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Eilard MS, Andersson M, Naredi P, Geronymakis C, Lindnér P, Cahlin C, Bennet W, Rizell M. A prospective clinical trial on sorafenib treatment of hepatocellular carcinoma before liver transplantation. BMC Cancer 2019; 19:568. [PMID: 31185950 PMCID: PMC6560824 DOI: 10.1186/s12885-019-5760-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 05/27/2019] [Indexed: 12/17/2022] Open
Abstract
Background Patients with hepatocellular carcinoma waiting for liver transplantation are commonly treated with locoregional treatments, such as TACE and ablation, to prevent tumor progression and dropout and to improve long-term outcome after transplantation. We wanted to prospectively assess feasibility of systemic antitumor treatment with sorafenib as neoadjuvant treatment for hepatocellular carcinoma while waiting for liver transplantation, evaluating tolerability, toxicity and posttransplant morbidity. We also wanted to evaluate perfusion CT parameters to assess tumor properties and response early after start of sorafenib treatment in patients with early hepatocellular carcinoma. Methods Twelve patients assigned for liver transplantation due to hepatocellular carcinoma, within the UCSF and who fulfilled other criteria, were included January 2012–August 2014. After baseline evaluation, sorafenib treatment was started. Treatment was evaluated by perfusion CT at 1, 4 and 12 weeks and thereafter every 8 weeks. Toxicity and quality of life was assessed at 1 and 4 weeks and every 4 weeks thereafter during treatment. Treatment was stopped when patients were prioritized on the transplantation waiting list or when intolerable side effects or tumor progress warranted other treatments. Posttransplant morbidity after 90 days was registered according to Clavien-Dindo. Results Baseline perfusion CT parameters in the tumors predicted the outcome according to RECIST/mRECIST at three months, but no change in CTp parameters was detected as a result of sorafenib. Sorafenib as neoadjuvant treatment was associated with intolerability and dose reductions. Therefore the prerequisites for evaluation of the sorafenib effect on both CT parameters and tumor response were impaired. Conclusions This study failed to show changes in CTp parameters during sorafenib treatment. Despite the curative treatment intention, tolerability of neoadjuvant sorafenib treatment before liver transplantation was inadequate in this study. Trial registration EudraCT number: 2010–024306-36 (date 2011-04-07). Electronic supplementary material The online version of this article (10.1186/s12885-019-5760-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Malin Sternby Eilard
- Transplantation Center, Sahlgrenska University Hospital, Gothenburg, 413 45, Gothenburg, Sweden. .,Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Mats Andersson
- Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Charalampos Geronymakis
- Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per Lindnér
- Transplantation Center, Sahlgrenska University Hospital, Gothenburg, 413 45, Gothenburg, Sweden.,Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christian Cahlin
- Transplantation Center, Sahlgrenska University Hospital, Gothenburg, 413 45, Gothenburg, Sweden
| | - William Bennet
- Transplantation Center, Sahlgrenska University Hospital, Gothenburg, 413 45, Gothenburg, Sweden.,Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Rizell
- Transplantation Center, Sahlgrenska University Hospital, Gothenburg, 413 45, Gothenburg, Sweden.,Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ippolito D, Querques G, Pecorelli A, Talei Franzesi C, Okolicsanyi S, Strazzabosco M, Sironi S. Diagnostic Value of Quantitative Perfusion Computed Tomography Technique in the Assessment of Tumor Response to Sorafenib in Patients With Advanced Hepatocellular Carcinoma. J Comput Assist Tomogr 2019; 43:206-213. [PMID: 30407241 DOI: 10.1097/rct.0000000000000807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The aim of this study was to assess the role of dynamic contrast-enhanced perfusion computed tomography (pCT) imaging in the early detection of blood flow changes related to antiangiogenic treatment with sorafenib, in patients with advanced hepatocellular carcinoma (HCC), being the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria the standard of reference. METHODS Between 2012 and 2016, 43 cirrhotic patients (male, n = 39; female, n = 4) with biopsy-proven multifocal HCC underwent multi-detector-row computed tomography, and pCT examinations were performed before and every 2 months after sorafenib administration. Perfusion CT technique is based on the acquisition of 16 dynamic slices/scan per 40 scans, performed on a 256-slice multi-detector-row computed tomography scanner, after intravenous bolus injection of 50 mL of iodinated contrast agent (350 mg I/mL) at a flow rate of 5 mL/s. According to mRECIST, patients were stratified into complete (CR) or partial response (PR) and stable (SD) or progressive disease (PD). The following pCT parameters were calculated: hepatic perfusion (mL/s per 100 g), time to peak (seconds), arterial perfusion (mL/s), and hepatic perfusion index (%). Perfusion CT values at baseline and first follow-up were reported for all mRECIST groups and then compared between the nonprogressor (CR, PR, SD) and progressor groups (PD). RESULTS Most pCT values were significantly higher (P < 0.01) between baseline and follow-up in the CR and PR groups, whereas nonsignificant differences were found among SD patients, and a nonsignificant trend (P > 0.05) toward increase was observed among PD patients. Moreover, pCT values were significantly higher (P = 0.05) at baseline in the nonprogressor group compared with the progressor. CONCLUSION Preliminary results suggest that pCT adds quantitative data of vascularization, thus demonstrating its usefulness in the assessment of therapeutic response to sorafenib in advanced HCC, in line with mRECIST criteria, offering 1-step information on tissue cellularity and vascularization.
