1H MRS of a boron neutron capture therapy 10B-carrier, L-p-boronophenylalanine-fructose complex, BPA-F: phantom studies at 1.5 and 3.0 T

In vitro studies on stability of L-p-boronophenylalanine-fructose complex (BPA-F)

Boron neutron capture therapy (BNCT) is an experimental drug-targeted treatment combining tumour-seeking boronated drug(s) and subsequent ¹⁰B activation by neutrons. Synthetic amino acid, L-p-boronophenylalanine (BPA), administered as a fructose complex (BPA-F) is used in BNCT trials. We tested the in vitro biological and structural stability of the BPA-F as a function of time (11 days). The BPA-F samples were analyzed using biological bacterial endotoxin and sterility tests. Visual tests were clarity, degree of opalescence and coloration according to European Pharmacopoeia. The structural stability of the BPA-F was monitored via ¹H NMR signal intensity of the aromatic protons of the BPA-F samples. A slight change of BPA-F samples in coloration was observed during storage. BPA-fructose complex remained sterile and bacterial endotoxin tests were negative. In the end of study period, relative intensity of the (1)H NMR signals of the BPA-F sample was ≥ 90% of the initial relative intensity. The biological properties of the BPA-fructose complex and chemical structure of the complex remained the same during the test period. Visually the solutions stayed clear, but there was a slight change in colour. The tests indicate that the prepared batch of BPA-F complex can be used for the patient infusion at least for a week.

Acquisition-weighted MRSI for detection and quantification of BNCT 10B-carrier L-p-boronophenylalanine-fructose complex, a phantom study

Proton magnetic resonance spectroscopy (1H MRS) is a potential method to detect and quantify a boron neutron capture therapy 10B-carrier compound, L-p-boronophenylalanine (BPA), in the brain. However, optimal positioning of MRS voxel to capture tissue with maximal BPA concentration can be challenging. Three dimensional proton magnetic resonance spectroscopic imaging (3D 1H MRSI) provides spectral data covering a large spatial volume, which is a major advantage in detecting and quantifying BPA. BPA detection limit in phantom conditions was determined at 1.5 T using a 3D 1H MRSI protocol with clinically acceptable nominal spatial resolution and duration. Quantification tests for aqueous phantom were performed using both single voxel MRS and 3D MRSI. In 3D MRSI, BPA detection limit was approximately 1.0 mM and BPA quantification accuracy was better than +/-5%. The results suggest that MRSI would be a feasible method for in vivo BPA evaluation in clinical conditions.

Boron detection from blood samples by ICP-AES and ICP-MS during boron neutron capture therapy

OBJECTIVE

The concept of boron neutron capture therapy (BNCT) involves infusion of a (10)B containing tracer into the patient's bloodstream followed by local neutron irradiation(s). Accurate estimation of the blood boron level for the treatment field before irradiation is required. Boron concentration can be quantified by inductively coupled plasma atomic emission spectrometry (ICP-AES), mass spectrometry (ICP-MS), spectrofluorometric and direct current atomic emission spectrometry (DCP-AES) or by prompt gamma photon detection methods.

MATERIAL AND METHODS

The blood boron concentrations were analysed and compared using ICP-AES and ICP-MS to ensure congruency of the results if the analysis had to be changed during the treatment, e.g. for technical reasons. The effect of wet-ashing on the results was studied in addition.

RESULTS

The mean of all samples analysed with ICP-MS was 5.8 % lower than with ICP-AES coupled to wet-ashing (R (2) = 0.88). Without wet-ashing, the mean of all samples analysed with ICP-MS was 9.1 % higher than with ICP-AES (R (2) = 0.99).

CONCLUSIONS

Boron concentration analysed from whole blood samples with ICP-AES correlated well with the values of ICP-MS with wet-ashing of the sample matrix, which is generally considered the reference method. When using these methods in parallel at certain intervals during the treatments, reliability of the blood boron concentration values remains satisfactory, taking into account the required accuracy of dose determination in the irradiation of cancer patients.

