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Swartz HM, Williams BB, Zaki BI, Hartford AC, Jarvis LA, Chen EY, Comi RJ, Ernstoff MS, Hou H, Khan N, Swarts SG, Flood AB, Kuppusamy P. Clinical EPR: unique opportunities and some challenges. Acad Radiol 2014; 21:197-206. [PMID: 24439333 DOI: 10.1016/j.acra.2013.10.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/03/2013] [Accepted: 10/14/2013] [Indexed: 11/29/2022]
Abstract
Electron paramagnetic resonance (EPR) spectroscopy has been well established as a viable technique for measurement of free radicals and oxygen in biological systems, from in vitro cellular systems to in vivo small animal models of disease. However, the use of EPR in human subjects in the clinical setting, although attractive for a variety of important applications such as oxygen measurement, is challenged with several factors including the need for instrumentation customized for human subjects, probe, and regulatory constraints. This article describes the rationale and development of the first clinical EPR systems for two important clinical applications, namely, measurement of tissue oxygen (oximetry) and radiation dose (dosimetry) in humans. The clinical spectrometers operate at 1.2 GHz frequency and use surface-loop resonators capable of providing topical measurements up to 1 cm depth in tissues. Tissue pO2 measurements can be carried out noninvasively and repeatedly after placement of an oxygen-sensitive paramagnetic material (currently India ink) at the site of interest. Our EPR dosimetry system is capable of measuring radiation-induced free radicals in the tooth of irradiated human subjects to determine the exposure dose. These developments offer potential opportunities for clinical dosimetry and oximetry, which include guiding therapy for individual patients with tumors or vascular disease by monitoring of tissue oxygenation. Further work is in progress to translate this unique technology to routine clinical practice.
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Affiliation(s)
- Harold M Swartz
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766.
| | - Benjamin B Williams
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766
| | - Bassem I Zaki
- Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Alan C Hartford
- Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Lesley A Jarvis
- Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Eunice Y Chen
- Department of Surgery, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Richard J Comi
- Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Marc S Ernstoff
- Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH
| | - Huagang Hou
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766
| | - Nadeem Khan
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766
| | - Steven G Swarts
- Dept. of Radiation Oncology, University of Florida, Gainesville, FL
| | - Ann B Flood
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766
| | - Periannan Kuppusamy
- Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth College, 48 Lafayette Street, Lebanon, NH 03766
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Yu JX, Hallac RR, Chiguru S, Mason RP. New frontiers and developing applications in 19F NMR. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2013; 70:25-49. [PMID: 23540575 PMCID: PMC3613763 DOI: 10.1016/j.pnmrs.2012.10.001] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/23/2012] [Indexed: 05/06/2023]
Affiliation(s)
- Jian-Xin Yu
- Laboratory of Prognostic Radiology, Division of Advanced Radiological Sciences, Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Rami R. Hallac
- Laboratory of Prognostic Radiology, Division of Advanced Radiological Sciences, Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Srinivas Chiguru
- Laboratory of Prognostic Radiology, Division of Advanced Radiological Sciences, Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Ralph P. Mason
- Laboratory of Prognostic Radiology, Division of Advanced Radiological Sciences, Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
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McIntyre DJO, Madhu B, Lee SH, Griffiths JR. Magnetic resonance spectroscopy of cancer metabolism and response to therapy. Radiat Res 2012; 177:398-435. [PMID: 22401303 DOI: 10.1667/rr2903.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Magnetic resonance spectroscopy allows noninvasive in vivo measurements of biochemical information from living systems, ranging from cultured cells through experimental animals to humans. Studies of biopsies or extracts offer deeper insights by detecting more metabolites and resolving metabolites that cannot be distinguished in vivo. The pharmacokinetics of certain drugs, especially fluorinated drugs, can be directly measured in vivo. This review briefly describes these methods and their applications to cancer metabolism, including glycolysis, hypoxia, bioenergetics, tumor pH, and tumor responses to radiotherapy and chemotherapy.
