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de Bruijn HS, Mashayekhi V, Schreurs TJL, van Driel PBAA, Strijkers GJ, van Diest PJ, Lowik CWGM, Seynhaeve ALB, Hagen TLMT, Prompers JJ, Henegouwen PMPVBE, Robinson DJ, Oliveira S. Acute cellular and vascular responses to photodynamic therapy using EGFR-targeted nanobody-photosensitizer conjugates studied with intravital optical imaging and magnetic resonance imaging. Theranostics 2020; 10:2436-2452. [PMID: 32089747 PMCID: PMC7019176 DOI: 10.7150/thno.37949] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/30/2019] [Indexed: 01/10/2023] Open
Abstract
Targeted photodynamic therapy (PDT) has the potential to selectively damage tumor tissue and to increase tumor vessel permeability. Here we characterize the tissue biodistribution of two EGFR-targeted nanobody-photosensitizer conjugates (NB-PS), the monovalent 7D12-PS and the biparatopic 7D12-9G8-PS. In addition, we report on the local and acute phototoxic effects triggered by illumination of these NB-PS which have previously shown to lead to extensive tumor damage. Methods: Intravital microscopy and the skin-fold chamber model, containing OSC-19-luc2-cGFP tumors, were used to investigate: a) the fluorescence kinetics and distribution, b) the vascular response and c) the induction of necrosis after illumination at 1 or 24 h post administration of 7D12-PS and 7D12-9G8-PS. In addition, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) of a solid tumor model was used to investigate the microvascular status 2 h after 7D12-PS mediated PDT. Results: Image analysis showed significant tumor colocalization for both NB-PS which was higher for 7D12-9G8-PS. Intravital imaging showed clear tumor cell membrane localization 1 and 2 h after administration of 7D12-9G8-PS, and fluorescence in or close to endothelial cells in normal tissue for both NB-PS. PDT lead to vasoconstriction and leakage of tumor and normal tissue vessels in the skin-fold chamber model. DCE-MRI confirmed the reduction of tumor perfusion after 7D12-PS mediated PDT. PDT induced extensive tumor necrosis and moderate normal tissue damage, which was similar for both NB-PS conjugates. This was significantly reduced when illumination was performed at 24 h compared to 1 h after administration. Discussion: Although differences were observed in distribution of the two NB-PS conjugates, both led to similar necrosis. Clearly, the response to PDT using NB-PS conjugates is the result of a complex mixture of tumor cell responses and vascular effects, which is likely to be necessary for a maximally effective treatment.
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Affiliation(s)
- Henriette S de Bruijn
- Center for Optical Diagnostics and Therapy, Dept. of Otolaryngology and Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Vida Mashayekhi
- Cell Biology Division, Dept. of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Tom J L Schreurs
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Pieter B A A van Driel
- Division of Optical Molecular Imaging, Dept. of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gustav J Strijkers
- Amsterdam University Medical Centers, University of Amsterdam, Dept. of Biomedical Engineering and Physics, The Netherlands
| | - Paul J van Diest
- Dept. of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Clemens W G M Lowik
- Division of Optical Molecular Imaging, Dept. of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ann L B Seynhaeve
- Laboratory of Experimental Oncology, Dept. of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Timo L M Ten Hagen
- Laboratory of Experimental Oncology, Dept. of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Jeanine J Prompers
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Dominic J Robinson
- Center for Optical Diagnostics and Therapy, Dept. of Otolaryngology and Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Sabrina Oliveira
- Cell Biology Division, Dept. of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
- Pharmaceutics Division, Dept. of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
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Abstract
Magnetic resonance spectroscopy (MRS) or spectroscopic imaging (MRSI) enables the detection of metabolites, amino acids, and lipids, among other biomolecules, in tumors of live mouse models of cancer. Tumor-bearing mice are anesthetized by breathing isoflurane in a magnetic resonance (MR) scanner dedicated to small animal MR. Here we describe the overall setup and steps for measuring 1H and 31P MRS and 1H MRSI of orthotopic breast tumor models in mice with surface coils. This protocol can be adapted to the use of volume coils to measure 1H and 31P MRS(I) of tumor models that grow inside the body. We address issues of animal handling, setting up the measurement, measurement options, and data analysis.
