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Lee H, Fu JF, Gaudet K, Bryant AG, Price JC, Bennett RE, Johnson KA, Hyman BT, Hedden T, Salat DH, Yen YF, Huang SY. Aberrant vascular architecture in the hippocampus correlates with tau burden in mild cognitive impairment and Alzheimer's disease. J Cereb Blood Flow Metab 2024; 44:787-800. [PMID: 38000018 PMCID: PMC11197134 DOI: 10.1177/0271678x231216144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/04/2023] [Accepted: 10/21/2023] [Indexed: 11/26/2023]
Abstract
Cerebrovascular dysfunction is a significant contributor to Alzheimer's disease (AD) progression. AD mouse models show altered capillary morphology, density, and diminished blood flow in areas of tau and beta-amyloid accumulation. The purpose of this study was to examine alterations in vascular structure and their contributions to perfusion deficits in the hippocampus in AD and mild cognitive impairment (MCI). Seven individuals with AD and MCI (1 AD/6 MCI), nine cognitively intact older healthy adults, and seven younger healthy adults underwent pseudo-continuous arterial spin labeling (PCASL) and gradient-echo/spin-echo (GESE) dynamic susceptibility contrast (DSC) MRI. Cerebral blood flow (CBF), cerebral blood volume, relative vessel size index (rVSI), and mean vessel density were calculated from model fitting. Lower CBF from PCASL and SE DSC MRI was observed in the hippocampus of AD/MCI group. rVSI in the hippocampus of the AD/MCI group was larger than that of the two healthy groups (FDR-P = 0.02). No difference in vessel density was detected between the groups. We also explored relationship of tau burden from 18F-flortaucipir positron emission tomography and vascular measures from MRI. Tau burden was associated with larger vessel size and lower CBF in the hippocampus. We postulate that larger vessel size may be associated with vascular alterations in AD/MCI.
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Affiliation(s)
- Hansol Lee
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Jessie Fanglu Fu
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Kyla Gaudet
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Annie G Bryant
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Rachel E Bennett
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Trey Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David H Salat
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Yi-Fen Yen
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Susie Y Huang
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
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Sanvito F, Raymond C, Cho NS, Yao J, Hagiwara A, Orpilla J, Liau LM, Everson RG, Nghiemphu PL, Lai A, Prins R, Salamon N, Cloughesy TF, Ellingson BM. Simultaneous quantification of perfusion, permeability, and leakage effects in brain gliomas using dynamic spin-and-gradient-echo echoplanar imaging MRI. Eur Radiol 2024; 34:3087-3101. [PMID: 37882836 PMCID: PMC11045669 DOI: 10.1007/s00330-023-10215-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To determine the feasibility and biologic correlations of dynamic susceptibility contrast (DSC), dynamic contrast enhanced (DCE), and quantitative maps derived from contrast leakage effects obtained simultaneously in gliomas using dynamic spin-and-gradient-echo echoplanar imaging (dynamic SAGE-EPI) during a single contrast injection. MATERIALS AND METHODS Thirty-eight patients with enhancing brain gliomas were prospectively imaged with dynamic SAGE-EPI, which was processed to compute traditional DSC metrics (normalized relative cerebral blood flow [nrCBV], percentage of signal recovery [PSR]), DCE metrics (volume transfer constant [Ktrans], extravascular compartment [ve]), and leakage effect metrics: ΔR2,ss* (reflecting T2*-leakage effects), ΔR1,ss (reflecting T1-leakage effects), and the transverse relaxivity at tracer equilibrium (TRATE, reflecting the balance between ΔR2,ss* and ΔR1,ss). These metrics were compared between patient subgroups (treatment-naïve [TN] vs recurrent [R]) and biological features (IDH status, Ki67 expression). RESULTS In IDH wild-type gliomas (IDHwt-i.e., glioblastomas), previous exposure to treatment determined lower TRATE (p = 0.002), as well as higher PSR (p = 0.006), Ktrans (p = 0.17), ΔR1,ss (p = 0.035), ve (p = 0.006), and ADC (p = 0.016). In IDH-mutant gliomas (IDHm), previous treatment determined higher Ktrans and ΔR1,ss (p = 0.026). In TN-gliomas, dynamic SAGE-EPI metrics tended to be influenced by IDH status (p ranging 0.09-0.14). TRATE values above 142 mM-1s-1 were exclusively seen in TN-IDHwt, and, in TN-gliomas, this cutoff had 89% sensitivity and 80% specificity as a predictor of Ki67 > 10%. CONCLUSIONS Dynamic SAGE-EPI enables simultaneous quantification of brain tumor perfusion and permeability, as well as mapping of novel metrics related to cytoarchitecture (TRATE) and blood-brain barrier disruption (ΔR1,ss), with a single contrast injection. CLINICAL RELEVANCE STATEMENT Simultaneous DSC and DCE analysis with dynamic SAGE-EPI reduces scanning time and contrast dose, respectively alleviating concerns about imaging protocol length and gadolinium adverse effects and accumulation, while providing novel leakage effect metrics reflecting blood-brain barrier disruption and tumor tissue cytoarchitecture. KEY POINTS • Traditionally, perfusion and permeability imaging for brain tumors requires two separate contrast injections and acquisitions. • Dynamic spin-and-gradient-echo echoplanar imaging enables simultaneous perfusion and permeability imaging. • Dynamic spin-and-gradient-echo echoplanar imaging provides new image contrasts reflecting blood-brain barrier disruption and cytoarchitecture characteristics.
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Affiliation(s)
- Francesco Sanvito
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
- Unit of Radiology, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Nicholas S Cho
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
- Medical Scientist Training Program, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California Los Angeles, 7400 Boelter Hall, Los Angeles, CA, 90095, USA
| | - Jingwen Yao
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Akifumi Hagiwara
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
- Department of Radiology, Juntendo University School of Medicine, Bunkyo City, 2-Chōme-1-1 Hongō, Tokyo, 113-8421, Japan
| | - Joey Orpilla
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Linda M Liau
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Richard G Everson
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Phioanh L Nghiemphu
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Albert Lai
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Robert Prins
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Timothy F Cloughesy
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, 924 Westwood Blvd, Los Angeles, CA, 90024, USA.
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA.
- Medical Scientist Training Program, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California Los Angeles, 7400 Boelter Hall, Los Angeles, CA, 90095, USA.
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA.
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, 885 Tiverton Dr, Los Angeles, CA, 90095, USA.
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Arzanforoosh F, Van der Velden M, Berman AJL, Van der Voort SR, Bos EM, Schouten JW, Vincent AJPE, Kros JM, Smits M, Warnert EAH. MRI-Based Assessment of Brain Tumor Hypoxia: Correlation with Histology. Cancers (Basel) 2023; 16:138. [PMID: 38201565 PMCID: PMC10778427 DOI: 10.3390/cancers16010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Cerebral hypoxia significantly impacts the progression of brain tumors and their resistance to radiotherapy. This study employed streamlined quantitative blood-oxygen-level-dependent (sqBOLD) MRI to assess the oxygen extraction fraction (OEF)-a measure of how much oxygen is being extracted from vessels, with higher OEF values indicating hypoxia. Simultaneously, we utilized vessel size imaging (VSI) to evaluate microvascular dimensions and blood volume. A cohort of ten patients, divided between those with glioma and those with brain metastases, underwent a 3 Tesla MRI scan. We generated OEF, cerebral blood volume (CBV), and vessel size maps, which guided 3-4 targeted biopsies per patient. Subsequent histological analyses of these biopsies used hypoxia-inducible factor 1-alpha (HIF-1α) for hypoxia and CD31 for microvasculature assessment, followed by a correlation analysis between MRI and histological data. The results showed that while the sqBOLD model was generally applicable to brain tumors, it demonstrated discrepancies in some metastatic tumors, highlighting the need for model adjustments in these cases. The OEF, CBV, and vessel size maps provided insights into the tumor's hypoxic condition, showing intertumoral and intratumoral heterogeneity. A significant relationship between MRI-derived measurements and histological data was only evident in the vessel size measurements (r = 0.68, p < 0.001).