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Affiliation(s)
- Dominick J O McIntyre
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK.
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Bell LK, Ainsworth NL, Lee SH, Griffiths JR. MRI & MRS assessment of the role of the tumour microenvironment in response to therapy. NMR IN BIOMEDICINE 2011; 24:612-35. [PMID: 21567513 DOI: 10.1002/nbm.1720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 02/28/2011] [Accepted: 03/07/2011] [Indexed: 05/30/2023]
Abstract
MRI and MRS techniques are being applied to the characterisation of various aspects of the tumour microenvironment and to the assessment of tumour response to therapy. For example, kinetic parameters describing tumour blood vessel flow and permeability can be derived from dynamic contrast-enhanced MRI data and have been correlated with a positive tumour response to antivascular therapies. The ongoing development and validation of noninvasive, high-resolution anatomical/molecular MR techniques will equip us with the means to detect specific tumour biomarkers early on, and then to monitor the efficacy of cancer treatments efficiently and reliably, all within a clinically relevant time frame. Reliable tumour microenvironment imaging biomarkers will provide obvious advantages by enabling tumour-specific treatment tailoring and potentially improving patient outcome. However, for routine clinical application across many disease types, such imaging biomarkers must be quantitative, robust, reproducible, sufficiently sensitive and cost-effective. These characteristics are all difficult to achieve in practice, but image biomarker development and validation have been greatly facilitated by an increasing number of pertinent preclinical in vivo cancer models. Emphasis must now be placed on discovering whether the preclinical results translate into an improvement in patient care and, therefore, overall survival.
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Affiliation(s)
- Leanne K Bell
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK.
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Pacheco-Torres J, López-Larrubia P, Ballesteros P, Cerdán S. Imaging tumor hypoxia by magnetic resonance methods. NMR IN BIOMEDICINE 2011; 24:1-16. [PMID: 21259366 DOI: 10.1002/nbm.1558] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 03/21/2010] [Accepted: 04/01/2010] [Indexed: 05/10/2023]
Abstract
Tumor hypoxia results from the negative balance between the oxygen demands of the tissue and the capacity of the neovasculature to deliver sufficient oxygen. The resulting oxygen deficit has important consequences with regard to the aggressiveness and malignancy of tumors, as well as their resistance to therapy, endowing the imaging of hypoxia with vital repercussions in tumor prognosis and therapy design. The molecular and cellular events underlying hypoxia are mediated mainly through hypoxia-inducible factor, a transcription factor with pleiotropic effects over a variety of cellular processes, including oncologic transformation, invasion and metastasis. However, few methodologies have been able to monitor noninvasively the oxygen tensions in vivo. MRI and MRS are often used for this purpose. Most MRI approaches are based on the effects of the local oxygen tension on: (i) the relaxation times of (19)F or (1)H indicators, such as perfluorocarbons or their (1)H analogs; (ii) the hemodynamics and magnetic susceptibility effects of oxy- and deoxyhemoglobin; and (iii) the effects of paramagnetic oxygen on the relaxation times of tissue water. (19)F MRS approaches monitor tumor hypoxia through the selective accumulation of reduced nitroimidazole derivatives in hypoxic zones, whereas electron spin resonance methods determine the oxygen level through its influence on the linewidths of appropriate paramagnetic probes in vivo. Finally, Overhauser-enhanced MRI combines the sensitivity of EPR methodology with the resolution of MRI, providing a window into the future use of hyperpolarized oxygen probes.