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Chen B. 14 Vascular imaging in photodynamic therapy. IMAGING IN PHOTODYNAMIC THERAPY 2017:275-292. [DOI: 10.1201/9781315278179-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Schreurs TJL, Hectors SJ, Jacobs I, Grüll H, Nicolay K, Strijkers GJ. Quantitative Multi-Parametric Magnetic Resonance Imaging of Tumor Response to Photodynamic Therapy. PLoS One 2016; 11:e0165759. [PMID: 27820832 PMCID: PMC5098733 DOI: 10.1371/journal.pone.0165759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 10/17/2016] [Indexed: 12/17/2022] Open
Abstract
Objective The aim of this study was to characterize response to photodynamic therapy (PDT) in a mouse cancer model using a multi-parametric quantitative MRI protocol and to identify MR parameters as potential biomarkers for early assessment of treatment outcome. Methods CT26.WT colon carcinoma tumors were grown subcutaneously in the hind limb of BALB/c mice. Therapy consisted of intravenous injection of the photosensitizer Bremachlorin, followed by 10 min laser illumination (200 mW/cm2) of the tumor 6 h post injection. MRI at 7 T was performed at baseline, directly after PDT, as well as at 24 h, and 72 h. Tumor relaxation time constants (T1 and T2) and apparent diffusion coefficient (ADC) were quantified at each time point. Additionally, Gd-DOTA dynamic contrast-enhanced (DCE) MRI was performed to estimate transfer constants (Ktrans) and volume fractions of the extravascular extracellular space (ve) using standard Tofts-Kermode tracer kinetic modeling. At the end of the experiment, tumor viability was characterized by histology using NADH-diaphorase staining. Results The therapy induced extensive cell death in the tumor and resulted in significant reduction in tumor growth, as compared to untreated controls. Tumor T1 and T2 relaxation times remained unchanged up to 24 h, but decreased at 72 h after treatment. Tumor ADC values significantly increased at 24 h and 72 h. DCE-MRI derived tracer kinetic parameters displayed an early response to the treatment. Directly after PDT complete vascular shutdown was observed in large parts of the tumors and reduced uptake (decreased Ktrans) in remaining tumor tissue. At 24 h, contrast uptake in most tumors was essentially absent. Out of 5 animals that were monitored for 2 weeks after treatment, 3 had tumor recurrence, in locations that showed strong contrast uptake at 72 h. Conclusion DCE-MRI is an effective tool for visualization of vascular effects directly after PDT. Endogenous contrast parameters T1, T2, and ADC, measured at 24 to 72 h after PDT, are also potential biomarkers for evaluation of therapy outcome.
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Affiliation(s)
- Tom J L Schreurs
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Stefanie J Hectors
- Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Igor Jacobs
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Holger Grüll
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Oncology Solutions, Philips Research, Eindhoven, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Gustav J Strijkers
- Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
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Wijnen JP, Haarsma J, Boer VO, Luijten PR, van der Stigchel S, Neggers SFW, Klomp DWJ. Detection of lactate in the striatum without contamination of macromolecules by J-difference editing MRS at 7T. NMR IN BIOMEDICINE 2015; 28:514-522. [PMID: 25802216 DOI: 10.1002/nbm.3278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 01/25/2015] [Accepted: 01/26/2015] [Indexed: 06/04/2023]
Abstract
Lactate levels are measurable by MRS and are related to neural activity. Therefore, it is of interest to accurately measure lactate levels in the basal ganglia networks. If sufficiently stable, lactate measurements may be used to investigate alterations in dopaminergic signalling in the striatum, facilitating the detection and diagnosis of metabolic deficits. The aim of this study is to provide a J-difference editing MRS technique for the selective editing of lactate only, thus allowing the detection of lactate without contamination of overlapping macromolecules. As a validation procedure, macromolecule nulling was combined with J-difference editing, and this was compared with J-difference editing with a new highly selective editing pulse. The use of a high-field (7T) MR scanner enables the application of editing pulses with very narrow bandwidth, which are selective for lactate. We show that, despite the sensitivity to B0 offsets, the use of a highly selective editing pulse is more efficient for the detection of lactate than the combination of a broad-band editing pulse with macromolecule nulling. Although the signal-to-noise ratio of uncontaminated lactate detection in healthy subjects is relatively low, this article describes the test-retest performance of lactate detection in the striatum when using highly selective J-difference editing MRS at 7 T. The coefficient of variation, σw and intraclass correlation coefficients for within- and between-subject differences of lactate were determined. Lactate levels in the left and right striatum were determined twice in 10 healthy volunteers. Despite the fact that the test-retest performance of lactate detection is moderate with a coefficient of variation of about 20% for lactate, these values can be used for the design of new studies comparing, for example, patient populations with healthy controls.