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Affiliation(s)
- Fatemeh Arzanforoosh
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Maaike Van der Velden
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Avery J. L. Berman
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6, Canada
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Sebastian R. Van der Voort
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Eelke M. Bos
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Neurosurgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Joost W. Schouten
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Neurosurgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Arnaud J. P. E. Vincent
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Neurosurgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Johan M. Kros
- Department of Pathology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Medical Delta, 2629 JH Delft, The Netherlands
| | - Esther A. H. Warnert
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
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Sanvito F, Kaufmann TJ, Cloughesy TF, Wen PY, Ellingson BM. Standardized brain tumor imaging protocols for clinical trials: current recommendations and tips for integration. FRONTIERS IN RADIOLOGY 2023; 3:1267615. [PMID: 38152383 PMCID: PMC10751345 DOI: 10.3389/fradi.2023.1267615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023]
Abstract
Standardized MRI acquisition protocols are crucial for reducing the measurement and interpretation variability associated with response assessment in brain tumor clinical trials. The main challenge is that standardized protocols should ensure high image quality while maximizing the number of institutions meeting the acquisition requirements. In recent years, extensive effort has been made by consensus groups to propose different "ideal" and "minimum requirements" brain tumor imaging protocols (BTIPs) for gliomas, brain metastases (BM), and primary central nervous system lymphomas (PCSNL). In clinical practice, BTIPs for clinical trials can be easily integrated with additional MRI sequences that may be desired for clinical patient management at individual sites. In this review, we summarize the general concepts behind the choice and timing of sequences included in the current recommended BTIPs, we provide a comparative overview, and discuss tips and caveats to integrate additional clinical or research sequences while preserving the recommended BTIPs. Finally, we also reflect on potential future directions for brain tumor imaging in clinical trials.
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Affiliation(s)
- Francesco Sanvito
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Timothy F. Cloughesy
- UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Patrick Y. Wen
- Center for Neuro-Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA, United States
| | - Benjamin M. Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Ahmed T. Biomaterial-based in vitro 3D modeling of glioblastoma multiforme. CANCER PATHOGENESIS AND THERAPY 2023; 1:177-194. [PMID: 38327839 PMCID: PMC10846340 DOI: 10.1016/j.cpt.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/24/2022] [Accepted: 01/04/2023] [Indexed: 02/09/2024]
Abstract
Adult-onset brain cancers, such as glioblastomas, are particularly lethal. People with glioblastoma multiforme (GBM) do not anticipate living for more than 15 months if there is no cure. The results of conventional treatments over the past 20 years have been underwhelming. Tumor aggressiveness, location, and lack of systemic therapies that can penetrate the blood-brain barrier are all contributing factors. For GBM treatments that appear promising in preclinical studies, there is a considerable rate of failure in phase I and II clinical trials. Unfortunately, access becomes impossible due to the intricate architecture of tumors. In vitro, bioengineered cancer models are currently being used by researchers to study disease development, test novel therapies, and advance specialized medications. Many different techniques for creating in vitro systems have arisen over the past few decades due to developments in cellular and tissue engineering. Later-stage research may yield better results if in vitro models that resemble brain tissue and the blood-brain barrier are used. With the use of 3D preclinical models made available by biomaterials, researchers have discovered that it is possible to overcome these limitations. Innovative in vitro models for the treatment of GBM are possible using biomaterials and novel drug carriers. This review discusses the benefits and drawbacks of 3D in vitro glioblastoma modeling systems.
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Affiliation(s)
- Tanvir Ahmed
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh
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Cho NS, Sanvito F, Thakuria S, Wang C, Hagiwara A, Nagaraj R, Oshima S, Lopez Kolkovsky AL, Lu J, Raymond C, Liau LM, Everson RG, Patel KS, Kim W, Yang I, Bergsneider M, Nghiemphu PL, Lai A, Nathanson DA, Cloughesy TF, Ellingson BM. Multi-nuclear sodium, diffusion, and perfusion MRI in human gliomas. J Neurooncol 2023; 163:417-427. [PMID: 37294422 PMCID: PMC10322966 DOI: 10.1007/s11060-023-04363-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE There is limited knowledge about the associations between sodium and proton MRI measurements in brain tumors. The purpose of this study was to quantify intra- and intertumoral correlations between sodium, diffusion, and perfusion MRI in human gliomas. METHODS Twenty glioma patients were prospectively studied on a 3T MRI system with multinuclear capabilities. Three mutually exclusive tumor volumes of interest (VOIs) were segmented: contrast-enhancing tumor (CET), T2/FLAIR hyperintense non-enhancing tumor (NET), and necrosis. Median and voxel-wise associations between apparent diffusion coefficient (ADC), normalized relative cerebral blood volume (nrCBV), and normalized sodium measurements were quantified for each VOI. RESULTS Both relative sodium concentration and ADC were significantly higher in areas of necrosis compared to NET (P = 0.003 and P = 0.008, respectively) and CET (P = 0.02 and P = 0.02). Sodium concentration was higher in CET compared to NET (P = 0.04). Sodium and ADC were higher in treated compared to treatment-naïve gliomas within NET (P = 0.006 and P = 0.01, respectively), and ADC was elevated in CET (P = 0.03). Median ADC and sodium concentration were positively correlated across patients in NET (r = 0.77, P < 0.0001) and CET (r = 0.84, P < 0.0001), but not in areas of necrosis (r = 0.45, P = 0.12). Median nrCBV and sodium concentration were negatively correlated across patients in areas of NET (r=-0.63, P = 0.003). Similar associations were observed when examining voxel-wise correlations within VOIs. CONCLUSION Sodium MRI is positively correlated with proton diffusion MRI measurements in gliomas, likely reflecting extracellular water. Unique areas of multinuclear MRI contrast may be useful in future studies to understand the chemistry of the tumor microenvironment.
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Affiliation(s)
- Nicholas S Cho
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, USA
- Medical Scientist Training Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Francesco Sanvito
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Shruti Thakuria
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Raksha Nagaraj
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sonoko Oshima
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alfredo L Lopez Kolkovsky
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France
| | - Jianwen Lu
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Linda M Liau
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard G Everson
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kunal S Patel
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Won Kim
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marvin Bergsneider
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Phioanh L Nghiemphu
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Albert Lai
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - David A Nathanson
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- UCLA Brain Tumor Imaging Laboratory (BTIL) Professor of Radiology, Psychiatry, and Neurosurgery Departments of Radiological Sciences, Psychiatry, and Neurosurgery David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.