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Wang ZZ, Liu F, Gong YF, Huang TY, Zhang XM, Huang XY. Antiarthritic Effects of Sorafenib in Rats with Adjuvant-Induced Arthritis. Anat Rec (Hoboken) 2018; 301:1519-1526. [DOI: 10.1002/ar.23856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/25/2018] [Accepted: 03/01/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Zhen-Zhen Wang
- Department of Anatomy; Anhui Medical University; Hefei China
| | - Fei Liu
- Department of Anatomy; Anhui Medical University; Hefei China
| | - Yong-Fang Gong
- Department of Anatomy; Bengbu Medical College; Bengbu China
| | - Tian-Yu Huang
- Grade 2016, The First Department of Clinical Medicine; Bengbu Medical College; Bengbu China
| | - Xiao-Ming Zhang
- Department of Anatomy; Anhui Medical University; Hefei China
| | - Xue-Ying Huang
- Department of Anatomy; Anhui Medical University; Hefei China
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Kaufmann S, Thaiss WM, Schulze M, Bitzer M, Lauer U, Nikolaou K, Horger M. Prognostic value of perfusion CT in hepatocellular carcinoma treatment with sorafenib: comparison with mRECIST in longitudinal follow-up. Acta Radiol 2018; 59:765-772. [PMID: 28927298 DOI: 10.1177/0284185117732805] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Targeted therapies are of increasing clinical importance and classic radiologic therapy response-criteria often fail to detect early therapeutic response or failure. For hepatocellular carcinoma (HCC), this is of major importance as therapeutic options are limited. Purpose To investigate the impact of sorafenib-treatment on intralesional perfusion using perfusion computed tomography (PCT) in HCC and to correlate the observed changes with mRECIST and the course of serum alpha-fetoprotein (AFP) for identification of their prognostic value. Material and Methods PCT was performed before and after two months of sorafenib treatment in 28 consecutive HCC patients and AFP levels were registered. Changes in tumor perfusion parameters blood flow (BF), blood volume (BV), mean transit time (MTT), volume transfer constant (Ktrans), arterial liver perfusion (ALP), and hepatic perfusion index (HPI) were registered in one target lesion. mRECIST measurements were performed at baseline and after two and four months during sorafenib treatment. Results According to mRECIST, after two months of treatment, all patients showed stable disease (SD), whereas after four months, 13 patients (46%) showed SD and 15 patients (54%) showed progressive disease (PD). A significant decrease was found in perfusion parameters BF, BV, Ktrans, ALP, and HPI in patients with SD as well as a significant increase in MTT ( P < 0.05) after two months compared to baseline, while patients with PD showed a significant increase in HPI, BF, and BV. There were no correlations between AFP and mRECIST or perfusion parameters. Conclusion Decreased intralesional BF and HPI after two months of sorafenib treatment predicts disease stabilization after four months, whereas AFP dynamics were of limited value.