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Affiliation(s)
- J P Wijnen
- Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
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Wijnen JP, Jiang L, Greenwood TR, van der Kemp WJM, Klomp DWJ, Glunde K. 1H/31P polarization transfer at 9.4 Tesla for improved specificity of detecting phosphomonoesters and phosphodiesters in breast tumor models. PLoS One 2014; 9:e102256. [PMID: 25036036 PMCID: PMC4103808 DOI: 10.1371/journal.pone.0102256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 06/17/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the ability of a polarization transfer (PT) magnetic resonance spectroscopy (MRS) technique to improve the detection of the individual phospholipid metabolites phosphocholine (PC), phosphoethanolamine (PE), glycerophosphocholine (GPC), and glycerophosphoethanolamine (GPE) in vivo in breast tumor xenografts. MATERIALS AND METHODS The adiabatic version of refocused insensitive nuclei enhanced by polarization transfer (BINEPT) MRS was tested at 9.4 Tesla in phantoms and animal models. BINEPT and pulse-acquire (PA) 31P MRS was acquired consecutively from the same orthotopic MCF-7 (n = 10) and MDA-MB-231 (n = 10) breast tumor xenografts. After in vivo MRS measurements, animals were euthanized, tumors were extracted and high resolution (HR)-MRS was performed. Signal to noise ratios (SNRs) and metabolite ratios were compared for BINEPT and PA MRS, and were also measured and compared with that from HR-MRS. RESULTS BINEPT exclusively detected metabolites with 1H-31P coupling such as PC, PE, GPC, and GPE, thereby creating a significantly improved, flat baseline because overlapping resonances from immobile and partly mobile phospholipids were removed without loss of sensitivity. GPE and GPC were more accurately detected by BINEPT in vivo, which enabled a reliable quantification of metabolite ratios such as PE/GPE and PC/GPC, which are important markers of tumor aggressiveness and treatment response. CONCLUSION BINEPT is advantageous over PA for detecting and quantifying the individual phospholipid metabolites PC, PE, GPC, and GPE in vivo at high magnetic field strength. As BINEPT can be used clinically, alterations in these phospholipid metabolites can be assessed in vivo for cancer diagnosis and treatment monitoring.
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Affiliation(s)
- Jannie P. Wijnen
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Lu Jiang
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Tiffany R. Greenwood
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | | | - Dennis W. J. Klomp
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Kristine Glunde
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Sidney Kimmel Comprehensive Cancer, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Wang H, Fei B. Diffusion-weighted MRI for monitoring tumor response to photodynamic therapy. J Magn Reson Imaging 2010; 32:409-17. [PMID: 20677270 DOI: 10.1002/jmri.22247] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To examine diffusion-weighted MRI (DW-MRI) for assessing the early tumor response to photodynamic therapy (PDT). MATERIALS AND METHODS Subcutaneous tumor xenografts of human prostate cancer cells (CWR22) were initiated in athymic nude mice. A second-generation photosensitizer, Pc 4, was delivered to each animal by a tail vein injection 48 h before laser illumination. A dedicated high-field (9.4 Tesla) small animal MR scanner was used to acquire diffusion-weighted MR images pre-PDT and 24 h after the treatment. DW-MRI and apparent diffusion coefficients (ADC) were analyzed for 24 treated and 5 control mice with photosensitizer only or laser light only. Tumor size, prostate specific antigen (PSA) level, and tumor histology were obtained at different time points to examine the treatment effect. RESULTS Treated mice showed significant tumor size shrinkage and decrease of PSA level within 7 days after the treatment. The average ADC of the 24 treated tumors increased 24 h after PDT (P < 0.001) comparing with pre-PDT. The average ADC was 0.511 +/- 0.119 x 10(-3) mm(2)/s pre-PDT and 0.754 +/- 0.181 x 10(-3) mm(2)/s 24 h after the PDT. There is no significant difference in ADC values pre-PDT and 24 h after PDT in the control tumors (P = 0.20). CONCLUSION The change of tumor ADC values measured by DW-MRI may provide a noninvasive imaging marker for monitoring tumor response to Pc 4-PDT as early as 24 h.
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Affiliation(s)
- Hesheng Wang
- Emory Center for Systems Imaging, Department of Radiology, Emory University, Atlanta, Georgia 30329, USA
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Celli JP, Spring BQ, Rizvi I, Evans CL, Samkoe KS, Verma S, Pogue BW, Hasan T. Imaging and photodynamic therapy: mechanisms, monitoring, and optimization. Chem Rev 2010; 110:2795-838. [PMID: 20353192 PMCID: PMC2896821 DOI: 10.1021/cr900300p] [Citation(s) in RCA: 1644] [Impact Index Per Article: 117.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jonathan P Celli
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
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Feng Y, Emerson L, Jeong EK, Parker DL, Lu ZR. Application of a biodegradable macromolecular contrast agent in dynamic contrast-enhanced MRI for assessing the efficacy of indocyanine green-enhanced photothermal cancer therapy. J Magn Reson Imaging 2009; 30:401-6. [PMID: 19629979 DOI: 10.1002/jmri.21838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To investigate the effectiveness of a polydisulfide-based biodegradable macromolecular contrast agent, (Gd-DTPA)-cystamine copolymers (GDCC), in assessing the efficacy of indocyanine green-enhanced photothermal cancer therapy using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS Breast cancer xenografts in mice were injected with indocyanine green and irradiated with a laser. The efficacy was assessed using DCE-MRI with GDCC of 40 kDa (GDCC-40) at 4 hours and 7 days after the treatment. The uptake of GDCC-40 by the tumors was fit to a two-compartment model to obtain tumor vascular parameters, including fractional plasma volume (f(PV)), endothelium transfer coefficient (K(PS)), and permeability surface area product (PS). RESULTS GDCC-40 resulted in similar tumor vascular parameters at three doses, with larger standard deviations at lower doses. The values of f(PV), K(PS), and PS of the treated tumors were smaller (P < 0.05) than those of untreated tumors at 4 hours after the treatment and recovered to pretreatment values (P > 0.05) at 7 days after the treatment. CONCLUSION DCE-MRI with GDCC-40 is effective for assessing tumor early response to dye-enhanced photothermal therapy and detecting tumor relapse after the treatment. GDCC-40 has a potential to noninvasively monitor anticancer therapies with DCE-MRI.