1H MRS studies in the Finnish boron neutron capture therapy project: detection of 10B-carrier, L-p-boronophenylalanine-fructose

This article summarizes the current status of 1H MRS in detecting and quantifying a boron neutron capture therapy (BNCT) boron carrier, L-p-boronophenylalanine-fructose (BPA-F) in vivo in the Finnish BNCT project. The applicability of 1H MRS to detect BPA-F is evaluated and discussed in a typical situation with a blood containing resection cavity within the gross tumour volume (GTV). 1H MRS is not an ideal method to study BPA concentration in GTV with blood in recent resection cavity. For an optimal identification of BPA signals in the in vivo 1H MR spectrum, both pre- and post-infusion 1H MRS should be performed. The post-infusion spectroscopy studies should be scheduled either prior to or, less optimally, immediately after the BNCT. The pre-BNCT MRS is necessary in order to utilise the MRS results in the actual dose planning.

Noninvasive quantitative in vivo mapping and metabolism of boronophenylalanine (BPA) by nuclear magnetic resonance (NMR) spectroscopy and imaging

10B-enriched L-p-boronophenylalanine (BPA) is one of the compounds used in boron neutron capture therapy (BNCT). In this study, several variations of nuclear magnetic resonance spectroscopy (MRS) and spectroscopic imaging (MRSI) were applied to investigate the uptake, clearance and metabolism of the BPA-fructose complex (BPA-F) in normal mouse kidneys, rat oligodendroglioma xenografts, and rat blood. Localized 1H MRS was capable of following the uptake and clearance of BPA-F in mouse kidneys with temporal resolution of a few minutes, while 1H MRSI was used to image the BPA distribution in the kidney with a spatial resolution of 9 mm3. The results also revealed significant dissociation of the BPA-F complex to free BPA. This finding was corroborated by 1H and 11B NMR spectroscopy of rat blood samples as well as of tumor samples excised from mice after i.v. injection of BPA-F. This investigation demonstrates the feasibility of using 1H MRS and MRSI to follow the distribution of BPA in vivo, using NMR techniques specifically designed to optimize BPA detection. The implementation of such procedures could significantly improve the clinical efficacy of BNCT.

Optimized 1H MRS and MRSI methods for the in vivo detection of boronophenylalanine

Boronophenylalanine (BPA) is used as Boron-10 carrier in boron neutron capture therapy, an experimental cancer radiotherapy. Results of quantitative, noninvasive in vivo detection and imaging of BPA in laboratory animals using (1)H NMR are presented for the first time. The purpose of this study was to implement and validate optimized techniques for the efficient detection of BPA. The (1)H NMR signals through which BPA is most readily detected in vivo are those from the aromatic ring of the molecule, which are part of a scalar-coupled spin system. The preferred detection method should therefore be based on a pulse sequence in which the effective TE is as short as possible. Modified versions of LASER (tau(CP) = 4.6 ms, TE = 27.6 ms) and double-echo slice-selective 2D MRSI (TE = 12 ms) were implemented for single-voxel spectroscopy and spectroscopic imaging of BPA, respectively. Chemical shift selective excitation was used for both sequences, based on a pulse that enabled narrow-band excitation without concomitant delay in TE. SI data without water suppression was used for absolute quantitation and for correction of B(0) variations. Experiments were conducted at 4.7 T in phantoms and in mice where the infused BPA was detected in the kidney.