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Affiliation(s)
- Sascha Kaufmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - Wolfgang M Thaiss
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - Maximilian Schulze
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - Michael Bitzer
- Department of Internal Medicine I, Eberhard-Karls-University, Tübingen, Germany
| | - Ulrich Lauer
- Department of Internal Medicine I, Eberhard-Karls-University, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
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Paris L, Podo F, Spadaro F, Abalsamo L, Pisanu ME, Ricci A, Cecchetti S, Altabella L, Buoncervello M, Lozneanu L, Bagnoli M, Ramoni C, Canevari S, Mezzanzanica D, Iorio E, Canese R. Phosphatidylcholine-specific phospholipase C inhibition reduces HER2-overexpression, cell proliferation and in vivo tumor growth in a highly tumorigenic ovarian cancer model. Oncotarget 2017; 8:55022-55038. [PMID: 28903399 PMCID: PMC5589638 DOI: 10.18632/oncotarget.18992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 06/19/2017] [Indexed: 01/02/2023] Open
Abstract
Antagonizing the oncogenic effects of human epidermal growth factor receptor 2 (HER2) with current anti-HER2 agents has not yet yielded major progress in the treatment of advanced HER2-positive epithelial ovarian cancer (EOC). Using preclinical models to explore alternative molecular mechanisms affecting HER2 overexpression and oncogenicity may lead to new strategies for EOC patient treatment. We previously reported that phosphatidylcholine-specific phospholipase C (PC-PLC) exerts a pivotal role in regulating HER2 overexpression in breast cancer cells. The present study, conducted on two human HER2-overexpressing EOC cell lines - SKOV3 and its in vivo-passaged SKOV3.ip cell variant characterized by enhanced in vivo tumorigenicity - and on SKOV3.ip xenografts implanted in SCID mice, showed: a) about 2-fold higher PC-PLC and HER2 protein expression levels in SKOV3.ip compared to SKOV3 cells; b) physical association of PC-PLC with HER2 in non-raft domains; c) HER2 internalization and ca. 50% reduction of HER2 mRNA and protein expression levels in SKOV3.ip cells exposed to the PC-PLC inhibitor tricyclodecan-9-yl-potassium xanthate (D609); d) differential effects of D609 and trastuzumab on HER2 protein expression and cell proliferation; e) decreased in vivo tumor growth in SKOV3.ip xenografts during in vivo treatment with D609; f) potential use of in vivo magnetic resonance spectroscopy (MRS) and imaging (MRI) parameters as biomarkers of EOC response to PC-PLC inhibition. Overall, these findings support the view that PC-PLC inhibition may represent an effective means to target the tumorigenic effects of HER2 overexpression in EOC and that in vivo MR approaches can efficiently monitor its effects.
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Affiliation(s)
- Luisa Paris
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Franca Podo
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Francesca Spadaro
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Laura Abalsamo
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Maria Elena Pisanu
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Alessandro Ricci
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Serena Cecchetti
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Luisa Altabella
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Maria Buoncervello
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Ludmila Lozneanu
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milano, Italy.,Department of Histology, University of Medicine and Pharmacy "Grigore T. Popa", 700115, Iasi, Romania
| | - Marina Bagnoli
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milano, Italy
| | - Carlo Ramoni
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Silvana Canevari
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milano, Italy
| | - Delia Mezzanzanica
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milano, Italy
| | - Egidio Iorio
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
| | - Rossella Canese
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161, Roma, Italy
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Roth GS, Macek Jilkova Z, Zeybek Kuyucu A, Kurma K, Ahmad Pour ST, Abbadessa G, Yu Y, Busser B, Marche PN, Leroy V, Decaens T. Efficacy of AKT Inhibitor ARQ 092 Compared with Sorafenib in a Cirrhotic Rat Model with Hepatocellular Carcinoma. Mol Cancer Ther 2017; 16:2157-2165. [PMID: 28566435 DOI: 10.1158/1535-7163.mct-16-0602-t] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 05/02/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022]
Abstract
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality worldwide. The AKT pathway has been found activated in 50% of HCC cases, making it a promising target. Therefore, we assess efficacy of the allosteric AKT inhibitor ARQ 092 compared with untreated control and standard treatment, sorafenib, in vitro and in vivo ARQ 092 blocked phosphorylation of AKT in vitro and strongly inhibited cell growth with significantly higher potency than sorafenib. Similarly, apoptosis and cell migration were strongly reduced by ARQ 092 in vitro To mimic human advanced HCC, we used a diethylnitrosamine-induced cirrhotic rat model with fully developed HCC. MRI analyses showed that ARQ 092 significantly reduced overall tumor size. Furthermore, number of tumors was decreased by ARQ 092, which was associated with increased apoptosis and decreased proliferation. Tumor contrast enhancement was significantly decreased in the ARQ 092 group. Moreover, on tumor tissue sections, we observed a vascular normalization and a significant decrease in fibrosis in the surrounding liver of animals treated with ARQ 092. Finally, pAKT/AKT levels in ARQ 092-treated tumors were reduced, followed by downregulation of actors of AKT downstream signaling pathway: pmTOR, pPRAS40, pPLCγ1, and pS6K1. In conclusion, we demonstrated that ARQ 092 blocks AKT phosphorylation in vitro and in vivo In the HCC-rat model, ARQ 092 was well tolerated, showed antifibrotic effect, and had stronger antitumor effect than sorafenib. Our results confirm the importance of targeting AKT in HCC. Mol Cancer Ther; 16(10); 2157-65. ©2017 AACR.