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Affiliation(s)
- Yi Feng
- Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, Utah, USA
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Zilberstein J, Schreiber S, Bloemers MCWM, Bendel P, Neeman M, Schechtman E, Kohen F, Scherz A, Salomon Y. Antivascular Treatment of Solid Melanoma Tumors with Bacteriochlorophyll-serine-based Photodynamic Therapy¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2001)0730257atosmt2.0.co2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Breidahl T, Nielsen FU, Stødkilde-Jørgensen H, Maxwell RJ, Horsman MR. The effects of the vascular disrupting agents combretastatin A-4 disodium phosphate, 5,6-dimethylxanthenone-4-acetic acid and ZD6126 in a murine tumour: a comparative assessment using MRI and MRS. Acta Oncol 2006; 45:306-16. [PMID: 16644574 DOI: 10.1080/02841860600570465] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of this study was to use magnetic resonance (MR) techniques to non-invasively compare the effects of the three leading vascular disrupting agents, namely combretastatin A-4 disodium phosphate (CA4DP), 5,6-dimethylxanthenone-4-acetic acid (DMXAA) and ZD6126. A C3H mouse mammary carcinoma grown in the right rear foot of female CDF1 mice was used and treatments performed when tumours had reached 200 mm3 in volume. Drugs were prepared fresh before each experiment and intraperitoneally injected into restrained non-anaesthetised mice. Tumour response was evaluated using 31P-MR spectroscopy and T1- and T2- weighted imaging with a 7-Tesla, horizontal bore magnet, before and up to 24 hours after treatment. All three drugs significantly decreased bioenergetic status and pH, and did so in a time and dose dependent fashion, but there were differences; the decrease by CA4DP occurred more rapidly than for DMXAA or ZD6126, while DMXAA had a narrow window of activity compared to CA4DP and ZD6126. Changes in T1 weighted images for all three agents suggested a dose dependent increase in tumour oedema within three hours after treatment, consistent with an increase in vessel permeability. Using T2 weighted images there was some evidence of haemorrhagic necrosis by DMXAA, but such necrosis was limited following treatment with CA4DP or ZD6126.
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Affiliation(s)
- Tomas Breidahl
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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Molckovsky A, Wilson BC. Monitoring of cell and tissue responses to photodynamic therapy by electrical impedance spectroscopy. Phys Med Biol 2001; 46:983-1002. [PMID: 11324973 DOI: 10.1088/0031-9155/46/4/306] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Electrical impedance spectroscopic (EIS) monitoring of photodynamic therapy (PDT) was investigated in vivo in rat liver and in vitro in multicellular spheroids. Liver impedance was continuously measured with two needle electrodes before, during and up to 3 hours following Photofrin-PDT. EIS spectra were altered immediately after PDT, with significant changes in conductivity at approximately 10 kHz, and in permittivity at approximately 30 kHz and 1 MHz. The change in permittivity at high frequencies was related to oedema, while low-frequency effects were attributed to cell necrosis and vascular changes. Photofrin-PDT-treated spheroids showed dose-dependent decreases in permittivity and conductivity at frequencies above 10 and 100 kHz, respectively. Histology showed concomitant development of a damaged rim containing sparsely distributed cells with compromised membranes and lightly staining cytoplasm. Different EIS responses to apoptotic versus necrotic modes of cell death further verified the sensitivity of impedance to purely cellular changes in the spheroid model. In conclusion, EIS sensitivity to PDT-induced damage, at both the cell and tissue level, varies with dose and time, and can be correlated qualitatively to biological changes.
