carcinoma rabbit model that is able to consistently develop metastasis to regional lymph nodes after tumor induction, we investigated the abilities of PLP for HNC diagnosis and management. RESULTS PLPs facilitated accurate detection of primary tumor and metastatic nodes (their PET image signal to surrounding muscle ratios were 10.0 and 7.3, respectively), and provided visualization of the lymphatic drainage from tumor to regional lymph nodes by both preoperative PET and intraoperative fluorescence imaging, allowing the identification of unknown primaries and recurrent tumors. PLP-PDT significantly enhanced cell apoptosis in mouse tumors (73.2% of PLP-PDT group vs 7.1% of PLP alone group) and demonstrated complete eradication of primary tumors and obstruction of tumor metastasis in HNC rabbit model without toxicity in normal tissues or damage to adjacent critical structures. CONCLUSIONS PLPs provide a multimodal imaging and therapy platform that could enhance HNC diagnosis by integrating PET/computed tomography and fluorescence imaging, and improve HNC therapeutic efficacy and specificity by tailoring treatment via fluorescence-guided surgery and PDT.
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Affiliation(s)
- Nidal Muhanna
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Liyang Cui
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada. Medical Isotopes Research Center, Peking University, Beijing, China
| | - Harley Chan
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Laura Burgess
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Cheng S Jin
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Thomas D MacDonald
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada
| | - Elizabeth Huynh
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Fan Wang
- Medical Isotopes Research Center, Peking University, Beijing, China
| | - Juan Chen
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada.
| | - Jonathan C Irish
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.
| | - Gang Zheng
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.
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12
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Jentsch C, Beuthien-Baumann B, Troost EGC, Shakirin G. Validation of functional imaging as a biomarker for radiation treatment response. Br J Radiol 2015; 88:20150014. [PMID: 26083533 DOI: 10.1259/bjr.20150014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Major advances in radiotherapy techniques, increasing knowledge of tumour biology and the ability to translate these advances into new therapeutic approaches are important goals towards more individualized cancer treatment. With the development of non-invasive functional and molecular imaging techniques such as positron emission tomography (PET)-CT scanning and MRI, there is now a need to evaluate potential new biomarkers for tumour response prediction, for treatment individualization is not only based on morphological criteria but also on biological tumour characteristics. The goal of individualization of radiotherapy is to improve treatment outcome and potentially reduce chronic treatment toxicity. This review gives an overview of the molecular and functional imaging modalities of tumour hypoxia and tumour cell metabolism, proliferation and perfusion as predictive biomarkers for radiation treatment response in head and neck tumours and in lung tumours. The current status of knowledge on integration of PET/CT/MRI into treatment management and bioimage-guided adaptive radiotherapy are discussed.
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Affiliation(s)
- C Jentsch
- 1 OncoRay-National Centre for Radiation Research in Oncology, Dresden, Germany.,2 Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden,Helmholtz-Zentrum Dresden-Rossendorf, Germany.,3 German Cancer Consortium (DKTK) Dresden, Germany
| | - B Beuthien-Baumann
- 1 OncoRay-National Centre for Radiation Research in Oncology, Dresden, Germany.,3 German Cancer Consortium (DKTK) Dresden, Germany.,4 Institute of Radiation Oncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - E G C Troost
- 1 OncoRay-National Centre for Radiation Research in Oncology, Dresden, Germany.,2 Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden,Helmholtz-Zentrum Dresden-Rossendorf, Germany.,3 German Cancer Consortium (DKTK) Dresden, Germany.,4 Institute of Radiation Oncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
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13
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Tsuji AB, Sugyo A, Sudo H, Suzuki C, Wakizaka H, Zhang MR, Kato K, Saga T. Preclinical assessment of early tumor response after irradiation by positron emission tomography with 2-amino-[3-¹¹C]isobutyric acid. Oncol Rep 2015; 33:2361-7. [PMID: 25813536 DOI: 10.3892/or.2015.3868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/09/2015] [Indexed: 11/06/2022] Open
Abstract
The positron emission tomography (PET) probe, 2-amino-[3-¹¹C]isobutyric acid ([3-¹¹C]AIB), is reported to accumulate less in inflammatory lesions than 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) and has the potential for evaluation of the efficacy of radiotherapy. To determine whether [3-¹¹C]AIB is useful to monitor early metabolic change in tumors after radiotherapy, we evaluated the temporal change in [3-¹¹C]AIB tumor uptake, tumor volume, histological features and expression of amino acid transporters early after radiotherapy in a mouse tumor model. PET with [3-¹¹C]AIB was conducted in mice bearing a subcutaneous tumor (SY, derived from small cell lung cancer) in two schedules: schedule 1, before (day -1) and after (days 1 and 3) 15 Gy of radiation and schedule 2, days -1, 1 and 5. [3-¹¹C]AIB tumor uptake tended to increase on day 1 after irradiation and decreased thereafter. Tumor uptake was not correlated with tumor volume in schedule 1. Although tumor uptake was correlated with tumor volume in schedule 2, this correlation was lost when the day 5 data of greatly reduced tumor volumes were excluded. In a separate group of tumor-bearing mice, excised tumor sections were stained with terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) or anti-Ki-67 antibody. There was no correlation between tumor uptake and percentages of TUNEL- or Ki-67-positive cells. Expression of amino acid transporters, SLC38A1, SLC38A2 and SLC38A4, was determined by real-time RT-PCR. SLC38A1 and SLC38A2 were expressed in SY tumors, and a significant correlation was observed between [3-¹¹C]AIB tumor uptake and SLC38A1 expression. In conclusion, early change in [3-¹¹C]AIB tumor uptake after irradiation reflected the temporal change in amino acid transporter expression, while it was independent of change in tumor volume, apoptosis and cell proliferation. PET with [3-¹¹C]AIB has the potential for use in non-invasive evaluation of early metabolic change after irradiation before morphological change of tumors.
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Affiliation(s)
- Atsushi B Tsuji
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Aya Sugyo
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Hitomi Sudo
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Chie Suzuki
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Hidekatsu Wakizaka
- Biophysics Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Ming-Rong Zhang
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Koichi Kato
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
| | - Tsuneo Saga
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Inage-ku, Chiba 263-8555, Japan
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14
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Bradshaw TJ, Bowen SR, Deveau MA, Kubicek L, White P, Bentzen SM, Chappell RJ, Forrest LJ, Jeraj R. Molecular imaging biomarkers of resistance to radiation therapy for spontaneous nasal tumors in canines. Int J Radiat Oncol Biol Phys 2015; 91:787-95. [PMID: 25752393 PMCID: PMC4355478 DOI: 10.1016/j.ijrobp.2014.12.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/26/2014] [Accepted: 12/04/2014] [Indexed: 12/12/2022]
Abstract
PURPOSE Imaging biomarkers of resistance to radiation therapy can inform and guide treatment management. Most studies have so far focused on assessing a single imaging biomarker. The goal of this study was to explore a number of different molecular imaging biomarkers as surrogates of resistance to radiation therapy. METHODS AND MATERIALS Twenty-two canine patients with spontaneous sinonasal tumors were treated with accelerated hypofractionated radiation therapy, receiving either 10 fractions of 4.2 Gy each or 10 fractions of 5.0 Gy each to the gross tumor volume. Patients underwent fluorodeoxyglucose (FDG)-, fluorothymidine (FLT)-, and Cu(II)-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM)-labeled positron emission tomography/computed tomography (PET/CT) imaging before therapy and FLT and Cu-ATSM PET/CT imaging during therapy. In addition to conventional maximum and mean standardized uptake values (SUV(max); SUV(mean)) measurements, imaging metrics providing response and spatiotemporal information were extracted for each patient. Progression-free survival was assessed according to response evaluation criteria in solid tumor. The prognostic value of each imaging biomarker was evaluated using univariable Cox proportional hazards regression. Multivariable analysis was also performed but was restricted to 2 predictor variables due to the limited number of patients. The best bivariable model was selected according to pseudo-R(2). RESULTS The following variables were significantly associated with poor clinical outcome following radiation therapy according to univariable analysis: tumor volume (P=.011), midtreatment FLT SUV(mean) (P=.018), and midtreatment FLT SUV(max) (P=.006). Large decreases in FLT SUV(mean) from pretreatment to midtreatment were associated with worse clinical outcome (P=.013). In the bivariable model, the best 2-variable combination for predicting poor outcome was high midtreatment FLT SUV(max) (P=.022) in combination with large FLT response from pretreatment to midtreatment (P=.041). CONCLUSIONS In addition to tumor volume, pronounced tumor proliferative response quantified using FLT PET, especially when associated with high residual FLT PET at midtreatment, is a negative prognostic biomarker of outcome in canine tumors following radiation therapy. Neither FDG PET nor Cu-ATSM PET were predictive of outcome.