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Zhang K, Triphan SMF, Kurz FT, Ziener CH, Kauczor HU, Schlemmer HP, Sedlaczek O. Navigator-based slice tracking for prospective motion correction in kidney vessel architecture imaging. Magn Reson Imaging 2023; 98:26-35. [PMID: 36603781 DOI: 10.1016/j.mri.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To apply a navigator-based slice tracking method to prospectively compensate the respiratory motion for kidney vessel architecture imaging (VAI). MATERIALS AND METHODS A dual gradient echo spin echo 2D EPI sequence was developed for kidney VAI. A single gradient-echo slice selection and projection readout at the location of the diaphragm along the inferior-superior direction was applied as a navigator. Navigator acquisition and fat suppression were inserted before each transverse imaging slice. Motion information was calculated after exclusion of the signal saturation in the navigator signal caused by imaging slices. The motion information was then directly sent back to the sequence and slice positioning was adjusted in real-time. The whole sequence was applied during a contrast agent pass-through. RESULTS VAI parametric maps show the structural heterogeneity of the renal vasculature. The respiratory motion from the navigator signal was precisely calculated and slice positioning was changed in real-time based on the motion information. The vibration amplitude of the signal intensity of the liver tissue at the liver-lung interface in the case of prospective motion correction (PMC) on is about 28% of the PMC off case. Compared to the case of PMC off, the coefficient of variation was reduced 30% of the case of PMC on. CONCLUSIONS This study demonstrates the feasibility of the motion-compensating technique in kidney VAI. The sequence may improve the evaluation of microvasculature in kidney diseases.
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Affiliation(s)
- Ke Zhang
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Christian H Ziener
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Oliver Sedlaczek
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
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8
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Venugopal K, Arzanforoosh F, van Dorth D, Smits M, van Osch MJP, Hernandez-Tamames JA, Warnert EAH, Poot DHJ. MR Vascular Fingerprinting with Hybrid Gradient–Spin Echo Dynamic Susceptibility Contrast MRI for Characterization of Microvasculature in Gliomas. Cancers (Basel) 2023; 15:cancers15072180. [PMID: 37046841 PMCID: PMC10093700 DOI: 10.3390/cancers15072180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Characterization of tumor microvasculature is important in tumor assessment and studying treatment response. This is possible by acquiring vascular biomarkers with magnetic resonance imaging (MRI) based on dynamic susceptibility contrast (DSC). We propose magnetic resonance vascular fingerprinting (MRVF) for hybrid echo planar imaging (HEPI) acquired during the first passage of the contrast agent (CA). The proposed approach was evaluated in patients with gliomas, and we simultaneously estimated vessel radius and relative cerebral blood volume. These parameters were also compared to the respective values estimated using the previously introduced vessel size imaging (VSI) technique. The results of both methods were found to be consistent. MRVF was also found to be robust to noise in the estimation of the parameters. DSC-HEPI-based MRVF provides characterization of microvasculature in gliomas with a short acquisition time and can be further improved in several ways to increase our understanding of tumor physiology.
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Affiliation(s)
- Krishnapriya Venugopal
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Fatemeh Arzanforoosh
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Daniëlle van Dorth
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Matthias J. P. van Osch
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Juan A. Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Department of Medical Imaging, Faculty of Applied Physics, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Esther A. H. Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Dirk H. J. Poot
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
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9
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Arzanforoosh F, van der Voort SR, Incekara F, Vincent A, Van den Bent M, Kros JM, Smits M, Warnert EAH. Microvasculature Features Derived from Hybrid EPI MRI in Non-Enhancing Adult-Type Diffuse Glioma Subtypes. Cancers (Basel) 2023; 15:cancers15072135. [PMID: 37046796 PMCID: PMC10093697 DOI: 10.3390/cancers15072135] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/07/2023] Open
Abstract
In this study, we used the vessel size imaging (VSI) MRI technique to characterize the microvasculature features of three subtypes of adult-type diffuse glioma lacking enhancement. Thirty-eight patients with confirmed non-enhancing glioma were categorized into three subtypes: Oligo (IDH-mut&1p/19q-codeleted), Astro (IDH-mut), and GBM (IDH-wt). The VSI technique provided quantitative maps of cerebral blood volume (CBV), microvasculature (µCBV), and vessel size for each patient. Additionally, tissue samples of 21 patients were histopathologically analyzed, and microvasculature features were quantified. Both MRI- and histology-derived features were compared across the three glioma subtypes with ANOVA or Kruskal–Wallis tests. Group averages of CBV, μCBV, and vessel size were significantly different between the three glioma subtypes (p < 0.01). Astro (IDH-mut) had a significantly lower CBV and µCBV compared to Oligo (IDH-mut&1p/19q-codeleted) (p = 0.004 and p = 0.001, respectively), and a higher average vessel size compared to GBM (IDH-wt) (p = 0.01). The histopathological analysis showed that GBM (IDH-wt) possessed vessels with more irregular shapes than the two other subtypes (p < 0.05). VSI provides a good insight into the microvasculature characteristics of the three adult-type glioma subtypes even when lacking enhancement. Further investigations into the specificity of VSI to differentiate glioma subtypes are thus warranted.
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Affiliation(s)
- Fatemeh Arzanforoosh
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Sebastian R. van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Department of Neurosurgery, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Arnaud Vincent
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Neurosurgery, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Martin Van den Bent
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Johan M. Kros
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Department of Pathology, Erasmus MC, 3000 CB Rotterdam, The Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- Medical Delta, 2629 JH Delft, The Netherlands
| | - Esther A. H. Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Brain Tumor Center, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
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10
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Yan X, Li S, Yan H, Yu C, Liu F. IONPs-Based Medical Imaging in Cancer Care: Moving Beyond Traditional Diagnosis and Therapeutic Assessment. Int J Nanomedicine 2023; 18:1741-1763. [PMID: 37034271 PMCID: PMC10075272 DOI: 10.2147/ijn.s399047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
Cancer-related burden of morbidity and mortality is rapidly rising worldwide. Medical imaging plays an important role in every phase of cancer management, including diagnosis, staging, treatment planning and evaluation. Iron oxide nanoparticles (IONPs) could serve as contrast agents or labeling agents to enhance the identification and visualization of pathological tissues as well as target cells. Multimodal or multifunctional imaging can be easily acquired by modifying IONPs with other imaging agents or functional groups, allowing the accessibility of combined imaging techniques and providing more comprehensive information for cancer care. To date, IONPs-enhanced medical imaging has gained intensive application in early diagnosis, monitoring treatment as well as guiding radio-frequency ablation, sentinel lymph node dissection, radiotherapy and hyperthermia therapy. Besides, IONPs mediated imaging is also capable of promoting the development of anti-cancer nanomedicines through identifying patients potentially sensitive to nanotherapeutics. Based on versatile imaging modes and application fields, this review highlights and summarizes recent research advances of IONPs-based medical imaging in cancer management. Besides, currently existing challenges are also discussed to provide perspectives and advices for the future development of IONPs-based imaging in cancer management.
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Affiliation(s)
- Xiaolin Yan
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, Shandong Province, People’s Republic of China
| | - Shanshan Li
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, Shandong Province, People’s Republic of China
| | - Haiyin Yan
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, Shandong Province, People’s Republic of China
| | - Chungang Yu
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, Shandong Province, People’s Republic of China
| | - Fengxi Liu
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, Shandong Province, People’s Republic of China
- Correspondence: Fengxi Liu, Tel +86 0531-89269594, Email
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11
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Cho NS, Hagiwara A, Sanvito F, Ellingson BM. A multi-reader comparison of normal-appearing white matter normalization techniques for perfusion and diffusion MRI in brain tumors. Neuroradiology 2023; 65:559-568. [PMID: 36301349 PMCID: PMC9905164 DOI: 10.1007/s00234-022-03072-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/14/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE There remains no consensus normal-appearing white matter (NAWM) normalization method to compute normalized relative cerebral blood volume (nrCBV) and apparent diffusion coefficient (nADC) in brain tumors. This reader study explored nrCBV and nADC differences using different NAWM normalization methods. METHODS Thirty-five newly diagnosed glioma patients were studied. For each patient, two readers created four NAWM regions of interests: (1) a single plane in the centrum semiovale (CSOp), (2) 3 spheres in the centrum semiovale (CSOs), (3) a single plane in the slice of the tumor center (TUMp), and (4) 3 spheres in the slice of the tumor center (TUMs). Readers repeated NAWM segmentations 1 month later. Differences in nrCBV and nADC of the FLAIR hyperintense tumor, inter-/intra-reader variability, and time to segment NAWM were assessed. As a validation step, the diagnostic performance of each method for IDH-status prediction was evaluated. RESULTS Both readers obtained significantly different nrCBV (P < .001), nADC (P < .001), and time to segment NAWM (P < .001) between the four normalization methods. nrCBV and nADC were significantly different between CSO and TUM methods, but not between planar and spherical methods in the same NAWM region. Broadly, CSO methods were quicker than TUM methods, and spherical methods were quicker than planar methods. For all normalization techniques, inter-reader reproducibility and intra-reader repeatability were excellent (intraclass correlation coefficient > 0.9), and the IDH-status predictive performance remained similar. CONCLUSION The selected NAWM region significantly impacts nrCBV and nADC values. CSO methods, particularly CSOs, may be preferred because of time reduction, similar reader variability, and similar diagnostic performance compared to TUM methods.