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Affiliation(s)
- Jesús Pacheco-Torres
- Laboratory for Imaging and Spectroscopy by Magnetic Resonance LISMAR, Institute of Biomedical Research Alberto Sols, CSIC/UAM, c/Arturo Duperier 4, Madrid, Spain
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Lee CP, Payne GS, Oregioni A, Ruddle R, Tan S, Raynaud FI, Eaton D, Campbell MJ, Cross K, Halbert G, Tracy M, McNamara J, Seddon B, Leach MO, Workman P, Judson I. A phase I study of the nitroimidazole hypoxia marker SR4554 using 19F magnetic resonance spectroscopy. Br J Cancer 2009; 101:1860-8. [PMID: 19935799 PMCID: PMC2788261 DOI: 10.1038/sj.bjc.6605425] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: SR4554 is a fluorine-containing 2-nitroimidazole, designed as a hypoxia marker detectable with 19F magnetic resonance spectroscopy (MRS). In an initial phase I study of SR4554, nausea/vomiting was found to be dose-limiting, and 1400 mg m−2 was established as MTD. Preliminary MRS studies demonstrated some evidence of 19F retention in tumour. In this study we investigated higher doses of SR4554 and intratumoral localisation of the 19F MRS signal. Methods: Patients had tumours ⩾3 cm in diameter and ⩽4 cm deep. Measurements were performed using 1H/19F surface coils and localised 19F MRS acquisition. SR4554 was administered at 1400 mg m−2, with subsequent increase to 2600 mg m−2 using prophylactic metoclopramide. Spectra were obtained immediately post infusion (MRS no. 1), at 16 h (MRS no. 2) and 20 h (MRS no. 3), based on the SR4554 half-life of 3.5 h determined from a previous study. 19Fluorine retention index (%) was defined as (MRS no. 2/MRS no. 1)*100. Results: A total of 26 patients enrolled at: 1400 (n=16), 1800 (n=1), 2200 (n=1) and 2600 mg m−2 (n=8). SR4554 was well tolerated and toxicities were all ⩽grade 1; mean plasma elimination half-life was 3.7±0.9 h. SR4554 signal was seen on both unlocalised and localised MRS no. 1 in all patients. Localised 19F signals were detected at MRS no. 2 in 5 out of 9 patients and 4 out of 5 patients at MRS no. 3. The mean retention index in tumour was 13.6 (range 0.6–43.7) compared with 4.1 (range 0.6–7.3) for plasma samples taken at the same times (P=0.001) suggesting 19F retention in tumour and, therefore, the presence of hypoxia. Conclusion: We have demonstrated the feasibility of using 19F MRS with SR4554 as a potential method of detecting hypoxia. Certain patients showed evidence of 19F retention in tumour, supporting further development of this technique for detection of tumour hypoxia.
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Affiliation(s)
- C P Lee
- Cancer Research UK Centre for Cancer Therapeutics, Cancer Research UK Clinical Magnetic Resonance Research Group and Section of Medicine, The Institute of Cancer Research and Drug Development Unit, The Royal Marsden Hospital, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
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7
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Abstract
Hypoxia, a condition of insufficient O2 to support metabolism, occurs when the vascular supply is interrupted, as in stroke or myocardial infarction, or when a tumor outgrows its vascular supply. When otherwise healthy tissues lose their O2 supply acutely, the cells usually die, whereas when cells gradually become hypoxic, they adapt by up-regulating the production of numerous proteins that promote their survival. These proteins slow the rate of growth, switch the mitochondria to glycolysis, stimulate growth of new vasculature, inhibit apoptosis, and promote metastatic spread. The consequence of these changes is that patients with hypoxic tumors invariably experience poor outcome to treatment. This has led the molecular imaging community to develop assays for hypoxia in patients, including regional measurements from O2 electrodes placed under CT guidance, several nuclear medicine approaches with imaging agents that accumulate with an inverse relationship to O2, MRI methods that measure either oxygenation directly or lactate production as a consequence of hypoxia, and optical methods with NIR and bioluminescence. The advantages and disadvantages of these approaches are reviewed, along with the individual strategies for validating different imaging methods. Ultimately the proof of value is in the clinical performance to predict outcome, select an appropriate cohort of patients to benefit from a hypoxia-directed treatment, or plan radiation fields that result in better local control. Hypoxia imaging in support of molecular medicine has become an important success story over the last decade and provides a model and some important lessons for development of new molecular imaging probes or techniques.