Distribution of BPA and metabolic assessment in glioblastoma patients during BNCT treatment: a microdialysis study

Boron neutron capture therapy (BNCT) is dependent on the selective accumulation of boron-10 in tumour cells. To maximise the radiation effect, the neutrons should be delivered when the ratio between the boron concentration in tumour cells to that in normal tissues reaches maximum. However, the pharmacokinetics of p-boronophenylalanine (BPA) and other boron delivery agents are only partly known. We used microdialysis to investigate the extracellular in vivo kinetics of boron in three intracerebral compartments -- solid tumour, brain adjacent to tumour (BAT), and the normal brain, as well as the subcutaneous tissue before, during, and after BNCT treatment. The findings were compared to the pharmacokinetics of BPA in the blood. We also measured the glucose metabolism and the levels of glutamate and glycerol in those compartments. Four patients were studied, two patients underwent surgical tumour resection and in two a stereotactic biopsy was performed. The patients were given BPA (900 mg/kg body weight) by a 6-h infusion. The infusion was completed approximately 2-3 h before neutron irradiation. In tumour tissue the extracellular concentration of BPA followed that of blood with a maximal concentration of 31.2 ppm and a maximal ratio vs. blood of 1.07. In BAT, the maximal concentration of BPA was 18.0 ppm with the peak level delayed for 4-6 h compared to the peak in blood with a maximal ratio of 1.2. Maximal blood concentration found was 41.0 ppm. The uptake of BPA in the normal brain was considerably lower than that in the blood and tumour tissue. No change in glucose metabolism was observed. The extracellular level of glycerol was increased after treatment in tumour tissue but not in normal brain suggesting a selective acute cytotoxic effect of BNCT on tumour cells.

Biomedical applications of 10B and 11B NMR

This review focuses mainly on the detection and investigation of molecules used for boron neutron capture therapy (BNCT) by 10B and 11B NMR. In this binary radiation treatment, boron-containing molecules (also called 'BNCT agents') enriched in the 10B isotope, are targeted to the tumor, and irradiated with thermal or epithermal neutrons. Capture of these neutrons by 10B nuclei generates cell-damaging radiation, confined to single cell dimensions. NMR research efforts have primarily been applied in two directions: first, to investigate the metabolism and pharmaco-kinetics of BNCT agents in-vivo, and second, to use localized NMR spectroscopy and/or MRI for non-invasive mapping of the administered molecules in treated animals or patients. While the first goal can be pursued using 11B NMR for natural-abundance samples (80% 11B / 20% 10B), molecules used in the actual treatment are > 95% enriched in 10B, and must therefore be detected by 10B NMR. Both 10B (spin 3) and 11B (spin 3/2) are quadrupolar nuclei, and their typical relaxation times, in common BNCT agents in biological environments, are rather short. This poses some technical challenges, particularly for MRI, which will be reviewed, along with possible solutions. The first attempts at 11B NMR and MRI detection of BNCT agents in biological tissue were conducted over a decade ago. Since then, results from 11B MRI in laboratory animals and in humans have been reported, and 11B NMR spectroscopy provided interesting and unique information about the metabolism of some BNCT agents in cultured cells. 10B NMR was applied either 'indirectly' (in double-resonance experiments involving coupled protons), but also by direct 10B MRI in mice. However, no results involving the NMR detection of 10B-enriched compounds in treated patients have been reported yet.

Enhanced blood boron concentration estimation for BPA-F mediated BNCT

The blood boron concentration regulates directly the BNCT irradiation time in which the prescribed dose to the patient is delivered. Therefore a proper estimation of the blood boron concentration for the treatment field based on the measured blood samples before irradiation is required. The bi-exponential model fit using Levenberg-Marquardt method was implemented for this purpose to provide the blood boron concentration estimates directly to the treatment data flow during the BNCT procedure. The harmonic mean bi-exponential decay half-lives of the studied patient data (n=28) were 15+/-8 and 320+/-70 min for the faster and slower half-life. The model uncertainty (n=28) was reasonably low, 0.7+/-0.1 microg/g (about 5%). The implemented algorithm provides a robust method for temporal blood boron concentration estimation for BPA-F mediated BNCT. Utilization of the infusion data improves the reliability of the estimate. The overall data flow during the treatment fulfills the practical requirements concerning the BNCT procedure.