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Affiliation(s)
- Nicholas S Cho
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, USA
- Medical Scientist Training Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Francesco Sanvito
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA
- Unit of Radiology, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Benjamin M Ellingson
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
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12
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Henssen D, Meijer F, Verburg FA, Smits M. Challenges and opportunities for advanced neuroimaging of glioblastoma. Br J Radiol 2023; 96:20211232. [PMID: 36062962 PMCID: PMC10997013 DOI: 10.1259/bjr.20211232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 08/10/2022] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
Abstract
Glioblastoma is the most aggressive of glial tumours in adults. On conventional magnetic resonance (MR) imaging, these tumours are observed as irregular enhancing lesions with areas of infiltrating tumour and cortical expansion. More advanced imaging techniques including diffusion-weighted MRI, perfusion-weighted MRI, MR spectroscopy and positron emission tomography (PET) imaging have found widespread application to diagnostic challenges in the setting of first diagnosis, treatment planning and follow-up. This review aims to educate readers with regard to the strengths and weaknesses of the clinical application of these imaging techniques. For example, this review shows that the (semi)quantitative analysis of the mentioned advanced imaging tools was found useful for assessing tumour aggressiveness and tumour extent, and aids in the differentiation of tumour progression from treatment-related effects. Although these techniques may aid in the diagnostic work-up and (post-)treatment phase of glioblastoma, so far no unequivocal imaging strategy is available. Furthermore, the use and further development of artificial intelligence (AI)-based tools could greatly enhance neuroradiological practice by automating labour-intensive tasks such as tumour measurements, and by providing additional diagnostic information such as prediction of tumour genotype. Nevertheless, due to the fact that advanced imaging and AI-diagnostics is not part of response assessment criteria, there is no harmonised guidance on their use, while at the same time the lack of standardisation severely hampers the definition of uniform guidelines.
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Affiliation(s)
- Dylan Henssen
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Frederick Meijer
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Frederik A. Verburg
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Marion Smits
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
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13
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Li H, Zheng C, Rao W, Sun J, Yu X, Zhang J. The risk factors of hemorrhage in stereotactic needle biopsy for brain lesions in a large cohort: 10 years of experience in a single center. Chin Neurosurg J 2022; 8:40. [PMID: 36494749 PMCID: PMC9732999 DOI: 10.1186/s41016-022-00307-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to identify the risk factors for hemorrhage from a large cohort who underwent stereotactic needle biopsy for brain lesions at a single center over a 10-year period. METHODS We performed a retrospective chart review of consecutive patients who underwent stereotactic biopsy at our institute between January 2010 and December 2019. Demographic characteristics and clinical variables were collected and analyzed to identify risk factors for postbiopsy hemorrhage using the chi-square test and univariable and multivariable logistic regression analyses. RESULTS A total of 3196 patients were included in this study; of these, a histological diagnosis was eventually made for 2938 (91.93%) patients. Hemorrhage occurred in 149 (4.66%) patients, and symptomatic hemorrhage occurred in 46 (1.44%) patients. In multivariable logistic regression analyses, the presence of deep-seated lesions (OR 1.272, p = 0.035), concomitant edema and enhancement on MR imaging scans (OR 1.827, p = 0.002), intraoperative hypertension without a past history (OR 1.012, p = 0.024), and the presence of high-grade glioma (OR 0.306, p = 0.003) were identified as independent predictors of hemorrhage after biopsy. CONCLUSION Stereotactic needle biopsy is a safe and effective way to obtain tissue from brain lesions for histological diagnosis. The presence of deep-seated lesions, concomitant edema, and enhancement on MR imaging scans and the presence of high-grade glioma are independent predictors of hemorrhage after stereotactic biopsy.
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Affiliation(s)
- Hailong Li
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Chunling Zheng
- grid.414252.40000 0004 1761 8894Cardiovascular Medical Department, PLA General Hospital, No. 6, Fucheng Road, Haidian District, 100048 Beijing China
| | - Wei Rao
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Junzhao Sun
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Xin Yu
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Jianning Zhang
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
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Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing. Tomography 2022; 8:2687-2697. [PMID: 36412683 PMCID: PMC9680251 DOI: 10.3390/tomography8060224] [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: 09/20/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
There is no noninvasive method to estimate lung shunting fraction (LSF) in patients with liver tumors undergoing Yttrium-90 (Y90) therapy. We propose to predict LSF from noninvasive dynamic contrast enhanced (DCE) MRI using perfusion quantification. Two perfusion quantification methods were used to process DCE MRI in 25 liver tumor patients: Kety's tracer kinetic modeling with a delay-fitted global arterial input function (AIF) and quantitative transport mapping (QTM) based on the inversion of transport equation using spatial deconvolution without AIF. LSF was measured on SPECT following Tc-99m macroaggregated albumin (MAA) administration via hepatic arterial catheter. The patient cohort was partitioned into a low-risk group (LSF ≤&nbsp;10%) and a high-risk group (LSF >&nbsp;10%). Results: In this patient cohort, LSF was positively correlated with QTM velocity |u| (r = 0.61, F = 14.0363, p = 0.0021), and no significant correlation was observed with Kety's parameters, tumor volume, patient age and gender. Between the low LSF and high LSF groups, there was a significant difference for QTM |u| (0.0760 ± 0.0440 vs. 0.1822 ± 0.1225 mm/s, p = 0.0011), and Kety's Ktrans (0.0401 ± 0.0360 vs 0.1198 ± 0.3048, p = 0.0471) and Ve&nbsp;(0.0900 ± 0.0307 vs. 0.1495 ± 0.0485, p = 0.0114). The area under the curve (AUC) for distinguishing between low LSF and high LSF was 0.87 for |u|, 0.80 for Ve and 0.74 for Ktrans. Noninvasive prediction of LSF is feasible from DCE MRI with QTM velocity postprocessing.