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Affiliation(s)
- A Molckovsky
- Department of Medical Biophysics, Ontario Cancer Institute/University of Toronto, Canada
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Zilberstein J, Schreiber S, Bloemers MC, Bendel P, Neeman M, Schechtman E, Kohen F, Scherz A, Salomon Y. Antivascular treatment of solid melanoma tumors with bacteriochlorophyll-serine-based photodynamic therapy. Photochem Photobiol 2001; 73:257-66. [PMID: 11281022 DOI: 10.1562/0031-8655(2001)073<0257:atosmt>2.0.co;2] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We describe here a strategy for photodynamic eradication of solid melanoma tumors that is based on photo-induced vascular destruction. The suggested protocol relies on synchronizing illumination with maximal circulating drug concentration in the tumor vasculature attained within the first minute after administrating the sensitizer. This differs from conventional photodynamic therapy (PDT) of tumors where illumination coincides with a maximal concentration differential of sensitizer in favor of the tumor, relative to the normal surrounding tissue. This time window is often achieved after a delay (3-48 h) following sensitizer administration. We used a novel photosensitizer, bacteriochlorophyll-serine (Bchl-Ser), which is water soluble, highly toxic upon illumination in the near-infrared (lambda max 765-780 nm) and clears from the circulation in less than 24 h. Nude CD1 mice bearing malignant M2R melanotic melanoma xenografts (76-212 mm3) received a single complete treatment session. Massive vascular damage was already apparent 1 h after treatment. Changes in vascular permeability were observed in vivo using contrast-enhanced magnetic resonance imaging (MRI), with the contrast reagent Gd-DTPA, by shortening spin-spin relaxation time because of hemorrhage formation and by determination of vascular macromolecular leakage. Twenty-four hours after treatment a complete arrest of vascular perfusion was observed by Gd-DTPA-enhanced MRI. Histopathology performed at the same time confirmed primary vascular damage with occlusive thrombi, hemorrhage and tumor necrosis. The success rate of cure of over 80% with Bchl-Ser indicates the benefits of the short and effective treatment protocol. Combining the sensitizer administration and illumination steps into one treatment session (30 min) suggests a clear advantage for future PDT of solid tumors.
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Affiliation(s)
- J Zilberstein
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
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Winsborrow BG, Grondey H, Savoie H, Fyfe CA, Dolphin D. Magnetic resonance imaging evaluation of photodynamic therapy-induced hemorrhagic necrosis in the murine M1 tumor model. Photochem Photobiol 1997; 66:847-52. [PMID: 9421970 DOI: 10.1111/j.1751-1097.1997.tb03236.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Proton magnetic resonance imaging (MRI) and histological methods were used to evaluate photodynamic therapy (PDT)-induced hemorrhagic necrosis in the murine M1 tumor within 72 h of treatment of male DBA/2 mice. The effects of three photosensitizing drugs were investigated: Photofrin (n = 4), Zn (II) phthalocyanine (n = 7) and benzoporphyrin derivative monoacid ring A (n = 11). As noted in previous studies of PDT using MRI, MRI makes possible serial, noninvasive, in vivo observation of tissue response to PDT. Our serial study of MRI and histological data confirms that tumors responded in the same way to PDT treatment using the three photosensitizing drugs: vascular damage followed by hemorrhagic necrosis. Most importantly and unlike previous MRI studies of PDT, we used a very high field magnet that enhanced the effect of magnetic susceptibility on image signal when blood is processed by the body after PDT-induced hemorrhagic necrosis. This last finding demonstrates the utility of high field magnets and the importance of localized, serial experiments in future magnetic resonance studies of PDT.
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Affiliation(s)
- B G Winsborrow
- Department of Chemistry, University of British Columbia, Vancouver, Canada
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Wilson BC, Patterson MS, Lilge L. Implicit and explicit dosimetry in photodynamic therapy: a New paradigm. Lasers Med Sci 1997; 12:182-99. [PMID: 20803326 DOI: 10.1007/bf02765099] [Citation(s) in RCA: 262] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/1996] [Accepted: 02/04/1997] [Indexed: 12/25/2022]
Abstract
Dosimetry for photodynamic therapy (PDT) is becoming increasingly complex as more factors are identified which may influence the effectiveness of a given treatment. The simple prescription of a PDT treatment in terms of the administered photosensitizer dose, the incident light and the drug-light time interval does not account for patient-to-patient variability in either the photosensitizer uptake, tissue optical properties or tissue oxygenation, nor for the interdependence of the photosensitizer-light-tissue factors. This interdependence is examined and the implications for developing adequate dosimetry for PDT are considered. The traditional dosimetric approach, measuring each dose factor independently, and termed here 'explicit dosimetry', may be contrasted with the recent trend to use photosensitizer photobleaching as an index of the effective delivered dose, termed here 'implicit dosimetry'. The advantages and limitations of each approach are discussed, and the need to understand the degree to which the photobleaching mechanism is linked, or 'coupled', to the photosensitizing mechanism is analysed. Finally, the influence of the tissue-response endpoints on the optimal dosimetry methods is considered.