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Affiliation(s)
- Tyler J Bradshaw
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stephen R Bowen
- Departments of Radiation Oncology and Radiology, University of Washington, Seattle, Washington
| | - Michael A Deveau
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | | | - Pamela White
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Richard J Chappell
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lisa J Forrest
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Robert Jeraj
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
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15
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Indium-111 labeled gold nanoparticles for in-vivo molecular targeting. Biomaterials 2014; 35:7050-7. [DOI: 10.1016/j.biomaterials.2014.04.098] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/24/2014] [Indexed: 12/22/2022]
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16
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Munley MT, Kagadis GC, McGee KP, Kirov AS, Jang S, Mutic S, Jeraj R, Xing L, Bourland JD. An introduction to molecular imaging in radiation oncology: a report by the AAPM Working Group on Molecular Imaging in Radiation Oncology (WGMIR). Med Phys 2014; 40:101501. [PMID: 24089890 DOI: 10.1118/1.4819818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Molecular imaging is the direct or indirect noninvasive monitoring and recording of the spatial and temporal distribution of in vivo molecular, genetic, and/or cellular processes for biochemical, biological, diagnostic, or therapeutic applications. Molecular images that indicate the presence of malignancy can be acquired using optical, ultrasonic, radiologic, radionuclide, and magnetic resonance techniques. For the radiation oncology physicist in particular, these methods and their roles in molecular imaging of oncologic processes are reviewed with respect to their physical bases and imaging characteristics, including signal intensity, spatial scale, and spatial resolution. Relevant molecular terminology is defined as an educational assist. Current and future clinical applications in oncologic diagnosis and treatment are discussed. National initiatives for the development of basic science and clinical molecular imaging techniques and expertise are reviewed, illustrating research opportunities in as well as the importance of this growing field.
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Affiliation(s)
- Michael T Munley
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
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17
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De Neve W, Duthoy W. Intensity-modulated radiation therapy for head and neck cancer. Expert Rev Anticancer Ther 2014; 4:425-34. [PMID: 15161441 DOI: 10.1586/14737140.4.3.425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In head and neck cancer, intensity-modulated radiation therapy (IMRT) makes the use of electron beams for irradiation of the posterior neck obsolete, inherently performs missing tissue compensation, and allows concave and intentionally nonhomogeneous dose distributions. By clinical use of these physical characteristics, salivary or lacrimal glands, optic pathway and auditory structures can be selectively underdosed and good evidence of decreased radiation toxicity is available. Evidence for increased local control is still lacking. Recurrences are mainly located in the high-dose-prescription regions, suggesting the need for even higher doses in these areas. Image-aided design of IMRT dose distribution is an area of intense research. New positron emission tomography and magnetic resonance imaging developments might allow definition of volumes inside the tumor where treatment failure is most likely to occur. If these volumes are small, focused dose escalation of large magnitude can be attempted and the hypothesis of improved local control by IMRT can be tested.
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Affiliation(s)
- Wilfried De Neve
- Ghent University Hospital, Department of Radiotherapy, De Pintelaan 185, 9000 Gent, Belgium.
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18
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Hiramatsu R, Kawabata S, Furuse M, Miyatake SI, Kuroiwa T. Identification of early and distinct glioblastoma response patterns treated by boron neutron capture therapy not predicted by standard radiographic assessment using functional diffusion map. Radiat Oncol 2013; 8:192. [PMID: 23915330 PMCID: PMC3751226 DOI: 10.1186/1748-717x-8-192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/30/2013] [Indexed: 12/21/2022] Open
Abstract
Background Radiologic response of brain tumors is traditionally assessed according to the Macdonald criteria 10 weeks from the start of therapy. Because glioblastoma (GB) responds in days rather than weeks after boron neutron capture therapy (BNCT) that is a form of tumor-selective particle radiation, it is inconvenient to use the Macdonald criteria to assess the therapeutic efficacy of BNCT by gadolinium-magnetic resonance imaging (Gd-MRI). Our study assessed the utility of functional diffusion map (fDM) for evaluating response patterns in GB treated by BNCT. Methods The fDM is an image assessment using time-dependent changes of apparent diffusion coefficient (ADC) in tumors on a voxel-by-voxel approach. Other than time-dependent changes of ADC, fDM can automatically assess minimum/maximum ADC, Response Evaluation Criteria In Solid Tumors (RECIST), and the volume of enhanced lesions on Gd-MRI over time. We assessed 17 GB patients treated by BNCT using fDM. Additionally, in order to verify our results, we performed a histopathological examination using F98 rat glioma models. Results Only the volume of tumor with decreased ADC by fDM at 2 days after BNCT was a good predictor for GB patients treated by BNCT (P value = 0.022 by log-rank test and 0.033 by wilcoxon test). In a histopathological examination, brain sections of F98 rat glioma models treated by BNCT showed cell swelling of both the nuclei and the cytoplasm compared with untreated rat glioma models. Conclusions The fDM could identify response patterns in BNCT-treated GB earlier than a standard radiographic assessment. Early detection of treatment failure can allow a change or supplementation before tumor progression and might lead to an improvement of GB patients’ prognosis.
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Affiliation(s)
- Ryo Hiramatsu
- Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
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19
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Meng ZJ, Sajib SZK, Chauhan M, Sadleir RJ, Kim HJ, Kwon OI, Woo EJ. Numerical simulations of MREIT conductivity imaging for brain tumor detection. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:704829. [PMID: 23737862 PMCID: PMC3657440 DOI: 10.1155/2013/704829] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/21/2013] [Accepted: 04/05/2013] [Indexed: 01/21/2023]
Abstract
Magnetic resonance electrical impedance tomography (MREIT) is a new modality capable of imaging the electrical properties of human body using MRI phase information in conjunction with external current injection. Recent in vivo animal and human MREIT studies have revealed unique conductivity contrasts related to different physiological and pathological conditions of tissues or organs. When performing in vivo brain imaging, small imaging currents must be injected so as not to stimulate peripheral nerves in the skin, while delivery of imaging currents to the brain is relatively small due to the skull's low conductivity. As a result, injected imaging currents may induce small phase signals and the overall low phase SNR in brain tissues. In this study, we present numerical simulation results of the use of head MREIT for brain tumor detection. We used a realistic three-dimensional head model to compute signal levels produced as a consequence of a predicted doubling of conductivity occurring within simulated tumorous brain tissues. We determined the feasibility of measuring these changes in a time acceptable to human subjects by adding realistic noise levels measured from a candidate 3 T system. We also reconstructed conductivity contrast images, showing that such conductivity differences can be both detected and imaged.