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Affiliation(s)
- Gaël S Roth
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France.,Clinique Universitaire d'Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble Alpes, Grenoble, France
| | - Zuzana Macek Jilkova
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France
| | - Ayca Zeybek Kuyucu
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France
| | - Keerthi Kurma
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France
| | - Séyédéh Tayébéh Ahmad Pour
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France
| | | | | | - Benoit Busser
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France.,Département de biochimie, toxicologie et pharmacologie, Pôle de biologie, CHU Grenoble Alpes, Grenoble, France
| | - Patrice N Marche
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France
| | - Vincent Leroy
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France.,Clinique Universitaire d'Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble Alpes, Grenoble, France
| | - Thomas Decaens
- Université Grenoble Alpes, Grenoble, France. .,Institute for Advanced Biosciences - Inserm U1209/CNRS UMR 5309/Université de Grenoble-Alpes, Grenoble, France.,Clinique Universitaire d'Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble Alpes, Grenoble, France
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Zhang D, Xu A. Application of dual-source CT perfusion imaging and MRI for the diagnosis of primary liver cancer. Oncol Lett 2017; 14:5753-5758. [PMID: 29113204 PMCID: PMC5661360 DOI: 10.3892/ol.2017.6170] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 04/25/2017] [Indexed: 01/16/2023] Open
Abstract
The objective of the present study was to evaluate the application of dual-source CT perfusion imaging and MRI for the diagnosis of primary liver cancer. Sixty-three patients with primary liver cancer were selected between February 2015 and May 2016. All patients underwent examinations by dual-source CT perfusion imaging and MRI. The perfusion parameters of the focus center and normal liver parenchyma by CT examination and the hemodynamic parameters of the focus center and normal liver parenchyma by MRI examination were analyzed. The accuracy rates of the three detection methods (CT perfusion imaging, MRI, and combined examination) were analyzed and compared by ROC curves. Dual-source CT perfusion imaging revealed that blood flow and blood volume of the focus center were significantly higher than those of normal liver parenchyma (P<0.05). MRI examination showed that hepatic arterial perfusion and hepatic perfusion index of the focus center were significantly higher than those of normal liver parenchyma; portal venous perfusion of the focus center was significantly lower than that of normal liver parenchyma (P<0.05); the difference in total liver perfusion between the focus center and normal liver parenchyma was not significant (P>0.05); the accuracy rates of CT perfusion imaging, MRI, and combined examination were 76.19, 85.71, and 95.24% respectively; the area under the curve of CT perfusion imaging was 0.753 (P<0.05), the sensitivity was 79.2% and the specificity was 74.7%; the area under the curve of MRI was 0.846 (P<0.05), the sensitivity was 84.6%, and the specificity was 80.5%; the area under the curve of CT combined with MRI was 0.947 (P<0.05), the sensitivity was 94.6%, and the specificity was 86.5%. In conclusion, the effect of dual-source CT perfusion imaging combined with MRI for examination of primary liver cancer is superior to that of single use of CT or MRI, and has high clinical application and popularization value.