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Affiliation(s)
- B C Wilson
- Ontario Cancer Institute, Toronto, Ontario, Canada
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Abstract
The subcellular, cellular and tissue/tumour interactions with non-toxic photosensitizing chemicals plus non-thermal visible light (photodynamic therapy (PDT) are reviewed. The extent to which endothelium/vasculature is the primary target is discussed, and the biochemical opportunities for manipulating outcome highlighted. The nature of tumour destruction by PDT lends itself to imaging outcome by MRI and PET.
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Affiliation(s)
- J V Moore
- Laser Oncology Programme, Paterson Institute for Cancer Research, Christie Hospital (NHS) Trust, Manchester, UK
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Jakobsen I, Kaalhus O, Lyng H, Rofstad EK. Detection of necrosis in human tumour xenografts by proton magnetic resonance imaging. Br J Cancer 1995; 71:456-61. [PMID: 7880724 PMCID: PMC2033651 DOI: 10.1038/bjc.1995.93] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Tumours with necrotic regions have an inadequate blood supply and are expected to differ from well-vascularised tumours in response to treatment. The purpose of the present work was to investigate whether proton magnetic resonance imaging (MRI) might be used to detect necrotic regions in tumours. MR images and histological sections from individual tumours of three different amelanotic human melanoma xenograft lines (BEX-t, HUX-t, SAX-t) were analysed in pairs. MRI was performed at 1.5 T using two spin-echo pulse sequences, one with a repetition time (TR) of 600 ms and echo times (TEs) of 20, 40, 60 and 80 ms and the other with a TR of 2000 ms and TEs of 20, 40, 60 and 80 ms. Spin-lattice relaxation time (T1), spin-spin relaxation time (T2) and proton density (N0) were calculated for each volume element corresponding to a pixel. Synthetic MR images, pure T1, T2 and N0 images and spin-echo images with chosen values for TR and TE were generated from these data. T1, T2 and N0 distributions of tumour subregions, corresponding to necrotic regions and regions of viable tissue as defined by histological criteria, were also generated. T1 and T2 were significantly shorter in the necrotic regions than in the regions of viable tissue in all tumours. These differences were sufficiently large to allow the generation of synthetic spin-echo images showing clear contrast between necrosis and viable tissue. Maximum contrast was achieved with TRs within the range 2800-4000 ms and TEs within the range 160-200 ms. Necrotic tissue could also be distinguished from viable tissue in pure T1 and T2 images. Consequently, the possibility exists that MRI might be used for detection of necrotic regions in tumours and hence for prediction of tumour treatment response.
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Affiliation(s)
- I Jakobsen
- Institute for Cancer Research, Norwegian Radium Hospital, Montebello, Oslo
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20
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Liu YH, Hawk RM, Ramaprasad S. In vivo relaxation time measurements on a murine tumor model--prolongation of T1 after photodynamic therapy. Magn Reson Imaging 1995; 13:251-8. [PMID: 7739367 DOI: 10.1016/0730-725x(94)00107-e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
RIF tumors implanted on mice feet were investigated for changes in relaxation times (T1 and T2) after photodynamic therapy (PDT). Photodynamic therapy was performed using Photofrin II as the photosensitizer and laser light at 630 nm. A home-built proton solenoid coil in the balanced configuration was used to accommodate the tumors, and the relaxation times were measured before, immediately after, and up to several hours after therapy. Several control experiments were performed untreated tumors, tumors treated with Photofrin II alone, or tumors treated with laser light alone. Significant increases in T1s of water protons were observed after PDT treatment. In all experiments, 31P spectra were recorded before and after the therapy to study the tumor status and to confirm the onset of PDT. These studies show significant prolongation of T1s after the PDT treatment. The spin-spin relaxation measurements, on the other hand, did not show such prolongation in T2 values after PDT treatment.
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Affiliation(s)
- Y H Liu
- Department of Electronics and Instrumentation, University of Arkansas at Little Rock 72204, USA
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21
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Abstract
Photodynamic therapy (PDT) is a cancer treatment based on the accumulation in malignant tissue of a photosensitiser with low systemic toxicity. Subsequent illumination induces a type II photochemical reaction with singlet oxygen production that results in destruction of biomolecules and subcellular organelles. The first full clinical report of PDT dates from 1976. Haematoporphyrin derivative, a complex mixture of porphyrins, was initially used as a photosensitiser. An enriched fraction (porfimer sodium) is now the most commonly used clinical agent. After systemic administration porphyrins bind to albumin and lipoproteins. Accumulation occurs mainly in tumours and organs of the reticuloendothelial system. The light of an argon-dye laser can be tuned to the appropriate wavelength and delivered either superficially, interstitially or intraluminally. Light distribution can be assessed by using a radiation transport model and tissue optical properties, or direct measurement with light detectors. The effects of PDT depend in a complex way on: characteristics, tissue concentration and localisation of the photosensitiser; the target tissue optical properties and oxygenation; activation wavelength, power density and treatment regimen. Future research is directed towards: better photosensitisers (i.e. phthalocyanines, chlorins or protoporphyrin IX endogenously produced from 5-aminolevulinic acid); improved light generation and delivery; and combination with hyperthermia, chemotherapy, radiotherapy or surgery. Adjuvant intraoperative PDT is a promising approach to destroying residual tumour after surgery.