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Affiliation(s)
- Zi Jun Meng
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
| | - Saurav Z. K. Sajib
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
| | - Munish Chauhan
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
| | - Rosalind J. Sadleir
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Hyung Joong Kim
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
| | - Oh In Kwon
- Department of Mathematics, Konkuk University, Seoul, Republic of Korea
| | - Eung Je Woo
- Department of Biomedical Engineering, Impedance Imaging Research Center (IIRC), Kyung Hee University, Yongin, Republic of Korea
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20
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Fatema CN, Zhao S, Zhao Y, Murakami M, Yu W, Nishijima KI, Tamaki N, Kitagawa Y, Kuge Y. Monitoring tumor proliferative response to radiotherapy using (18)F-fluorothymidine in human head and neck cancer xenograft in comparison with Ki-67. Ann Nucl Med 2013; 27:355-62. [PMID: 23417197 DOI: 10.1007/s12149-013-0693-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 01/22/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although radiotherapy is an important treatment strategy for head and neck cancers, it induces tumor repopulation which adversely affects therapeutic outcome. In this regard, fractionated radiotherapy is widely applied to prevent tumor repopulation. Evaluation of tumor proliferative activity using (18)F-fluorothymidine (FLT), a noninvasive marker of tumor proliferation, may be useful for determining the optimal timing of and dose in the repetitive irradiation. Thus, to assess the potentials of FLT, we evaluated the sequential changes in intratumoral proliferative activity in head and neck cancer xenografts (FaDu) using FLT. METHODS FaDu tumor xenografts were established in nude mice and assigned to control and two radiation-treated groups (10 and 20 Gy). Tumor volume was measured daily. (3)H-FLT was injected intravenously 2 h before killing. Mice were killed 6, 24, 48 h, and 7 days after the radiation treatment. Intratumoral (3)H-FLT level was visually and quantitatively assessed by autoradiography. Ki-67 immunohistochemistry (IHC) was performed. RESULTS In radiation-treated mice, the tumor growth was significantly suppressed compared with the control group, but the tumor volume in these mice gradually increased with time. In the visual assessment, intratumoral (3)H-FLT level diffusely decreased 6 h after the radiation treatment and then gradually increased with time, whereas no apparent changes were observed in Ki-67 IHC. Six hours after the radiation treatment at 10 and 20 Gy, the intratumoral (3)H-FLT level markedly decreased to 45 and 40 % of the control, respectively (P < 0.0001 vs control), and then gradually increased with time. In each radiation-treated group, the (3)H-FLT levels at 48 h and on day 7 were significantly higher than that at 6 h. The intratumoral (3)H-FLT levels in both treated groups were 68 and 60 % at 24 h (P < 0.001), 71 and 77 % at 48 h (P < 0.001), and 83 and 81 % on day 7 (P = NS) compared with the control group. CONCLUSION Intratumoral FLT uptake level markedly decreased at 6 h and then gradually increased with time. Sequential evaluation of intratumoral proliferative activity using FLT can be beneficial for determining the optimal timing of and dose in repetitive irradiation of head and neck cancer.
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Affiliation(s)
- Chowdhury Nusrat Fatema
- Department of Oral Diagnosis and Oral Medicine, Graduate School of Dental Medicine, Hokkaido University, Kita 13 Nishi 7, Kita-ku, Sapporo, 060-8586, Japan
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21
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Comparison of 2-amino-[3- 11C]isobutyric acid and 2-deoxy-2-[18F]fluoro-D-glucose in nude mice with xenografted tumors and acute inflammation. Nucl Med Commun 2012; 33:1058-64. [DOI: 10.1097/mnm.0b013e328356efb0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Liu Y, Solomon M, Achilefu S. Perspectives and potential applications of nanomedicine in breast and prostate cancer. Med Res Rev 2010; 33:3-32. [PMID: 23239045 DOI: 10.1002/med.20233] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Nanomedicine is a branch of nanotechnology that includes the development of nanostructures and nanoanalytical systems for various medical applications. Among these applications, utilization of nanotechnology in oncology has captivated the attention of many research endeavors in recent years. The rapid development of nano-oncology raises new possibilities in cancer diagnosis and treatment. It also holds great promise for realization of point-of-care, theranostics, and personalized medicine. In this article, we review advances in nano-oncology, with an emphasis on breast and prostate cancer because these organs are amenable to the translation of nanomedicine from small animals to humans. As new drugs are developed, the incorporation of nanotechnology approaches into medicinal research becomes critical. Diverse aspects of nano-oncology are discussed, including nanocarriers, targeting strategies, nanodevices, as well as nanomedical diagnostics, therapeutics, and safety. The review concludes by identifying some limitations and future perspectives of nano-oncology in breast and prostate cancer management.
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Affiliation(s)
- Yang Liu
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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23
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Bussink J, van Herpen CML, Kaanders JHAM, Oyen WJG. PET-CT for response assessment and treatment adaptation in head and neck cancer. Lancet Oncol 2010; 11:661-9. [PMID: 20226735 DOI: 10.1016/s1470-2045(09)70353-5] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Preferred treatment strategies for advanced-stage squamous cell carcinoma of the head and neck have shifted from surgery to organ-preservation approaches such as radiotherapy, which can be combined with chemotherapy or giving of biologically modifying molecules. Preclinical and clinical researchers aim to customise these treatments on the basis of biological tumour characteristics, including tumour cell proliferation, hypoxia, and apoptosis--important resistance mechanisms for cytotoxic antitumour therapy. Monitoring of these biologically relevant variables before and early during treatment could improve patient selection for specific treatment strategies and guide adaptation of treatment at an early stage. PET provides a non-invasive molecular imaging method with the potential ability to undertake repetitive non-invasive quantification of relevant tumour characteristics. We discuss the role of PET scanning and available radiopharmaceutical tracers for treatment selection, early response monitoring, and treatment adaptation in head and neck cancer.
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Affiliation(s)
- Johan Bussink
- Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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24
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Uehara T, Nakagawa M, Takai N, Koike S, Furusawa Y, Ando K, Kawai K, Akizawa H, Irie T, Arano Y. Intracellular reactions affecting 2-amino-4-([(11)C]methylthio)butyric acid ([(11)C]methionine) response to carbon ion radiotherapy in C10 glioma cells. Nucl Med Biol 2009; 36:985-91. [PMID: 19875056 DOI: 10.1016/j.nucmedbio.2009.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 06/22/2009] [Accepted: 07/23/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The response of 2-amino-4-([(14)C]methylthio)butyric acid ([(14)C]Met) uptake and [(125)I]3-iodo-alpha-methyl-l-tyrosine ([(125)I]IMT) uptake to radiotherapy of C10 glioma cells was compared to elucidate the intracellular reactions that affect the response of 2-amino-4-([(11)C]methylthio)butyric acid ([(11)C]Met) uptake to radiotherapy. METHODS After irradiation of cultured (3 Gy) or xenografted C10 glioma cells (25 Gy) using a carbon ion beam, the accumulation of [(14)C]Met and [(125)I]IMT in the tumors was investigated. The radiometabolites in xenografted tumors after radiotherapy were analyzed by size-exclusion HPLC. RESULTS [(14)C]Met provided earlier responses to the carbon ion beam irradiation than [(125)I]IMT in both cultured and xenografted tumors. While [(125)I]IMT remained intact in xenografted tumor before and after irradiation, the radioactivity derived from [(14)C]Met was observed both in high molecular fractions and intact fractions, and the former decreased after irradiation. CONCLUSION The earlier response of [(11)C]Met uptake to tumor radiotherapy could be attributable to the decline in the intracellular energy-dependent reactions of tumors due to radiotherapy.
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Affiliation(s)
- Tomoya Uehara
- Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan.
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25
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Ford EC, Herman J, Yorke E, Wahl RL. 18F-FDG PET/CT for image-guided and intensity-modulated radiotherapy. J Nucl Med 2009; 50:1655-65. [PMID: 19759099 PMCID: PMC2899678 DOI: 10.2967/jnumed.108.055780] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Advances in technology have allowed extremely precise control of radiation dose delivery and localization within a patient. The ability to confidently delineate target tumor boundaries, however, has lagged behind. (18)F-FDG PET/CT, with its ability to distinguish metabolically active disease from normal tissue, may provide a partial solution to this problem. Here we review the current applications of (18)F-FDG PET/CT in a variety of disease sites, including non-small cell lung cancer, head and neck cancer, and pancreatic adenocarcinoma. This review focuses on the use of (18)F-FDG PET/CT to aid in planning radiotherapy and the associated benefits and challenges. We also briefly consider novel radiopharmaceuticals that are beginning to be used in the context of radiotherapy planning.
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Affiliation(s)
- Eric C Ford
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231, USA.