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15
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Morales-Martinez A, Nichelli L, Hernandez-Verdin I, Houillier C, Alentorn A, Hoang-Xuan K. Prognostic factors in primary central nervous system lymphoma. Curr Opin Oncol 2022; 34:676-684. [PMID: 36093869 DOI: 10.1097/cco.0000000000000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal diffuse large B cell lymphoma. Despite its apparent immunopathological homogeneity, PCNSL displays a wide variability in outcome. Identifying prognostic factors is of importance for patient stratification and clinical decision-making. The purpose of this review is to focus on the clinical, neuroradiological and biological variables correlated with the prognosis at the time of diagnosis in immunocompetent patients. RECENT FINDINGS Age and performance status remain the most consistent clinical prognostic factors. The current literature suggests that neurocognitive dysfunction is an independent predictor of poor outcome. Cumulating data support the prognostic value of increased interleukin-10 level in the cerebrospinal fluid (CSF), in addition to its interest as a diagnostic biomarker. Advances in neuroimaging and in omics have identified several semi-quantitative radiological features (apparent diffusion restriction measures, dynamic contrast-enhanced perfusion MRI (pMRI) pattern and 18F-fluorodeoxyglucose metabolism) and molecular genetic alterations with prognostic impact in PCNSL. SUMMARY Validation of new biologic and neuroimaging markers in prospective studies is required before integrating future prognostic scoring systems. In the era of radiomic, large clinicoradiological and molecular databases are needed to develop multimodal artificial intelligence algorithms for the prediction of accurate outcome.
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Affiliation(s)
| | - Lucia Nichelli
- APHP, Sorbonne Université, IHU, ICM, Service de Neuroradiologie, Groupe Hospitalier Salpêtrière
| | - Isaias Hernandez-Verdin
- Laboratoire de Génétique et developpement des tumeurs cérébrales, Inserm, CNRS, UMR S 1127, ICM Institut du cerveau, Paris, France
| | | | - Agustí Alentorn
- APHP, Sorbonne Université, IHU, Service de Neurologie 2-Mazarin
- Laboratoire de Génétique et developpement des tumeurs cérébrales, Inserm, CNRS, UMR S 1127, ICM Institut du cerveau, Paris, France
| | - Khê Hoang-Xuan
- APHP, Sorbonne Université, IHU, Service de Neurologie 2-Mazarin
- Laboratoire de Génétique et developpement des tumeurs cérébrales, Inserm, CNRS, UMR S 1127, ICM Institut du cerveau, Paris, France
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Du X, He Y, Lin W. Diagnostic Accuracy of the Diffusion-Weighted Imaging Method Used in Association With the Apparent Diffusion Coefficient for Differentiating Between Primary Central Nervous System Lymphoma and High-Grade Glioma: Systematic Review and Meta-Analysis. Front Neurol 2022; 13:882334. [PMID: 35812103 PMCID: PMC9263097 DOI: 10.3389/fneur.2022.882334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/27/2022] [Indexed: 12/30/2022] Open
Abstract
Background It is difficult to differentiate between a few primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG) using conventional magnetic resonance imaging techniques. The purpose of this study is to explore whether diffusion-weighted imaging (DWI) can be effectively used to differentiate between these two types of tumors by analyzing the apparent diffusion coefficient (ADC). Research Design and Methods Data presented in Pubmed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (CQVIP) were analyzed. High-quality literature was included, and the quality was evaluated using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool, and the studies were based on the inclusion and exclusion rules. The pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (DOR), area under the curve (AUC) of the summary operating characteristic curve (SROC), and corresponding 95% confidence interval (CI) were calculated using the bivariate mixed effect model. Meta-regression analysis and subgroup analysis were used to explore the sources of heterogeneity. The publication bias was evaluated by conducting Deek's test. Results In total, eighteen high-quality studies were included. The pooled sensitivity was 0.82 (95% CI: 0.75–0.88), the pooled specificity was 0.87 (95% CI: 0.84–0.90), the pooled positive likelihood ratio was 6.49 (95% CI: 5.06–8.32), the pooled NLR was 0.21 (95% CI: 0.14–0.30), the pooled DOR was 31.31 (95% CI: 18.55–52.86), and the pooled AUC was 0.90 (95% CI: 0.87–0.92). Sample size, language and country of publication, magnetic field strength, region of interest (ROI), and cut-off values of different types of ADC can potentially be the sources of heterogeneity. There was no publication bias in this meta-analysis. Conclusions The results obtained from the meta-analysis suggest that DWI is characterized by high diagnostic accuracy and thus can be effectively used for differentiating between PCNSL and HGG.
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Affiliation(s)
- Xiaoli Du
- Department of Radiology, Chengdu First People's Hospital, Chengdu, China
| | - Yue He
- Department of Orthopedics, Chengdu First People's Hospital, Chengdu, China
| | - Wei Lin
- Department of Radiology, Chengdu First People's Hospital, Chengdu, China
- *Correspondence: Wei Lin
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17
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van Dinther M, Voorter PH, Jansen JF, Jones EA, van Oostenbrugge RJ, Staals J, Backes WH. Assessment of microvascular rarefaction in human brain disorders using physiological magnetic resonance imaging. J Cereb Blood Flow Metab 2022; 42:718-737. [PMID: 35078344 PMCID: PMC9014687 DOI: 10.1177/0271678x221076557] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cerebral microvascular rarefaction, the reduction in number of functional or structural small blood vessels in the brain, is thought to play an important role in the early stages of microvascular related brain disorders. A better understanding of its underlying pathophysiological mechanisms, and methods to measure microvascular density in the human brain are needed to develop biomarkers for early diagnosis and to identify targets for disease modifying treatments. Therefore, we provide an overview of the assumed main pathophysiological processes underlying cerebral microvascular rarefaction and the evidence for rarefaction in several microvascular related brain disorders. A number of advanced physiological MRI techniques can be used to measure the pathological alterations associated with microvascular rarefaction. Although more research is needed to explore and validate these MRI techniques in microvascular rarefaction in brain disorders, they provide a set of promising future tools to assess various features relevant for rarefaction, such as cerebral blood flow and volume, vessel density and radius and blood-brain barrier leakage.
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Affiliation(s)
- Maud van Dinther
- Department of Neurology, Maastricht University Medical Center, The Netherlands.,CARIM - School for Cardiovascular Diseases, Maastricht University, The Netherlands
| | - Paulien Hm Voorter
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, The Netherlands
| | - Jacobus Fa Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, The Netherlands
| | | | - Robert J van Oostenbrugge
- Department of Neurology, Maastricht University Medical Center, The Netherlands.,CARIM - School for Cardiovascular Diseases, Maastricht University, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, The Netherlands
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, The Netherlands.,CARIM - School for Cardiovascular Diseases, Maastricht University, The Netherlands
| | - Walter H Backes
- CARIM - School for Cardiovascular Diseases, Maastricht University, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, The Netherlands
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18
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Foda A, Kellner E, Gunawardana A, Gao X, Janz M, Kufner A, Khalil AA, Geran R, Mekle R, Fiebach JB, Galinovic I. Differentiation of Cerebral Neoplasms with Vessel Size Imaging (VSI). Clin Neuroradiol 2022; 32:239-248. [PMID: 34940899 PMCID: PMC8894153 DOI: 10.1007/s00062-021-01129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Cerebral neoplasms of various histological origins may show comparable appearances on conventional Magnetic Resonance Imaging (MRI). Vessel size imaging (VSI) is an MRI technique that enables noninvasive assessment of microvasculature by providing quantitative estimates of microvessel size and density. In this study, we evaluated the potential of VSI to differentiate between brain tumor types based on their microvascular morphology. METHODS Using a clinical 3T MRI scanner, VSI was performed on 25 patients with cerebral neoplasms, 10 with glioblastoma multiforme (GBM), 8 with primary CNS lymphoma (PCNSL) and 7 with cerebral lung cancer metastasis (MLC). Following the postprocessing of VSI maps, mean vessel diameter (vessel size index, vsi) and microvessel density (Q) were compared across tumors, peritumoral areas, and healthy tissues. RESULTS The MLC tumors have larger and less dense microvasculature compared to PCNSLs in terms of vsi and Q (p = 0.0004 and p < 0.0001, respectively). GBM tumors have higher yet non-significantly different vsi values than PCNSLs (p = 0.065) and non-significant differences in Q. No statistically significant differences in vsi or Q were present between GBMs and MLCs. GBM tumor volume was positively correlated with vsi (r = 0.502, p = 0.0017) and negatively correlated with Q (r = -0.531, p = 0.0007). CONCLUSION Conventional MRI parameters are helpful in differentiating between PCNSLs, GBMs, and MLCs. Additionally incorporating VSI parameters into the diagnostic protocol could help in further differentiating between PCNSLs and metastases and potentially between PCNSLs and GBMs. Future studies in larger patient cohorts are required to establish diagnostic cut-off values for VSI.