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Affiliation(s)
- Kenneth A Krohn
- Department of Radiology, University of Washington, Seattle, Washington 98195-6004, USA.
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Davda S, Bezabeh T. Advances in methods for assessing tumor hypoxia in vivo: implications for treatment planning. Cancer Metastasis Rev 2007; 25:469-80. [PMID: 17029029 DOI: 10.1007/s10555-006-9009-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Tumor hypoxia and its downstream effects have remained of considerable interest for decades due to its negative impact on response to various cancer therapies and promotion of metastasis. Diagnosing hypoxia non-invasively can provide a significant advancement in cancer treatment and is the dire necessity for implementing specific targeted therapies now emerging to treat different aspects of cancer. A variety of techniques are being proposed to do so. However, none of them has yet been established in the clinical arena. This review summarizes the methods currently available to assess tumor hypoxia in vivo and their respective advantages and shortcomings. It also points out the impedances that need to be overcome to establish any particular method in the clinic, along with a broad overview of requirements for further advancement in this sphere of cancer research.
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Affiliation(s)
- Sonal Davda
- Institute for Biodiagnostics, National Research Council, 435 Ellice Avenue, Winnipeg, Manitoba, Canada, R3B 1Y6
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Abstract
Bioreductive drugs are inactive prodrugs that are converted into potent cytotoxins under conditions of either low oxygen tension or in the presence of high levels of specific reductases. The biochemical basis for selectivity relies on the ability of oxygen to reverse the activation process and the presence of elevated reductase levels in some tumour types. Key criteria for an ideal bioreductive drug should include poor activity against aerobic cells, activation over a broad range of oxygen tensions and, penetration through the aerobic fraction of cells. In addition, the active drug should be capable of killing non-proliferating cells. Numerous compounds are currently at various stages of drug development but Mitomycin C, which is generally considered to be the prototype bioreductive drug, is the only one in clinical use today. Of the drugs currently being evaluated clinically, tirapazamine has definite clinical activity against a variety of solid tumours when used in combination with cisplatin. Other drugs, such as EO9 and various nitroimidazoles, have not been impressive in the clinic and further development is required to improve properties such as drug delivery in the case of indoloquinones. A novel approach to exploiting tumour hypoxia is the development of a gene-directed enzyme prodrug therapy (GDEPT) strategy, where a gene encoding for a prodrug activating enzyme has been placed under the control of a hypoxia responsive promoter sequence. It is generally recognised that bioreductive drugs must be directed towards patients whose tumours have hypoxic regions or have appropriate enzymological characteristics. In terms of identifying tumour hypoxia, there has been considerable progress in the development of nitroimidazole based hypoxia markers that can be detected either via non-invasive or invasive procedures. Another strategy currently undergoing preclinical evaluation is the use of agents that modulate tumour blood flow and synergistic effects have been reported between bioreductive drugs and photodynamic therapy or inhibitors of nitric oxide synthase for example. The development of clinically useful bioreductive drugs depends therefore on the expertise of scientists and clinicians with varying backgrounds. The purpose of this review is to describe and critically assess recent developments in this field, with particular emphasis being placed on drug development and strategies aimed at optimising bioreductive drug activity.