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26
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Zhang MR, Kumata K, Hatori A, Takai N, Toyohara J, Yamasaki T, Yanamoto K, Yui J, Kawamura K, Koike S, Ando K, Suzuki K. [11C]Gefitinib ([11C]Iressa): Radiosynthesis, In Vitro Uptake, and In Vivo Imaging of Intact Murine Fibrosarcoma. Mol Imaging Biol 2009; 12:181-91. [DOI: 10.1007/s11307-009-0265-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 03/30/2009] [Accepted: 04/28/2009] [Indexed: 10/20/2022]
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27
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Touboul E, Huguet F, Talbot JN. [Use of PET for staging, treatment evaluation, and follow-up in esophageal cancers]. Cancer Radiother 2008; 12:633-9. [PMID: 18693057 DOI: 10.1016/j.canrad.2008.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Accepted: 07/01/2008] [Indexed: 11/16/2022]
Abstract
FDG-(18F) PET can now be usually included in the treatment strategy of esophageal cancers for the pretreatment staging in operable tumours or for the diagnosis of recurrence. PET is also a good tool in conformal radiation therapy for improving the target coverage to treat the metabolic target volume or the biological target volume. Furthermore, PET seems to be interesting for evaluation of tumour response and could modify the treatment strategy after neoadjuvant chemotherapy or concurrent chemotherapy and radiation therapy. New radiotracers could allow advances in biological and molecular tumour delineation and contribute to change in treatment strategy based on functional and biological imaging.
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Affiliation(s)
- E Touboul
- Service d'oncologie-radiothérapie, hôpital Tenon, GHU Est, AP-HP CancerEst, 4, rue de la Chine, 75020 Paris, France.
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Abstract
Increased cellular proliferation is an integral part of the cancer phenotype. Several in vitro assays have been developed to measure the rate of tumor growth, but these require biopsies, which are particularly difficult to obtain over time and in different areas of the body in patients with multiple metastatic lesions. Most of the effort to develop imaging methods to noninvasively measure the rate of tumor cell proliferation has focused on the use of PET in conjunction with tracers for the thymidine salvage pathway of DNA synthesis, because thymidine contains the only pyrimidine or purine base that is unique to DNA. Imaging with 11C-thymidine has been tested for detecting tumors and tracking their response to therapy in animals and patients. Its major limitations are the short half-life of 11C and the rapid catabolism of thymidine after injection. These limitations led to the development of analogs that are resistant to degradation and can be labeled with radionuclides more conducive to routine clinical use, such as 18F. At this point, the thymidine analogs that have been studied the most are 3'-deoxy-3'-fluorothymidine (FLT) and 1-(2'-deoxy-2'-fluoro-1-beta-d-arabinofuranosyl)-thymine (FMAU). Both are resistant to degradation and track the DNA synthesis pathway. FLT is phosphorylated by thymidine kinase 1, thus being retained in proliferating cells. It is incorporated by the normal proliferating marrow and is glucuronidated in the liver. FMAU can be incorporated into DNA after phosphorylation but shows less marrow uptake. It shows high uptake in the normal heart, kidneys, and liver, in part because of the role of mitochondrial thymidine kinase 2. Early clinical data for 18F-FLT demonstrated that its uptake correlates well with in vitro measures of proliferation. Although 18F-FLT can be used to detect tumors, its tumor-to-normal tissue contrast is generally lower than that of 18F-FDG in most cancers outside the brain. The most promising use for thymidine and its analogs is in monitoring tumor treatment response, as demonstrated in animal studies and pilot human trials. Further work is needed to determine the optimal tracer(s) and timing of imaging after treatment.
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Affiliation(s)
- James R Bading
- Department of Radioimmunotherapy, City of Hope, Duarte, California, USA
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Beachy SH, Repasky EA. Using extracellular biomarkers for monitoring efficacy of therapeutics in cancer patients: an update. Cancer Immunol Immunother 2008; 57:759-75. [PMID: 18188561 PMCID: PMC11029872 DOI: 10.1007/s00262-007-0445-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Accepted: 12/17/2007] [Indexed: 10/22/2022]
Abstract
Rapidly detectable and easily accessible markers of tumor cell death are needed for evaluating early therapeutic efficacy for immunotherapy and chemotherapy so that patients and their physicians can decide whether to remain with a given therapeutic strategy. Currently, image-based tests such as computed tomography scans and magnetic resonance imaging are used to visualize the response of a patient's tumor, but often these evaluations are not conducted for weeks to months after treatment begins. While serum levels of secreted proteins such as carcinoembryonic antigen and prostate specific antigen are commonly monitored to gauge tumor status during therapy and between image evaluations, the levels of these proteins do not always correlate well with the actual tumor response. In laboratory studies, it has been shown that tumor cells undergoing apoptosis can release cellular components into cell culture media such as cytochrome c, nucleosomes, cleaved cytokeratin-18 and E-cadherin. Studies of patient sera have found that these and other macromolecules can be found in circulation during cancer therapy, providing a potential source of material for monitoring treatment efficacy. In the future, analysis of biofluids from severe combined immunodeficiency mice bearing patient tumor specimens treated with a targeted therapy such as Apo2L/tumor necrosis factor-related apoptosis-inducing ligand will be useful in the preclinical identification of therapy response markers. In this review, the current status of the identification of serum markers of tumor cell apoptosis is provided, as well as a discussion of critical research questions that must be addressed and the considerations necessary when identifying a marker that reflects true clinical outcome.
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Affiliation(s)
- S. H. Beachy
- Department of Molecular and Cellular Biophysics and Biochemistry, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA
| | - E. A. Repasky
- Department of Immunology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA
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FDG uptake, a surrogate of tumour hypoxia? Eur J Nucl Med Mol Imaging 2008; 35:1544-9. [PMID: 18509637 PMCID: PMC2491423 DOI: 10.1007/s00259-008-0758-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 02/18/2008] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Tumour hyperglycolysis is driven by activation of hypoxia-inducible factor-1 (HIF-1) through tumour hypoxia. Accordingly, the degree of 2-fluro-2-deoxy-D: -glucose (FDG) uptake by tumours might indirectly reflect the level of hypoxia, obviating the need for more specific radiopharmaceuticals for hypoxia imaging. DISCUSSION In this paper, available data on the relationship between hypoxia and FDG uptake by tumour tissue in vitro and in vivo are reviewed. In pre-clinical in vitro studies, acute hypoxia was consistently shown to increase FDG uptake by normal and tumour cells within a couple of hours after onset with mobilisation or modification of glucose transporters optimising glucose uptake, followed by a delayed response with increased rates of transcription of GLUT mRNA. In pre-clinical imaging studies on chronic hypoxia that compared FDG uptake by tumours grown in rat or mice to uptake by FMISO, the pattern of normoxic and hypoxic regions within the human tumour xenografts, as imaged by FMISO, largely correlated with glucose metabolism although minor locoregional differences could not be excluded. In the clinical setting, data are limited and discordant. CONCLUSION Further evaluation of FDG uptake by various tumour types in relation to intrinsic and bioreductive markers of hypoxia and response to radiotherapy or hypoxia-dependent drugs is needed to fully assess its application as a marker of hypoxia in the clinical setting.
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Abstract
The goal of radiation therapy is to eradicate tumor stem cells while sparing healthy tissue. Therefore, the first aim must be to delineate tumor from healthy tissue. Advanced imaging techniques will enable one to reduce the uncertainty of microscopic extension of disease. Ultimately, advanced functional imaging systems correlated with image-registered pathological specimens will allow one to delineate disease extent from normal tissue at the tumor periphery. When it is not possible to determine the CTV margin with reasonable certainty, the margins must remain generous and conformal avoidance methodology could and should be deployed to spare critical normal structures. Of equal importance to defining the CTV is the need to guarantee that this target is indeed treated. For this purpose, image guidance using a variety of systems including portal images, ultrasound devices, and CT scanners at the time of treatment has been implemented. Some image-guided methods, portal images for instance, are more amenable for use with rigid structures such as encountered in the sinus whereas others like ultrasound or CT scanners are able to account for nonrigid setup variations. Several strategies for preventing organ motion from degrading the precision that radiotherapy offers have been described. In particular, a CT scan at the time of treatment delivery can also be used as the basis to reconstruct the dose received by the patient. Dose reconstruction will allow the dose just delivered to be superimposed on the pretreatment CT scan and will allow one to compare the reconstructed delivered dose distribution with the planned dose distribution to assess discrepancies between these. Furthermore, reconstruction of the delivered dose distributions holds the promise of allowing one to accumulate dose delivered to the tumor and normal structures on a fraction per fraction basis. This will ultimately allow for the determination of treatment-specific tumor control probabilities and normal tissue complication probabilities.