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Affiliation(s)
- Asmaa Foda
- International Graduate Program Medical Neurosciences, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elias Kellner
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
| | - Asanka Gunawardana
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Xiang Gao
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Janz
- Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Kufner
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ahmed A Khalil
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Berlin, Germany
| | - Rohat Geran
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ivana Galinovic
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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19
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Tang PLY, Méndez Romero A, Jaspers JPM, Warnert EAH. The potential of advanced MR techniques for precision radiotherapy of glioblastoma. MAGMA (NEW YORK, N.Y.) 2022; 35:127-143. [PMID: 35129718 PMCID: PMC8901515 DOI: 10.1007/s10334-021-00997-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
As microscopic tumour infiltration of glioblastomas is not visible on conventional magnetic resonance (MR) imaging, an isotropic expansion of 1-2 cm around the visible tumour is applied to define the clinical target volume for radiotherapy. An opportunity to visualize microscopic infiltration arises with advanced MR imaging. In this review, various advanced MR biomarkers are explored that could improve target volume delineation for radiotherapy of glioblastomas. Various physiological processes in glioblastomas can be visualized with different advanced MR techniques. Combining maps of oxygen metabolism (CMRO2), relative cerebral blood volume (rCBV), vessel size imaging (VSI), and apparent diffusion coefficient (ADC) or amide proton transfer (APT) can provide early information on tumour infiltration and high-risk regions of future recurrence. Oxygen consumption is increased 6 months prior to tumour progression being visible on conventional MR imaging. However, presence of the Warburg effect, marking a switch from an infiltrative to a proliferative phenotype, could result in CMRO2 to appear unaltered in high-risk regions. Including information on biomarkers representing angiogenesis (rCBV and VSI) and hypercellularity (ADC) or protein concentration (APT) can omit misinterpretation due to the Warburg effect. Future research should evaluate these biomarkers in radiotherapy planning to explore the potential of advanced MR techniques to personalize target volume delineation with the aim to improve local tumour control and/or reduce radiation-induced toxicity.
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Affiliation(s)
- Patrick L Y Tang
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Alejandra Méndez Romero
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Jaap P M Jaspers
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Esther A H Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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20
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Álvarez-Torres MDM, Fuster-García E, Juan-Albarracín J, Reynés G, Aparici-Robles F, Ferrer-Lozano J, García-Gómez JM. Local detection of microvessels in IDH-wildtype glioblastoma using relative cerebral blood volume: an imaging marker useful for astrocytoma grade 4 classification. BMC Cancer 2022; 22:40. [PMID: 34991512 PMCID: PMC8734263 DOI: 10.1186/s12885-021-09117-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The microvessels area (MVA), derived from microvascular proliferation, is a biomarker useful for high-grade glioma classification. Nevertheless, its measurement is costly, labor-intense, and invasive. Finding radiologic correlations with MVA could provide a complementary non-invasive approach without an extra cost and labor intensity and from the first stage. This study aims to correlate imaging markers, such as relative cerebral blood volume (rCBV), and local MVA in IDH-wildtype glioblastoma, and to propose this imaging marker as useful for astrocytoma grade 4 classification. METHODS Data from 73 tissue blocks belonging to 17 IDH-wildtype glioblastomas and 7 blocks from 2 IDH-mutant astrocytomas were compiled from the Ivy GAP database. MRI processing and rCBV quantification were carried out using ONCOhabitats methodology. Histologic and MRI co-registration was done manually with experts' supervision, achieving an accuracy of 88.8% of overlay. Spearman's correlation was used to analyze the association between rCBV and microvessel area. Mann-Whitney test was used to study differences of rCBV between blocks with presence or absence of microvessels in IDH-wildtype glioblastoma, as well as to find differences with IDH-mutant astrocytoma samples. RESULTS Significant positive correlations were found between rCBV and microvessel area in the IDH-wildtype blocks (p < 0.001), as well as significant differences in rCBV were found between blocks with microvascular proliferation and blocks without it (p < 0.0001). In addition, significant differences in rCBV were found between IDH-wildtype glioblastoma and IDH-mutant astrocytoma samples, being 2-2.5 times higher rCBV values in IDH-wildtype glioblastoma samples. CONCLUSIONS The proposed rCBV marker, calculated from diagnostic MRIs, can detect in IDH-wildtype glioblastoma those regions with microvessels from those without it, and it is significantly correlated with local microvessels area. In addition, the proposed rCBV marker can differentiate the IDH mutation status, providing a complementary non-invasive method for high-grade glioma classification.
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Affiliation(s)
| | - Elies Fuster-García
- Oslo University Hospital, Department of Diagnostic Physics, 0424, Oslo, Norway
| | - Javier Juan-Albarracín
- Universitat Politècnica de València, Biomedical Data Science Laboratory, ITACA, 46022, Valencia, Spain
| | - Gaspar Reynés
- Health Research Institute Hospital La Fe, Department of Medical Oncology, Cancer Research Group, 46026, Valencia, Spain
| | - Fernando Aparici-Robles
- Health Research Institute Hospital La Fe, Department of Medical Imaging, 46026, Valencia, Spain
| | - Jaime Ferrer-Lozano
- Health Research Institute Hospital La Fe, Department of Pathology, 46026, Valencia, Spain
| | - Juan Miguel García-Gómez
- Universitat Politècnica de València, Biomedical Data Science Laboratory, ITACA, 46022, Valencia, Spain
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21
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Schoen S, Kilinc MS, Lee H, Guo Y, Degertekin FL, Woodworth GF, Arvanitis C. Towards controlled drug delivery in brain tumors with microbubble-enhanced focused ultrasound. Adv Drug Deliv Rev 2022; 180:114043. [PMID: 34801617 PMCID: PMC8724442 DOI: 10.1016/j.addr.2021.114043] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/27/2021] [Accepted: 11/04/2021] [Indexed: 02/06/2023]
Abstract
Brain tumors are particularly challenging malignancies, due to their location in a structurally and functionally distinct part of the human body - the central nervous system (CNS). The CNS is separated and protected by a unique system of brain and blood vessel cells which together prevent most bloodborne therapeutics from entering the brain tumor microenvironment (TME). Recently, great strides have been made through microbubble (MB) ultrasound contrast agents in conjunction with ultrasound energy to locally increase the permeability of brain vessels and modulate the brain TME. As we elaborate in this review, this physical method can effectively deliver a wide range of anticancer agents, including chemotherapeutics, antibodies, and nanoparticle drug conjugates across a range of preclinical brain tumors, including high grade glioma (glioblastoma), diffuse intrinsic pontine gliomas, and brain metastasis. Moreover, recent evidence suggests that this technology can promote the effective delivery of novel immunotherapeutic agents, including immune check-point inhibitors and chimeric antigen receptor T cells, among others. With early clinical studies demonstrating safety, and several Phase I/II trials testing the preclinical findings underway, this technology is making firm steps towards shaping the future treatments of primary and metastatic brain cancer. By elaborating on its key components, including ultrasound systems and MB technology, along with methods for closed-loop spatial and temporal control of MB activity, we highlight how this technology can be tuned to enable new, personalized treatment strategies for primary brain malignancies and brain metastases.