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22
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Rofstad EK, Steinsland E, Kaalhus O, Chang YB, Høvik B, Lyng H. Magnetic resonance imaging of human melanoma xenografts in vivo: proton spin-lattice and spin-spin relaxation times versus fractional tumour water content and fraction of necrotic tumour tissue. Int J Radiat Biol 1994; 65:387-401. [PMID: 7908318 DOI: 10.1080/09553009414550451] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Proton nuclear magnetic resonance (1H-nmr) imaging is used routinely in clinical oncology to provide macroscopic anatomical information, whereas its potential to provide physiological information about tumours is not well explored. To evaluate the potential usefulness of 1H-nmr imaging in the prediction of tumour treatment resistance caused by unfavourable microenvironmental conditions, possible correlations between proton spin-lattice and spin-spin relaxation times (T1 and T2) and physiological parameters of the tumour microenvironment were investigated. Tumours from six human melanoma xenograft lines were included in the study. 1H-nmr imaging was performed at 1.5 T using spin-echo pulse sequences. T1- and T2-distributions were generated from the images. Fractional tumour water content and the fraction of necrotic tumour tissue were measured immediately after 1H-nmr imaging. Significant correlations across tumour lines were found for T1 and T2 versus fractional tumour water content (p < 0.001) as well as for T1 and T2 versus fraction of necrotic tumour tissue (p < 0.05). Tumours with high fractional water contents had high values of T1 and T2, probably caused by free water in the tumour interstitium. Fractional water content is correlated to interstitial fluid pressure in tumours, high interstitial fluid pressure being indicative of high vascular resistance. Tumours with high fractional water contents are thus expected to show regions with radiobiologically hypoxic cells as well as poor intravascular and interstitial transport of many therapeutic agents. T1 and T2 decreased with increasing fraction of necrotic tumour tissue, perhaps because complexed paramagnetic ions were released during development of necrosis. Viable tumour cells adjacent to necrotic regions are usually chronically hypoxic. Tumours with high fractions of necrotic tissue are thus expected to contain significant proportions of radiobiologically hypoxic cells. Consequently, quantitative 1H-nmr imaging has the potential to be developed as an efficient clinical tool in prediction of tumour treatment resistance caused by hypoxia and/or transport barriers for therapeutic agents. However, much work remains to be done before this potential can be adequately evaluated. One problem is that high fractional tumour water contents result in longer T1 and T2 whereas high fractions of necrotic tumour tissue result in shorter T1 and T2; i.e. the two parameters which are indicative of treatment resistance contribute in opposite directions. Another problem is that the correlations for T1 and T2 versus fraction of necrotic tumour tissue are not particularly strong.
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Affiliation(s)
- E K Rofstad
- Department of Biophysics, Norwegian Radium Hospital, Montebello, Oslo
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23
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Sternberg ED, Dolphin D. Second generation photodynamic agents: a review. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 1993; 11:233-41. [PMID: 10146514 DOI: 10.1089/clm.1993.11.233] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Over the last decade, laser treatment of neoplastic diseases has become routine. The ability of these light-induced therapies to effect positive results is increased with the utilization of photosensitizing dyes. The approval of Photofrin in Canada as a first generation photodynamic therapeutic agent for the treatment of some forms of bladder cancer is being followed by the development of other agents with improved properties. At this time a number of second generation photosensitizing dyes are under study in phase I/II clinical trials. A review of the status of these trials along with mechanistic aspects is reviewed in this article. In addition, a review of the status of lasers to be utilized for photodynamic therapy gives some indication of which instruments could be considered for this therapy in the future.
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Affiliation(s)
- E D Sternberg
- Department of Chemistry, University of British Columbia, Vancouver
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24
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Abstract
New photosensitizing drugs are becoming available which should improve on some of the disadvantages of haematoporphyrin derivates for photodynamic therapy (PDT). The main features are shorter duration of systemic photosensitisation, activation by longer and more penetrating light and better tumour to normal tissue drug uptake ratios. These drugs together with better understanding of in vivo light dosimetry promise to improve both results and clinical acceptability for PDT in future studies.