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Affiliation(s)
- Thomas Rockwell Mackie
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, USA
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Peremans K, Kersemans V, Liuti T, Vandermeulen E, Cornelissen B, Gielen I, De Spiegeleer B, Mertens J, Burvenich C, Slegers G. Use of [123I]-2-iodo-L-phenylalanine as a tumor imaging agent in two dogs with synovial cell sarcoma. Vet Radiol Ultrasound 2007; 48:471-4. [PMID: 17899985 DOI: 10.1111/j.1740-8261.2007.00281.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
[123I]-iodo-L-phenylalanine was successfully evaluated for gamma camera imaging in vivo in tumor-bearing athymic mice and in humans with brain tumors. Here, we report the use of this tracer in two dogs with synovial cell sarcoma of the tarsus. [123I]-iodo-L-phenylalanine was quantitatively prepared as a kit formulation using the Cu(1+) +-assisted nucleophilic exchange. Rapid [123I]-2-iodo-L-phenylalanine tumor accumulation was observed with good tumor to background contrast and rapid clearance in these two dogs. This radiopharmaceutical is a promising alternative tumor tracer to overcome the known limitations of 18F-fluorodeoxyglucose and, when labelled with radioiodine-131, has the potential to be used for therapeutic purposes.
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Affiliation(s)
- K Peremans
- Department of Medical Imaging, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
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Wang H, Yu J, Yang G, Song X, Sun X, Zhao S, Mu D. Assessment of 11C-labeled-4-N-(3-bromoanilino)-6,7-dimethoxyquinazoline as a positron emission tomography agent to monitor epidermal growth factor receptor expression. Cancer Sci 2007; 98:1413-6. [PMID: 17627611 PMCID: PMC11160051 DOI: 10.1111/j.1349-7006.2007.00562.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of the present study was to investigate the biodistribution of (11)C-labeled-4-N-(3-bromoanilino), 6,7-dimethoxyquinazoline ((11)C-PD153035) and the relationship between accumulation of the tracer and epidermal growth factor receptor (EGFR) expression levels. Biodistribution studies of (11)C-PD153035 were performed in tumor-bearing nude mice. The amount of radioactivity in the lungs was small while concentrations were highest in the liver and intestine. From in vitro studies, the level of (11)C-PD153035 accumulation was detected in MDA-MB-468, A549, and MDA-MB-231 cells. The uptake of (11)C-PD153035 in cells was closely correlated with the EGFR expression level of cells (r(2) = 0.85; P < 0.001), and the results obtained in excised tumors were also significantly correlated (r(2) = 0.63; P = 0.003). Binding in MDA-MB-468, A549, and MDA-MB-231 tumors was reduced to background level at 60 min post injection( 11)C-PD153035 by pretreatment with cold PD153035. The present study showed that whether in vitro or ex vivo the uptake of (11)C-PD153035 closely correlated with EGFR expression levels. In contrast, blocking studies revealed specific binding in the three kinds of tumors. Thus (11)C-PD153035 may be used as a positron emission tomography tracer to yield useful information about tumors, particularly for lung cancer with different EGFR expression levels.
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Affiliation(s)
- Hui Wang
- Medical School of Shandong University, Wenhua West Road 44, Jinan, Shandong 250012, China
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Kartachova M, van Zandwijk N, Burgers S, van Tinteren H, Verheij M, Valdés Olmos RA. Prognostic significance of 99mTc Hynic-rh-annexin V scintigraphy during platinum-based chemotherapy in advanced lung cancer. J Clin Oncol 2007; 25:2534-9. [PMID: 17577031 DOI: 10.1200/jco.2006.10.1337] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate if sequential 99mTc Hynic-rh- annexin V scintigraphy (TAS) can predict outcome in patients with advanced lung cancer, shortly after the start of platinum-based chemotherapy. PATIENTS AND METHODS In 16 consecutive chemotherapy-naive patients with advanced stage non-small-cell lung cancer scheduled for platinum-based chemotherapy, TAS was performed before and within 48 hours after the start of therapy. Chemotherapy-induced changes in tumor annexin V uptake, calculated as maximum count per pixel and expressed as percentage to baseline value, were compared with treatment response determined according to Response Evaluation Criteria in Solid Tumors. RESULTS A significant correlation (r2 = 0.86; P = .0001) was found between annexin V metabolic changes and treatment outcome. All patients with notably increased annexin V tumor uptake showed complete or partial response. Less prominently increased or decreased uptake correlated with stable or progressive disease. CONCLUSION TAS is a promising test to predict tumor response in patients with advanced lung cancer early in the course of platinum-based chemotherapy.
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Affiliation(s)
- Marina Kartachova
- Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Belkacémi Y, Tsoutsou P, Magné N, Castadot P, Azria D. Metabolic functional imaging for tumor radiosensitivity monitoring. Crit Rev Oncol Hematol 2007; 62:227-39. [PMID: 17241788 DOI: 10.1016/j.critrevonc.2006.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 12/05/2006] [Accepted: 12/08/2006] [Indexed: 11/17/2022] Open
Abstract
Assessing tumor radiosensitivity before and during radiation therapy can be a crucial element in decision-making with regard to treatment. However, no known non-invasive test is available at present, which allows for a reliable evaluation of the radiosensitivity of a tissue subjected to radiotherapy. Among tests being evaluated, positron emission tomography (PET) is considered to be a promising method. The purpose of this review is to identify the tests and research paths that have recently been explored for the evaluation of tumor response to treatment after isotopic labeling revealed by nuclear imaging. The majority of the explored methodologies are based on the indirect evaluation of the radiosensitivity by cell proliferation or apoptosis, tissue oxygenation or hypoxia, intrinsic radiosensitivity of clonogenic cells, tumor metabolism and angiogenesis. The development of such methods would permit the adoption of a therapeutic regimen with respect to a given radiosensitivity of a tissue. Therefore, a given therapeutic strategy could be readjusted (by associating, for instance, a radiosensitizer of hypoxic cells) or even modified if it proved to be inadequate or when it presents an unfavorable cost-effectiveness ratio. We present here a critical review of the radiotracers revealed by nuclear imaging that are developed for radiosensitivity monitoring.
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Affiliation(s)
- Yazid Belkacémi
- Department of Radiation Oncology, Oscar Lambret Anti-Cancer Center and University of Lille II, Lille, France.
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de Geus-Oei LF, Kaanders JHAM, Pop LAM, Corstens FHM, Oyen WJG. Effects of hyperoxygenation on FDG-uptake in head-and-neck cancer. Radiother Oncol 2006; 80:51-6. [PMID: 16820237 DOI: 10.1016/j.radonc.2006.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 05/18/2006] [Accepted: 06/08/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE Tumor hyperoxygenation results in high response rates to ARCON (accelerated radiotherapy with carbogen and nicotinamide). The effect of hyperoxygenation on tumor metabolism using [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) was investigated. METHODS Within one week, FDG-PET was performed without and with hyperoxygenation by carbogen breathing and/or nicotinamide administration in 22 patients, eligible for ARCON for head-and-neck cancer. Maximum standardized uptake values (SUV(max)) in both scans and the relative change were calculated in the primary tumor and in normal muscle. RESULTS Alteration of the tumor oxygenation state induced profound, but variable, metabolic changes (median DeltaSUV(max) -4%; range -61% to +30%). Metabolism in normal muscle was not affected. In three patients who did not achieve local tumor control, the SUV(max) after hyperoxygenation differed less than 5% change as compared to baseline, whereas 13 of the 16 patients with local tumor control showed a larger difference (p<0.05). CONCLUSION Given the heterogeneous response pattern of nicotinamide and carbogen on FDG-uptake in head-and-neck carcinoma, the prognostic significance of semiquantitative FDG-PET before and after hyperoxygenation remains uncertain and requires confirmation in larger clinical studies before introducing the procedure as a predictive tool for oxygenation modifying treatments.