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Affiliation(s)
- Scott Schoen
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - M. Sait Kilinc
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Hohyun Lee
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Yutong Guo
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - F. Levent Degertekin
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Graeme F. Woodworth
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA,Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, College Park, MD 20742, USA,Fischell Department of Bioengineering A. James Clarke School of Engineering, University of Maryland
| | - Costas Arvanitis
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA,Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
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22
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Wälchli T, Bisschop J, Miettinen A, Ulmann-Schuler A, Hintermüller C, Meyer EP, Krucker T, Wälchli R, Monnier PP, Carmeliet P, Vogel J, Stampanoni M. Hierarchical imaging and computational analysis of three-dimensional vascular network architecture in the entire postnatal and adult mouse brain. Nat Protoc 2021; 16:4564-4610. [PMID: 34480130 DOI: 10.1038/s41596-021-00587-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 06/08/2021] [Indexed: 02/08/2023]
Abstract
The formation of new blood vessels and the establishment of vascular networks are crucial during brain development, in the adult healthy brain, as well as in various diseases of the central nervous system. Here, we describe a step-by-step protocol for our recently developed method that enables hierarchical imaging and computational analysis of vascular networks in postnatal and adult mouse brains. The different stages of the procedure include resin-based vascular corrosion casting, scanning electron microscopy, synchrotron radiation and desktop microcomputed tomography imaging, and computational network analysis. Combining these methods enables detailed visualization and quantification of the 3D brain vasculature. Network features such as vascular volume fraction, branch point density, vessel diameter, length, tortuosity and directionality as well as extravascular distance can be obtained at any developmental stage from the early postnatal to the adult brain. This approach can be used to provide a detailed morphological atlas of the entire mouse brain vasculature at both the postnatal and the adult stage of development. Our protocol allows the characterization of brain vascular networks separately for capillaries and noncapillaries. The entire protocol, from mouse perfusion to vessel network analysis, takes ~10 d.
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Affiliation(s)
- Thomas Wälchli
- Group of CNS Angiogenesis and Neurovascular Link, Neuroscience Center Zurich, and Division of Neurosurgery, University and University Hospital Zurich, Zurich, Switzerland.
- Division of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
- Group Brain Vasculature and Perivascular Niche, Division of Experimental and Translational Neuroscience, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Jeroen Bisschop
- Group of CNS Angiogenesis and Neurovascular Link, Neuroscience Center Zurich, and Division of Neurosurgery, University and University Hospital Zurich, Zurich, Switzerland
- Division of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Group Brain Vasculature and Perivascular Niche, Division of Experimental and Translational Neuroscience, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Arttu Miettinen
- Swiss Light Source, Paul Scherrer Institute, Villigen, Switzerland
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | | | | | - Eric P Meyer
- Institute of Molecular Life Sciences, University of Zurich, Zurich, Switzerland
| | - Thomas Krucker
- Novartis Institutes for BioMedical Research Inc, Emeryville, CA, USA
| | - Regula Wälchli
- Department of Dermatology, Pediatric Skin Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Philippe P Monnier
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, Vision Division, Krembil Discovery Tower, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter Carmeliet
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, KU Leuven, Leuven, Belgium
- Laboratory of Angiogenesis and Vascular Metabolism, VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Johannes Vogel
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Stampanoni
- Swiss Light Source, Paul Scherrer Institute, Villigen, Switzerland
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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23
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Ellingson BM, Wen PY, Cloughesy TF. Therapeutic Response Assessment of High-Grade Gliomas During Early-Phase Drug Development in the Era of Molecular and Immunotherapies. Cancer J 2021; 27:395-403. [PMID: 34570454 PMCID: PMC8480435 DOI: 10.1097/ppo.0000000000000543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Several new therapeutic strategies have emerged over the past decades to address unmet clinical needs in high-grade gliomas, including targeted molecular agents and various forms of immunotherapy. Each of these strategies requires addressing fundamental questions, depending on the stage of drug development, including ensuring drug penetration into the brain, engagement of the drug with the desired target, biologic effects downstream from the target including metabolic and/or physiologic changes, and identifying evidence of clinical activity that could be expanded upon to increase the likelihood of a meaningful survival benefit. The current review article highlights these strategies and outlines how imaging technology can be used for therapeutic response evaluation in both targeted and immunotherapies in early phases of drug development in high-grade gliomas.
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Affiliation(s)
- Benjamin M. Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Patrick Y. Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard University, Boston, MA
| | - Timothy F. Cloughesy
- UCLA Neuro Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
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24
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Abstract
The central role of MRI in neuro-oncology is undisputed. The technique is used, both in clinical practice and in clinical trials, to diagnose and monitor disease activity, support treatment decision-making, guide the use of focused treatments and determine response to treatment. Despite recent substantial advances in imaging technology and image analysis techniques, clinical MRI is still primarily used for the qualitative subjective interpretation of macrostructural features, as opposed to quantitative analyses that take into consideration multiple pathophysiological features. However, the field of quantitative imaging and imaging biomarker development is maturing. The European Imaging Biomarkers Alliance (EIBALL) and Quantitative Imaging Biomarkers Alliance (QIBA) are setting standards for biomarker development, validation and implementation, as well as promoting the use of quantitative imaging and imaging biomarkers by demonstrating their clinical value. In parallel, advanced imaging techniques are reaching the clinical arena, providing quantitative, commonly physiological imaging parameters that are driving the discovery, validation and implementation of quantitative imaging and imaging biomarkers in the clinical routine. Additionally, computational analysis techniques are increasingly being used in the research setting to convert medical images into objective high-dimensional data and define radiomic signatures of disease states. Here, I review the definition and current state of MRI biomarkers in neuro-oncology, and discuss the clinical potential of quantitative image analysis techniques.
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25
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Stokes AM, Ragunathan S, Robison RK, Fuentes A, Bell LC, Karis JP, Pipe JG, Quarles CC. Development of a spiral spin- and gradient-echo (spiral-SAGE) approach for improved multi-parametric dynamic contrast neuroimaging. Magn Reson Med 2021; 86:3082-3095. [PMID: 34288112 DOI: 10.1002/mrm.28933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop a spiral-based combined spin- and gradient-echo (spiral-SAGE) method for simultaneous dynamic contrast-enhanced (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI). METHODS Using this sequence, we obtained gradient-echo TEs of 1.69 and 26 ms, a SE TE of 87.72 ms, with a TR of 1663 ms. Using an iterative SENSE reconstruction followed by deblurring, spiral-induced image artifacts were minimized. Healthy volunteer images are shown to demonstrate image quality using the optimized reconstruction, as well as for comparison with EPI-based SAGE. A bioreactor phantom was used to compare dynamic-contrast time courses with both spiral-SAGE and EPI-SAGE. A proof-of-concept cohort of patients with brain tumors shows the range of hemodynamic maps available using spiral-SAGE. RESULTS Comparison of spiral-SAGE images with conventional EPI-SAGE images illustrates substantial reductions of image distortion and artifactual image intensity variations. Bioreactor phantom data show similar dynamic contrast time courses between standard EPI-SAGE and spiral-SAGE for the second and third echoes, whereas first-echo data show improvements in quantifying T1 changes with shorter echo times. In a cohort of patients with brain tumors, spiral-SAGE-based perfusion and permeability maps are shown with comparison with the standard single-echo EPI perfusion map. CONCLUSION Spiral-SAGE provides a substantial improvement for the assessment of perfusion and permeability by mitigating artifacts typically encountered with EPI and by providing a shorter echo time for improved characterization of permeability. Spiral-SAGE enables quantification of perfusion, permeability, and vessel architectural parameters, as demonstrated in brain tumors.