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Affiliation(s)
- R M Phillips
- Clinical Oncology Unit, University of Bradford, Bradford, BD7 1DP, UK
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Russell PJ, Ow KT, Tam PN, Juarez J, Kingsley EA, Qu CF, Li Y, Cozzi PJ, Martiniello-Wilks R. Immunohistochemical characterisation of the monoclonal antibody BLCA-38 for the detection of prostate cancer. Cancer Immunol Immunother 2004; 53:995-1004. [PMID: 15449043 PMCID: PMC11032839 DOI: 10.1007/s00262-004-0527-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2004] [Accepted: 02/29/2004] [Indexed: 11/28/2022]
Abstract
BACKGROUND Monoclonal antibodies (MAbs) can be used to detect, image and treat cancers. This study aimed to characterise the binding of BLCA-38 MAbs to human prostate cancer cell lines, human prostate cancer biopsy samples and normal tissues to enable future targeted studies. METHODS BLCA-38 antigen expression on cancer lines was determined by flow cytometry; that on patient specimens from normal tissues and cancers was tested by immunohistochemistry using fresh frozen tissues or paraffin-embedded tissues that had undergone antigen retrieval. RESULTS Cell surface BLCA-38 antigen expression was seen on DU-145, PC-3, PC-3 M and PC-3 M-MM2 prostate cancer lines, but LNCaP, MDA PCa 2a or MDA PCa 2b lines were negative. Other human lines, including 8/12 bladder cancer and A431 vulval epidermoid cells, but not breast cancer lines, expressed BLCA-38 antigen. Staining occurred in glandular epithelial cells in the majority of frozen, and paraffin-embedded prostate cancer tissues and was occasionally seen in prostatic intraepithelial neoplasia (PIN). No staining was observed in normal cadaver tissues or in benign areas from various other cancer tissues. CONCLUSIONS The BLCA-38 antibody binds to the majority of human prostate cancers but not to normal cells, and has potential for targeting novel therapies in patients with this disease.
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Affiliation(s)
- P J Russell
- Oncology Research Centre, Prince of Wales Hospital, Clinical Sciences Building, Level 2, Barker Street, Randwick, 2031, Sydney, NSW, Australia.
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Robinson SP, Griffiths JR. Current issues in the utility of 19F nuclear magnetic resonance methodologies for the assessment of tumour hypoxia. Philos Trans R Soc Lond B Biol Sci 2004; 359:987-96. [PMID: 15306411 PMCID: PMC1693379 DOI: 10.1098/rstb.2003.1376] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
It is now well established that uncontrolled proliferation of tumour cells together with the chaotic and poorly regulated blood supply of solid tumours result in tissue hypoxia, and that hypoxic regions of tumours are resistant to radiotherapy and chemotherapy. The development and application of non-invasive methods to rapidly determine the degree and extent of tumour hypoxia in an individual tumour would clearly enhance cancer treatment strategies. This review describes the current status of two (19)F nuclear magnetic resonance (NMR) methodologies that have been exploited to investigate tumour hypoxia, namely: (i) (19)F NMR oximetry following administration of perfluorocarbons, from which tumour p(O)(2) measurements can be made; and (ii) (19)F NMR measurements of the tumour retention of fluorinated 2-nitroimidazoles.
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Affiliation(s)
- Simon P Robinson
- Department of Basic Medical Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
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Pandian RP, Parinandi NL, Ilangovan G, Zweier JL, Kuppusamy P. Novel particulate spin probe for targeted determination of oxygen in cells and tissues. Free Radic Biol Med 2003; 35:1138-48. [PMID: 14572616 DOI: 10.1016/s0891-5849(03)00496-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The synthesis and characterization of a new lithium octa-n-butoxy-substituted naphthalocyanine radical probe (LiNc-BuO) and its use in the determination of concentration of oxygen (oximetry) by electron paramagnetic resonance (EPR) spectroscopy are reported. The probe is synthesized as a needle-shaped microcrystalline particulate. The particulate shows a single-line EPR spectrum that is highly exchange-narrowed with a line-width of 210 mG. The EPR line-width is sensitive to molecular oxygen showing a linear relationship between the line-width and concentration of oxygen (pO(2)) with a sensitivity of 8.5 mG/mmHg. We studied a variety of physicochemical and biological properties of LiNc-BuO particulates to evaluate the suitability of the probe for in vivo oximetry. The probe is unaffected by biological oxidoreductants, stable in tissues for several months, and can be successfully internalized in cells. We used this probe to monitor changes in concentration of oxygen in the normal muscle and RIF-1 tumor tissue of mice as a function of tumor growth. The data showed a rapid decrease in the tumor pO(2) with increase of tumor volume. Human arterial smooth muscle cells, upon internalization of the LiNc-BuO probe, showed a marked oxygen gradient across the cell membrane. In summary, the newly synthesized octa-n-butoxy derivative of lithium naphthalocyanine has unique properties that are useful for determining oxygen concentration in chemical and biological systems by EPR spectroscopy and also for magnetic tagging of cells.