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Affiliation(s)
- Lioe-Fee de Geus-Oei
- Department of Nuclear Medicine, Radbound University Nijmegen Medical Center, The Netherlands.
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38
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Vanderstraeten B, Duthoy W, De Gersem W, De Neve W, Thierens H. [18F]fluoro-deoxy-glucose positron emission tomography ([18F]FDG-PET) voxel intensity-based intensity-modulated radiation therapy (IMRT) for head and neck cancer. Radiother Oncol 2006; 79:249-58. [PMID: 16564588 DOI: 10.1016/j.radonc.2006.03.003] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2005] [Revised: 02/16/2006] [Accepted: 03/02/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE Focused dose escalation may improve local control in head and neck cancer. Planning results of [(18)F]fluoro-deoxy-glucose positron emission tomography ([(18)F]FDG-PET) voxel intensity-based intensity-modulated radiation therapy (IMRT) were compared with those of PET contour-based IMRT. PATIENTS AND METHODS PET contour-based IMRT aims to deliver a homogeneous boost dose to a PET-based subvolume of the planning target volume (PTV), called PTV(PET). The present PET voxel intensity-based planning study aims to prescribe the boost dose directly as a function of PET voxel intensity values, while leaving the dose distribution outside the PTV unchanged. Two escalation steps (2.5 and 3 Gy/fraction) were performed for 15 patients. RESULTS PTV(PET) was irradiated with a homogeneous dose in the contour-based approach. In the voxel intensity-based approach, one or more sharp dose peaks were created inside the PTV, following the distribution of PET voxel intensity values. CONCLUSIONS While PET voxel intensity-based IMRT had a large effect on the dose distribution within the PTV, only small effects were observed on the dose distribution outside this PTV and on the dose delivered to the organs at risk. Therefore both methods are alternatives for boosting subvolumes inside a selected PTV.
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Belkacémi Y, Tsoutsou PG, Comet B, Kerrou K, Lartigau E. Évaluation de la radiosensibilité tumorale par l'imagerie fonctionnelle et métabolique : de la recherche à l'application clinique. Revue de la littérature. Cancer Radiother 2006; 10:124-33. [PMID: 16310397 DOI: 10.1016/j.canrad.2005.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Revised: 09/06/2005] [Accepted: 09/22/2005] [Indexed: 11/16/2022]
Abstract
During the last half of century considerable research on radiosensitivity biomarkers has been published. However, to date there is no non-invasive marker of cellular radiosensitivity identified for clinical routinely use. In this review, the main functional and metabolic imaging isotopic techniques for tumor radiosensitivity that have been explored over the last years are being described. This indirect evaluation fall into 3 topics associated with tumor proliferation rate or apoptosis, tumor hypoxic fraction, neoangiogenesis and the intrinsic radiosensitivity of clonogenic tumor cells. The final objective of the radiosensitivity monitoring during radiotherapy would be to adapt treatment strategy for overcoming the identified radioresistance mechanism such as hypoxia by the addition of radiosensitisers for example. This would allow better tumor control rather than continue inefficient and costly treatment delivery, which in addition could compromise outcome.
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Affiliation(s)
- Y Belkacémi
- Département universitaire de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59020, Lille, France.
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Winkelmann CT, Figueroa SD, Rold TL, Volkert WA, Hoffman TJ. Microimaging Characterization of a B16-F10 Melanoma Metastasis Mouse Model. Mol Imaging 2006. [DOI: 10.2310/7290.2006.00011] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Said Daibes Figueroa
- University of Missouri-Columbia
- Harry S. Truman Memorial Veterans Hospital-Columbia
| | | | | | - Timothy J. Hoffman
- University of Missouri-Columbia
- Harry S. Truman Memorial Veterans Hospital-Columbia
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Ballegeer EA, Forrest LJ, Jeraj R, Mackie TR, Nickles RJ. PET/CT FOLLOWING INTENSITY-MODULATED RADIATION THERAPY FOR PRIMARY LUNG TUMOR IN A DOG. Vet Radiol Ultrasound 2006; 47:228-33. [PMID: 16553158 DOI: 10.1111/j.1740-8261.2006.00132.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A primary lung tumor in a dog treated with intensity-modulated radiation therapy was imaged approximately 6 weeks and 1-year posttreatment with combined positron emission tomography (PET) and computed tomography, utilizing the radiotracers 18F-fluorodeoxyglucose and 18F-fluorothymidine. These two tracers allowed discrimination of tumor from inflammation, and demonstrated spread of tumor along airways over time after treatment. Fusion of functional imaging with anatomic imaging is a useful tool, particularly in the field of oncology, with the potential for PET markers that delineate tumor from normal or reactive tissue, and potential or actual response to therapy.
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Yang YJ, Ryu JS, Kim SY, Oh SJ, Im KC, Lee H, Lee SW, Cho KJ, Cheon GJ, Moon DH. Use of 3′-deoxy-3′-[18F]fluorothymidine PET to monitor early responses to radiation therapy in murine SCCVII tumors. Eur J Nucl Med Mol Imaging 2006; 33:412-9. [PMID: 16404598 DOI: 10.1007/s00259-005-0011-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Accepted: 09/10/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE 3'-Deoxy-3'-[(18)F]fluorothymidine (FLT) is a promising new radiopharmaceutical for imaging cell proliferation. We evaluated whether FLT PET can be used to monitor early responses to radiation treatment. METHODS C3H/HeN mice bearing murine squamous cell carcinomas were randomized to irradiation with 0, 10, or 20 Gy. Twenty-four hours later, the mice were sacrificed for histopathological and biological assessment such as cell cycle analysis, Hoechst staining, and clonogenic cell survival assay. PET scans were performed on other mice after injection of [(18)F]FLT or [(18)F]fluorodeoxyglucose (FDG) before and after radiation treatment, and tumor growth was assessed over 9 days. RESULTS Histopathological examination detected no morphological changes 24 h after radiation treatment, but cell cycle analysis showed that irradiated tumors had a decreased fraction of cells in S phase and an increased fraction in G2-M phase, compared with nonirradiated tumors. Irradiated tumors also had a higher incidence of apoptotic features and reduced clonogenic cell survival. Tumor growth was significantly delayed in irradiated mice (p<0.001) compared with control mice. PET images showed increased tumoral uptake of both FLT and FDG before radiation treatment. Following irradiation, FLT uptake differed significantly (p=0.020) from that in control mice. In contrast, FDG uptake after irradiation did not differ significantly from that in control mice. CONCLUSION Our finding that tumor uptake of FLT was reduced at 24 h after radiation treatment suggests that FLT PET may be a promising imaging modality for monitoring the early effects of radiation therapy.