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Affiliation(s)
- D V Ash
- Cookridge Hospital, West Yorkshire, U.K
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25
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Gomer CJ. Preclinical examination of first and second generation photosensitizers used in photodynamic therapy. Photochem Photobiol 1991; 54:1093-107. [PMID: 1775531 DOI: 10.1111/j.1751-1097.1991.tb02133.x] [Citation(s) in RCA: 252] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Numerous photosensitizers with absorption peaks spanning the 600-800 nm "therapeutic window" have been and continue to be synthesized. Structural modifications of the dyes can then be made in order to improve tumor deliverability and retention. Chemical alterations can also enhance the yields of light generated reactive oxygen species. Utilization of lipoproteins, emulsions and antibody conjugates can enhance the selectivity of drug localization. Most cell types and subcellular structures are highly photosensitive and biochemical analysis indicates that cellular target sites associated with PDT correlate with photosensitizer location. In vivo data suggest that vascular and direct tumor cell damage as well as systemic and local immunological reactions are involved in PDT responsiveness. Additional mechanistic, synthetic and developmental studies are required in order to fully appreciate the potentials of PDT. However, continued enthusiasm and support for basic PDT research (as observed during the past 8 years) will depend to a large extent on the outcome of the current clinical trials.
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Affiliation(s)
- C J Gomer
- Clayton Ocular Oncology Center, Childrens Hospital of Los Angeles, CA
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26
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Mueller-Klieser W, Kroeger M, Walenta S, Rofstad EK. Comparative imaging of structure and metabolites in tumours. Int J Radiat Biol 1991; 60:147-59. [PMID: 1677963 DOI: 10.1080/09553009114551741] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A novel technique for metabolic imaging using quantitative bioluminescence and single photon imaging was used to measure the distribution of ATP and lactate in two types of human melanoma xenografts with different radiobiologically hypoxic cell fractions (MF: 45 +/- 17% and EE: 6 +/- 3%; mean +/- SD). The tumours were s.c. grown in nude mice and were used for measurement at volumes of 153-3072 mm3. For metabolic imaging the rapidly frozen tumours were serially sectioned, and each cryosection was brought into contact with a frozen bioluminescent enzyme cocktail using a specially designed glass sandwich system. After thawing section and cocktail the luminescence was started, and light was emitted from the section with an intensity that is proportional to the local metabolite concentration. The photons were imaged directly through a microscope and an imaging photon counting system. A clear-cut correlation was documented between the distribution of relatively high ATP concentrations and of viable cell regions. The data obtained showed lower ATP concentrations in the tumour centres compared to the periphery, whereas lactate was inversely distributed within the melanomas. There was a trend towards a decrease in ATP with increasing tumour size in central, but not in peripheral, parts of both melanoma types. The concentration of neither ATP nor lactate measured in corresponding tumour areas showed differences related to the melanoma type. Thus, these two metabolites did not reflect the difference in the radiosensitivity of these tumours.
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Affiliation(s)
- W Mueller-Klieser
- Institute of Physiology and Pathophysiology, Pathophysiology Division, University of Mainz, Germany
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27
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Ceckler TL, Gibson SL, Kennedy SD, Hill R, Bryant RG. Hetergeneous tumour response to photodynamic therapy assessed by in vivo localised 31P NMR spectroscopy. Br J Cancer 1991; 63:916-22. [PMID: 1829953 PMCID: PMC1972526 DOI: 10.1038/bjc.1991.201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Photodynamic therapy (PDT) is efficacious in the treatment of small malignant lesions when all cells in the tumour receive sufficient drug, oxygen and light to induce a photodynamic effect capable of complete cytotoxicity. In large tumours, only partial effectiveness is observed presumably because of insufficient light penetration into the tissue. The heterogeneity of the metabolic response in mammary tumours following PDT has been followed in vivo using localised phosphorus NMR spectroscopy. Alterations in nucleoside triphosphates (NTP), inorganic phosphate (Pi) and pH within localised regions of the tumour were monitored over 24-48 h following PDT irradiation of the tumour. Reduction of NTP and increases in Pi were observed at 4-6 h after PDT irradiation in all regions of treated tumours. The uppermost regions of the tumours (those nearest the skin surface and exposed to the greatest light fluence) displayed the greatest and most prolonged reduction of NTP and concomitant increase in Pi resulting in necrosis. The metabolite concentrations in tumour regions located towards the base of the tumour returned a near pre-treatment levels by 24-48 h after irradiation. The ability to follow heterogeneous metabolic responses in situ provides one means to assess the degree of metabolic inhibition which subsequently leads to tumour necrosis.
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Affiliation(s)
- T L Ceckler
- Department of Biophysics, University of Rochester School of Medicine and Dentistry, New York 14642
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28
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Moore JV, Dodd NJ, Wood B. Proton nuclear magnetic resonance imaging as a predictor of the outcome of photodynamic therapy of tumours. Br J Radiol 1989; 62:869-70. [PMID: 2790432 DOI: 10.1259/0007-1285-62-741-869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- J V Moore
- Paterson Institute for Cancer Research, Christie Hospital and Holt Radium Institute, Manchester
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