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Affiliation(s)
- Ramasamy P Pandian
- Center for Biomedical EPR Spectroscopy and Imaging, Department of Internal Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH 43210, USA
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Swartz HM, Dunn JF. Measurements of Oxygen in Tissues: Overview and Perspectives on Methods. OXYGEN TRANSPORT TO TISSUE XXIV 2003; 530:1-12. [PMID: 14562699 DOI: 10.1007/978-1-4615-0075-9_1] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The goal of this manuscript is to provide a summary of the major techniques that currently are being applied to measure oxygenation of tissues in vivo. Oxygen is one of the key components of metabolism. Oxygen is also a major variable in many diseases, both with respect to the pathophysiological processes and influencing the efficacy of treatment. Unfortunately, however, the measurement of tissue oxygenation is non-trivial. Consequently many different methods have been developed to try to make this measurement. This paper presents a summary, largely in tabular form, of most of the current methods for assessing tissue oxygenation. The table attempts to cover the most pertinent aspects of the techniques and their applications, including their potential niche, limitations, and advantages. Citations are given for each method to point the reader in the direction of relevant literature.
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Affiliation(s)
- Harold M Swartz
- EPR Center for Study of Viable Systems, Biomedical NMR Laboratory, Department of Diagnostic Radiology, Dartmouth Medical School, 7785 Vail Building, Hanover, NH 03755, USA
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14
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Affiliation(s)
- P Workman
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Sutton, Surrey SN2 5NG, UK.
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15
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Gillies RJ, Raghunand N, Karczmar GS, Bhujwalla ZM. MRI of the tumor microenvironment. J Magn Reson Imaging 2002; 16:430-50. [PMID: 12353258 DOI: 10.1002/jmri.10181] [Citation(s) in RCA: 418] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The microenvironment within tumors is significantly different from that in normal tissues. A major difference is seen in the chaotic vasculature of tumors, which results in unbalanced blood supply and significant perfusion heterogeneities. As a consequence, many regions within tumors are transiently or chronically hypoxic. This exacerbates tumor cells' natural tendency to overproduce acids, resulting in very acidic pH values. The hypoxia and acidity of tumors have important consequences for antitumor therapy and can contribute to the progression of tumors to a more aggressive metastatic phenotype. Over the past decade, techniques have emerged that allow the interrogation of the tumor microenvironment with high resolution and molecularly specific probes. Techniques are available to interrogate perfusion, vascular distribution, pH, and pO(2) nondestructively in living tissues with relatively high precision. Studies employing these methods have provided new insights into the causes and consequences of the hostile tumor microenvironment. Furthermore, it is quite exciting that there are emerging techniques that generate tumor image contrast via ill-defined mechanisms. Elucidation of these mechanisms will yield further insights into the tumor microenvironment. This review attempts to identify techniques and their application to tumor biology, with an emphasis on nuclear magnetic resonance (NMR) approaches. Examples are also discussed using electron MR, optical, and radionuclear imaging techniques.
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Affiliation(s)
- Robert J Gillies
- Department of Biochemistry, Arizona Cancer Center, University of Arizona HSC, Tucson, Arizona 85724-5024, USA.
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