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Affiliation(s)
- You-Jung Yang
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong Songpa-gu, Seoul 138-736, South Korea
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43
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Nelson DW, Cao H, Zhu Y, Sunar-Reeder B, Choi CYH, Faix JD, Brown JM, Koong AC, Giaccia AJ, Le QT. A noninvasive approach for assessing tumor hypoxia in xenografts: developing a urinary marker for hypoxia. Cancer Res 2005; 65:6151-8. [PMID: 16024616 DOI: 10.1158/0008-5472.can-04-2602] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tumor hypoxia modifies the efficacy of conventional anticancer therapy and promotes malignant tumor progression. Human chorionic gonadotropin (hCG) is a glycoprotein secreted during pregnancy that has been used to monitor tumor burden in xenografts engineered to express this marker. We adapted this approach to use urinary beta-hCG as a secreted reporter protein for tumor hypoxia. We used a hypoxia-inducible promoter containing five tandem repeats of the hypoxia-response element (HRE) ligated upstream of the beta-hCG gene. This construct was stably integrated into two different cancer cell lines, FaDu, a human head and neck squamous cell carcinoma, and RKO, a human colorectal cancer cell line. In vitro studies showed that tumor cells stably transfected with this plasmid construct secrete beta-hCG in response to hypoxia or hypoxia-inducible factor 1alpha (HIF-1alpha) stabilizing agents. The hypoxia responsiveness of this construct can be blocked by treatment with agents that affect the HIF-1alpha pathways, including topotecan, 1-benzyl-3-(5'-hydroxymethyl-2'-furyl)indazole (YC-1), and flavopiridol. Immunofluorescent analysis of tumor sections and quantitative assessment with flow cytometry indicate colocalization between beta-hCG and 2-(2-nitro-1H-imidazol-1-yl)-N-(2,2,3,3,3-pentafluoropropyl)acetamide (EF5) and beta-hCG and pimonidazole, two extrinsic markers for tumor hypoxia. Secretion of beta-hCG from xenografts that contain these stable constructs is directly responsive to changes in tumor oxygenation, including exposure of the animals to 10% O2 and tumor bed irradiation. Similarly, urinary beta-hCG levels decline after treatment with flavopiridol, an inhibitor of HIF-1 transactivation. This effect was observed only in tumor cells expressing a HRE-regulated reporter gene and not in tumor cells expressing a cytomegalovirus-regulated reporter gene. The 5HRE beta-hCG reporter system described here enables serial, noninvasive monitoring of tumor hypoxia in a mouse model by measuring a urinary reporter protein.
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MESH Headings
- Animals
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/urine
- Cell Hypoxia/physiology
- Cell Line, Tumor
- Chorionic Gonadotropin, beta Subunit, Human/genetics
- Chorionic Gonadotropin, beta Subunit, Human/urine
- Colorectal Neoplasms/drug therapy
- Colorectal Neoplasms/genetics
- Colorectal Neoplasms/metabolism
- Colorectal Neoplasms/urine
- DNA-Binding Proteins/genetics
- Flavonoids/pharmacology
- Genes, Reporter/genetics
- Genetic Vectors/genetics
- Head and Neck Neoplasms/drug therapy
- Head and Neck Neoplasms/genetics
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/urine
- Humans
- Hypoxia-Inducible Factor 1
- Hypoxia-Inducible Factor 1, alpha Subunit
- Mice
- Mice, Inbred BALB C
- Mice, Inbred SENCAR
- Neoplasm Transplantation
- Nuclear Proteins/genetics
- Piperidines/pharmacology
- Topotecan/pharmacology
- Transcription Factors/genetics
- Transfection
- Transplantation, Heterologous
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Affiliation(s)
- Daniel W Nelson
- Department of Radiation Oncology, Stanford University, Stanford, California 94305-5847, USA
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Brianzoni E, Rossi G, Ancidei S, Berbellini A, Capoccetti F, Cidda C, D'Avenia P, Fattori S, Montini GC, Valentini G, Proietti A, Algranati C. Radiotherapy planning: PET/CT scanner performances in the definition of gross tumour volume and clinical target volume. Eur J Nucl Med Mol Imaging 2005; 32:1392-9. [PMID: 16133395 DOI: 10.1007/s00259-005-1845-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2004] [Accepted: 05/02/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE Positron emission tomography is the most advanced scintigraphic imaging technology and can be employed in the planning of radiation therapy (RT). The aim of this study was to evaluate the possible role of fused images (anatomical CT and functional FDG-PET), acquired with a dedicated PET/CT scanner, in delineating gross tumour volume (GTV) and clinical target volume (CTV) in selected patients and thus in facilitating RT planning. METHODS Twenty-eight patients were examined, 24 with lung cancer (17 non-small cell and seven small cell) and four with non-Hodgkin's lymphoma in the head and neck region. All patients underwent a whole-body PET scan after a CT scan. The CT images provided morphological volumetric information, and in a second step, the corresponding PET images were overlaid to define the effective target volume. The images were exported off-line via an internal network to an RT simulator. RESULTS Three patient were excluded from the study owing to change in the disease stage subsequent to the PET/CT study. Among the remaining 25 patients, PET significantly altered the GTV or CTV in 11 (44%) . In five of these 11 cases there was a reduction in GTV or CTV, while in six there was an increase in GTV or CTV. CONCLUSION FDG-PET is a highly sensitive imaging modality that offers better visualisation of local and locoregional tumour extension. This study confirmed that co-registration of CT data and FDG-PET images may lead to significant modifications of RT planning and patient management.
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Affiliation(s)
- Ernesto Brianzoni
- Department of Nuclear Medicine, Department of Oncology, S. Lucia Hospital, Via S. Lucia 2, 62100 Macerata, ASUR Marche, Italy.
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Moffat BA, Chenevert TL, Lawrence TS, Meyer CR, Johnson TD, Dong Q, Tsien C, Mukherji S, Quint DJ, Gebarski SS, Robertson PL, Junck LR, Rehemtulla A, Ross BD. Functional diffusion map: a noninvasive MRI biomarker for early stratification of clinical brain tumor response. Proc Natl Acad Sci U S A 2005; 102:5524-9. [PMID: 15805192 PMCID: PMC555936 DOI: 10.1073/pnas.0501532102] [Citation(s) in RCA: 474] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Assessment of radiation and chemotherapy efficacy for brain cancer patients is traditionally accomplished by measuring changes in tumor size several months after therapy has been administered. The ability to use noninvasive imaging during the early stages of fractionated therapy to determine whether a particular treatment will be effective would provide an opportunity to optimize individual patient management and avoid unnecessary systemic toxicity, expense, and treatment delays. We investigated whether changes in the Brownian motion of water within tumor tissue as quantified by using diffusion MRI could be used as a biomarker for early prediction of treatment response in brain cancer patients. Twenty brain tumor patients were examined by standard and diffusion MRI before initiation of treatment. Additional images were acquired 3 weeks after initiation of chemo- and/or radiotherapy. Images were coregistered to pretreatment scans, and changes in tumor water diffusion values were calculated and displayed as a functional diffusion map (fDM) for correlation with clinical response. Of the 20 patients imaged during the course of therapy, 6 were classified as having a partial response, 6 as stable disease, and 8 as progressive disease. The fDMs were found to predict patient response at 3 weeks from the start of treatment, revealing that early changes in tumor diffusion values could be used as a prognostic indicator of subsequent volumetric tumor response. Overall, fDM analysis provided an early biomarker for predicting treatment response in brain tumor patients.
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Affiliation(s)
- Bradford A Moffat
- Department of Radiology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
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46
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Abstract
The technological revolution in imaging during recent decades has transformed the way image-guided radiation therapy is performed. Anatomical imaging (plain radiography, computed tomography, magnetic resonance imaging) greatly improved the accuracy of delineating target structures and has formed the foundation of 3D-based radiation treatment. However, the treatment planning paradigm in radiation oncology is beginning to shift toward a more biological and molecular approach as advances in biochemistry, molecular biology, and technology have made functional imaging (positron emission tomography, nuclear magnetic resonance spectroscopy, optical imaging) of physiological processes in tumors more feasible and practical. This review provides an overview of the role of current imaging strategies in radiation oncology, with a focus on functional imaging modalities, as it relates to staging and molecular profiling (cellular proliferation, apoptosis, angiogenesis, hypoxia, receptor status) of tumors, defining radiation target volumes, and assessing therapeutic response. In addition, obstacles such as imaging-pathological validation, optimal timing of post-therapy scans, spatial and temporal evolution of tumors, and lack of clinical outcome studies are discussed that must be overcome before a new era of functional imaging-guided therapy becomes a clinical reality.