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Affiliation(s)
- Ashley M Stokes
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Sudarshan Ragunathan
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Ryan K Robison
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA.,Philips Healthcare, Nashville, Tennessee, USA.,Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alberto Fuentes
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Laura C Bell
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - John P Karis
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA.,Neuroradiology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - James G Pipe
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA.,Mayo Clinic, Rochester, Minnesota, USA
| | - C Chad Quarles
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA
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26
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Kim M, Park JE, Emblem K, Bjørnerud A, Kim HS. Vessel Type Determined by Vessel Architectural Imaging Improves Differentiation between Early Tumor Progression and Pseudoprogression in Glioblastoma. AJNR Am J Neuroradiol 2021; 42:663-670. [PMID: 33541891 DOI: 10.3174/ajnr.a6984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/01/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Currently available perfusion parameters are limited in differentiating early tumor progression and pseudoprogression with no insight about vessel size and type. We aimed to investigate differences in vessel size and type between early tumor progression and pseudoprogression in posttreatment glioblastoma and to demonstrate diagnostic performance using vessel architectural imaging. MATERIALS AND METHODS Fifty-eight patients with enlarging contrast-enhancing masses in posttreatment glioblastomas underwent simultaneous gradient recalled-echo and spin-echo dynamic susceptibility contrast imaging. Relative CBV and vessel architectural imaging parameters, including the relative vessel size index, peak shift between gradient recalled echo and spin-echo bolus signal peaks, and arterial dominance scores using spatial dominance of arterial/venous vessel type, were calculated and compared between the 2 conditions. The area under the curve and cross-validation were performed to compare the diagnostic performance of the relative CBV, vessel architectural imaging parameters, and their combinations. RESULTS There were 41 patients with early tumor progression and 17 patients with pseudoprogression. Relative to pseudoprogression, early tumor progression showed a lower peak shift (-0.02 versus 0.33, P = .02) and a lower arterial dominance score (1.46 versus 2.11, P = .001), indicating venous dominance. Patients with early tumor progression had higher relative CBV (1.88 versus 1.38, P = .02) and a tendency toward a larger relative vessel size index (99.67 versus 83.17, P = .15) than those with pseudoprogression. Combining arterial dominance scores and relative CBV showed significantly higher diagnostic performance (area under the curve = 0.82; 95% CI, 0.70-0.94; P = .02) than relative CBV alone (area under the curve = 0.64; 95% CI, 0.49-0.79) in distinguishing early tumor progression from pseudoprogression. CONCLUSIONS Vessel architectural imaging significantly improved the diagnostic performance of relative CBV by demonstrating venous dominance and a tendency toward larger vessel size in early tumor progression.
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Affiliation(s)
- M Kim
- From the Department of Radiology and Research Institute of Radiology (M.K., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - J E Park
- From the Department of Radiology and Research Institute of Radiology (M.K., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - K Emblem
- Department of Diagnostic Physics, (K.E.)
| | - A Bjørnerud
- Unit for Computational Radiology and Artificial Intelligence (A.B.), Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Department of Physics (A.B.), University of Oslo, Oslo, Norway
| | - H S Kim
- From the Department of Radiology and Research Institute of Radiology (M.K., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Guerraty M, Bhargava A, Senarathna J, Mendelson AA, Pathak AP. Advances in translational imaging of the microcirculation. Microcirculation 2021; 28:e12683. [PMID: 33524206 PMCID: PMC8647298 DOI: 10.1111/micc.12683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 12/21/2022]
Abstract
The past few decades have seen an explosion in the development and use of methods for imaging the human microcirculation during health and disease. The confluence of innovative imaging technologies, affordable computing power, and economies of scale have ushered in a new era of "translational" imaging that permit us to peer into blood vessels of various organs in the human body. These imaging techniques include near-infrared spectroscopy (NIRS), positron emission tomography (PET), and magnetic resonance imaging (MRI) that are sensitive to microvascular-derived signals, as well as computed tomography (CT), optical imaging, and ultrasound (US) imaging that are capable of directly acquiring images at, or close to microvascular spatial resolution. Collectively, these imaging modalities enable us to characterize the morphological and functional changes in a tissue's microcirculation that are known to accompany the initiation and progression of numerous pathologies. Although there have been significant advances for imaging the microcirculation in preclinical models, this review focuses on developments in the assessment of the microcirculation in patients with optical imaging, NIRS, PET, US, MRI, and CT, to name a few. The goal of this review is to serve as a springboard for exploring the burgeoning role of translational imaging technologies for interrogating the structural and functional status of the microcirculation in humans, and highlight the breadth of current clinical applications. Making the human microcirculation "visible" in vivo to clinicians and researchers alike will facilitate bench-to-bedside discoveries and enhance the diagnosis and management of disease.
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Affiliation(s)
- Marie Guerraty
- Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,
USA
| | - Akanksha Bhargava
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janaka Senarathna
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Asher A. Mendelson
- Department of Medicine, Section of Critical Care, Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Arvind P. Pathak
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, The Johns Hopkins
University School of Medicine, Baltimore, MD, USA
- Department of Electrical Engineering, Johns Hopkins
University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns
Hopkins University School of Medicine, Baltimore, MD, USA
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28
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Gaustad JV, Simonsen TG, Hansem LMK, Rofstad EK. Intravital microscopy of tumor vessel morphology and function using a standard fluorescence microscope. Eur J Nucl Med Mol Imaging 2021; 48:3089-3100. [PMID: 33606081 PMCID: PMC8426228 DOI: 10.1007/s00259-021-05243-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/04/2021] [Indexed: 11/26/2022]
Abstract
Purpose The purpose of the study was to demonstrate the performance and possible applications of an intravital microscopy assay using a standard fluorescence microscope. Methods Melanoma and pancreatic ductal adenocarcinoma xenografts were initiated in dorsal window chambers and subjected to repeated intravital microscopy. The entire tumor vasculature as well as the normal tissue surrounding the tumor was imaged simultaneously with high spatial and temporal resolution. Vascular morphology images were recorded by using transillumination, and vascular masks were produced to quantify vessel density, vessel diameter, vessel segment length, and vessel tortuosity. First-pass imaging movies were recorded after an intervenous injection of a fluorescent marker and were used to investigate vascular function. Lymphatics were visualized by intradermal injections of a fluorescent marker. Results The intravital microscopy assay was used to study tumor growth and vascularization, tumor vessel morphology and function, tumor-associated lymphatics, and vascular effects of acute cyclic hypoxia and antiangiogenic treatment. The assay was sensitive to tumor-line differences in vascular morphology and function and detected tumor-induced lymphatic dilation. Acute cyclic hypoxia induced angiogenesis and increased the density of small diameter vessels and blood supply times, whereas antiangiogenic treatment selectively removed small-diameter vessels, reduced blood supply times, and induced hypoxia. Moreover, the window chamber was compatible with magnetic resonance imaging (MRI), and parametric images derived by dynamic contrast-enhanced MRI were shown to reflect vascular morphology and function. Conclusions The presented assay represents a useful and affordable alternative to intravital microscopy assays using confocal and multi-photon microscopes. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05243-0.
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Affiliation(s)
- Jon-Vidar Gaustad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Box 4953 Nydalen, 0424, Oslo, Norway.
| | - Trude G Simonsen
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Box 4953 Nydalen, 0424, Oslo, Norway
| | - Lise Mari K Hansem
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Box 4953 Nydalen, 0424, Oslo, Norway
| | - Einar K Rofstad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Box 4953 Nydalen, 0424, Oslo, Norway
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