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Affiliation(s)
- Smith Apisarnthanarax
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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47
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Wang JZ, Li XA. Impact of tumor repopulation on radiotherapy planning. Int J Radiat Oncol Biol Phys 2005; 61:220-7. [PMID: 15629615 DOI: 10.1016/j.ijrobp.2004.09.043] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Revised: 09/16/2004] [Accepted: 09/22/2004] [Indexed: 01/22/2023]
Abstract
PURPOSE Biologic/functional imaging (e.g., fluorodeoxyglucose/3'-deoxy-3'-fluorothymidine-positron emission tomography) is promising to provide information on tumor cell repopulation. Such information is important in the design of biologically conformal radiotherapy for cancer. The questions remaining unclear are whether it is necessary to escalate the dose to the regions with rapid cell repopulation in the tumor target and, if so, by how much. The purpose of this work was to address these questions using radiobiologic modeling. METHODS AND MATERIALS The generalized linear-quadratic model, extended to account for the effect of clonogenic cell repopulation, was used to calculate the cell-killing efficiency of radiotherapy. The standard Poisson tumor control probability (TCP) model was used to bridge cell killing to treatment outcome. Prostate cancer was chosen as the example for this study. In situ measurements of prostate cancer patients have shown that the potential doubling time of tumor cells has a large variation, ranging from 15 to 170 days. On the basis of the linear-quadratic and TCP parameters (alpha = 0.14 Gy(-1), alpha/beta = 3.1 Gy, and the number of clonogens K = 10(6)-10(7) cells) determined in earlier studies, we evaluated the influence of tumor cell repopulation during protracted treatment courses on treatment outcome. The dose escalations, which can be used to combat aggressive cell repopulation in regions with different doubling times (15-170 days) and sizes (5, 10, 15, and 40 cm(3) of a 40-cm(3) tumor), were calculated for commonly practiced radiotherapy modalities. The influence of linear-quadratic parameters on this calculation was also considered. RESULTS The impact of tumor cell repopulation on TCP and the corresponding dose escalation required to account for this impact were investigated for both external beam radiotherapy and permanent implantation. The results indicated that for regions with aggressive tumor cell growth, dose escalation is necessary to compensate for the repopulation effect. For example, for tumors with an effective doubling time changing from 42 days to 15 days, the prescription dose of external beam radiotherapy needs to be increased from 75.6 to 81 Gy to maintain a target TCP of 80% for intermediate-risk prostate cancer. For (125)I implants, dose escalation from 152 to 160 Gy is required for the same target TCP. These data were calculated on the basis of an alpha/beta ratio of 3.1 Gy. Greater dose escalations are required if the alpha/beta ratio is 1.5 Gy (e.g., 88 Gy for external beam radiotherapy or 180 Gy for (125)I implantation for the same treatment outcome). Our study results showed that it is important to cover the entire tumor volume, including all aggressive spots, with the desired prescription dose, especially for low-dose-rate brachytherapy. CONCLUSION Dose escalation is necessary to offset the accelerated tumor cell repopulation during prolonged treatment courses. This study provides a preliminary estimate of the dose escalation for prostate cancer based on the in situ measurements of potential doubling time and radiobiologic models. The proposed dose prescriptions are technically feasible for clinical trials.
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Affiliation(s)
- Jian Z Wang
- Radiation Oncology Center, Department of Radiological Sciences, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA.
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48
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Dubois L, Landuyt W, Haustermans K, Dupont P, Bormans G, Vermaelen P, Flamen P, Verbeken E, Mortelmans L. Evaluation of hypoxia in an experimental rat tumour model by [(18)F]fluoromisonidazole PET and immunohistochemistry. Br J Cancer 2005; 91:1947-54. [PMID: 15520822 PMCID: PMC2409764 DOI: 10.1038/sj.bjc.6602219] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This study aimed to evaluate tumour hypoxia by comparing [18F]Fluoromisonidazole uptake measured using positron emission tomography ([18F]FMISO-PET) with immunohistochemical (IHC) staining techniques. Syngeneic rhabdomyosarcoma (R1) tumour pieces were transplanted subcutaneously in the flanks of WAG/Rij rats. Tumours were analysed at volumes between 0.9 and 7.3 cm3. Hypoxic volumes were defined using a 3D region of interest on 2 h postinjection [18F]FMISO-PET images, applying different thresholds (1.2–3.0). Monoclonal antibodies to pimonidazole (PIMO) and carbonic anhydrase IX (CA IX), exogenous and endogenous markers of hypoxia, respectively, were used for IHC staining. Marker-positive fractions were microscopically measured for each tumour, and hypoxic volumes were calculated. A heterogeneous distribution of hypoxia was observed both with histology and [18F]FMISO autoradiography. A statistically significant correlation (P<0.05) was obtained between the hypoxic volumes defined with [18F]FMISO-PET and the volumes derived from the PIMO-stained tumour sections (r=0.9066; P=0.0001), regardless of the selected threshold between 1.4 and 2.2. A similar observation was made with the CA IX staining (r=0.8636; P=0.0006). The relationship found between [18F]FMISO-PET and PIMO- and additionally CA IX-derived hypoxic volumes in rat rhabdomyosarcomas indicates the value of the noninvasive imaging method to measure hypoxia in whole tumours.
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Affiliation(s)
- L Dubois
- Department of Nuclear Medicine, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - W Landuyt
- Lab Experimental Radiobiology/LEO, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Experimental Radiobiology/LEO, KU Leuven, Gasthuisberg-CDG 8th floor, Herestraat 49, B-3000 Leuven, Belgium. Lab Experimental Radiobiology/LEO, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium. E-mail:
| | - K Haustermans
- Lab Experimental Radiobiology/LEO, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - P Dupont
- Department of Nuclear Medicine, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - G Bormans
- Lab Radiopharmaceutical Chemistry, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - P Vermaelen
- Department of Nuclear Medicine, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - P Flamen
- Department of Nuclear Medicine, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - E Verbeken
- Morphology and Molecular Pathology, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - L Mortelmans
- Department of Nuclear Medicine, University Hospital Gasthuisberg and KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Abstract
Theragnostic imaging for radiation oncology is the use of molecular and functional imaging to prescribe the distribution of radiation in four dimensions-the three dimensions of space plus time-of radiotherapy alone or combined with other treatment modalities in an individual patient. Several new imaging targets for positron-emission tomography, single-photon-emission CT, and magnetic resonance spectroscopy allow variations in microenvironmental or cellular phenotypes that modulate the effect of radiation to be mapped in three dimensions. Dose-painting by numbers is a strategy by which the dose distribution delivered by inverse planned intensity-modulated radiotherapy is prescribed in four dimensions. This approach will revolutionise the way that radiotherapy is prescribed and planned and, at least in theory, will improve the therapeutic outcome in terms of local tumour control and side-effects to unaffected tissue.
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Affiliation(s)
- Søren M Bentzen
- University of Wisconsin Medical School, Department of Human Oncology, K4/316 Clinical Sciences Center, WI 53792, USA.
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50
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Linder S, Havelka AM, Ueno T, Shoshan MC. Determining tumor apoptosis and necrosis in patient serum using cytokeratin 18 as a biomarker. Cancer Lett 2004; 214:1-9. [PMID: 15331168 DOI: 10.1016/j.canlet.2004.06.032] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2004] [Accepted: 06/24/2004] [Indexed: 12/15/2022]
Abstract
Intracellular macromolecules are released from dying tumor cells and may subsequently be detected in patient blood. In this review, we will discuss the use of cytokeratin-18 as a serum biomarker for monitoring therapy-induced cell death. Cytokeratins are abundant intracellular proteins expressed by most types of carcinoma, but not by treatment-sensitive cells from bone marrow and other tissues. Release of cytokeratins into blood is therefore expected to show some specificity for tumor cell death. Cytokeratin-18 (CK18) is cleaved by caspases specifically during apoptosis, and the molecular form of this protein (caspase-cleaved vs. non-cleaved) released from dying tumor cells is therefore diagnostic as to the type of cell death (apoptosis vs. necrosis). Analyses of different CK18 forms in patient sera have suggested that tumor apoptosis may not necessarily be the dominating death mode in many tumors in vivo. Measurements of increased levels of CK18 in serum during therapy of prostate and breast cancer patients have been encouraging with regard to the possible future use of CK18 as a biomarker for monitoring therapy efficiency.
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Affiliation(s)
- Stig Linder
- Department of Oncology and Pathology, Cancer Center Karolinska, Karolinska Institute and Hospital, S-171 76 Stockholm, Sweden.
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