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Affiliation(s)
- Dongwen Zhang
- Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
| | - Aixia Xu
- Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
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Orci LA, Oldani G, Lacotte S, Slits F, Friedli I, Wirth W, Toso C, Vallée JP, Crowe LA. Dynamic Volume Assessment of Hepatocellular Carcinoma in Rat Livers Using a Clinical 3T MRI and Novel Segmentation. J INVEST SURG 2017; 31:44-53. [PMID: 28107094 DOI: 10.1080/08941939.2016.1276987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In vivo liver cancer research commonly uses rodent models. One of the limitations of such models is the lack of accurate and reproducible endpoints for a dynamic assessment of growing tumor nodules. The aim of this study was to validate a noninvasive, true volume segmentation method using two rat hepatocellular carcinoma (HCC) models, correlating magnetic resonance imaging (MRI) with histological volume measurement, and with blood levels of α-fetoprotein. MATERIALS AND METHODS We used 3T clinical MRI to quantify tumor volume with follow-up over time. Using two distinct rat HCC models, calculated MRI tumor volumes were correlated with volumes from histological sections, or with blood levels of α-fetoprotein. Eleven rats, comprising six Buffalo rats (n = 9 scans) and five Fischer rats (n = 14 tumors), were injected in the portal vein with 2.5 × 105 and 2.0 × 106 syngeneic HCC cells, respectively. Longitudinal (T1) relaxation time- and transverse (T2) relaxation time-weighted MR images were acquired. RESULTS The three-dimensional (3D) T1-weighted gradient echo had 0.35-mm isotropic resolution allowing accurate semi-automatic volume segmentation. 2D T2-weighted imaging provided high tumor contrast. Segmentation of combined 3D gradient echo T1-weighted images and 2D turbo spin echo T2-weighted images provided excellent correlation with histology (y = 0.866x + 0.034, R² = 0.997 p < .0001) and with α-fetoprotein (y = 0.736x + 1.077, R² = 0.976, p < .0001). There was robust inter- and intra-observer reproducibility (intra-class correlation coefficient > 0.998, p < .0001). CONCLUSIONS We have developed a novel, noninvasive contrast imaging protocol which enables semi-automatic 3D volume quantification to analyze nonspherical tumor nodules and to follow up the growth of tumor nodules over time.
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Affiliation(s)
- Lorenzo A Orci
- a Divisions of Abdominal and Transplantation Surgery, Hepato-Pancreato-Biliary Centre, Department of Surgery , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Graziano Oldani
- a Divisions of Abdominal and Transplantation Surgery, Hepato-Pancreato-Biliary Centre, Department of Surgery , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Stephanie Lacotte
- a Divisions of Abdominal and Transplantation Surgery, Hepato-Pancreato-Biliary Centre, Department of Surgery , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Florence Slits
- a Divisions of Abdominal and Transplantation Surgery, Hepato-Pancreato-Biliary Centre, Department of Surgery , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Iris Friedli
- b Division of Radiology , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Wolfgang Wirth
- c Institute of Anatomy, Paracelsus Medical University , Salzburg , Austria
| | - Christian Toso
- a Divisions of Abdominal and Transplantation Surgery, Hepato-Pancreato-Biliary Centre, Department of Surgery , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Jean-Paul Vallée
- b Division of Radiology , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
| | - Lindsey A Crowe
- b Division of Radiology , University Hospitals of Geneva and Faculty of Medicine, University of Geneva , Geneva , Switzerland
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Significant perturbation in renal functional magnetic resonance imaging parameters and contrast retention for iodixanol compared with iopromide: an experimental study using blood-oxygen-level-dependent/diffusion-weighted magnetic resonance imaging and computed tomography in rats. Invest Radiol 2015; 49:699-706. [PMID: 24879299 DOI: 10.1097/rli.0000000000000073] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the renal changes after intravenous administration of a high dose of either iodixanol or iopromide using functional magnetic resonance imaging (MRI) and computed tomography (CT). MATERIALS AND METHODS The study was approved by the institutional committee on animal research. Seventy-two male Sprague-Dawley rats were divided into 5 cohorts, comprising normal saline (NS), iopromide, iopromide + NS, iodixanol, and iodixanol + NS. Intravenous contrast was administrated at 8 g iodine/kg of body weight. Renal CT, quantitative functional MRI of blood-oxygen-level-dependent (BOLD) imaging and diffusion-weighted imaging (DWI), and histologic examinations were performed for 18 days after contrast administration. Statistical analysis was performed by using 1-way analysis of variance, Mann-Whitney test, and regression analysis. RESULTS In the renal cortex, BOLD showed persistent elevation of R2* and DWI showed persistent suppression of apparent diffusion coefficient after iodixanol administration for 18 days. Compared with iopromide, adjusted ΔR2* (ΔR2*adj) was significantly higher in the iodixanol group from 1 hour to 18 days (P < 0.04) after contrast; adjusted ΔADC (ΔADCadj) was significantly more pronounced at day 6 (P = 0.01) after contrast. The iodixanol cohort also exhibited persistently higher attenuation in the renal cortex on CT and more severe microscopic renal cortical vacuolization up to 18 days. Intravenous hydration decreased the magnetic resonance changes in both groups but more markedly with iodixanol. CONCLUSIONS At high doses, iodixanol induced greater changes in renal functional MRI (BOLD and DWI) relative to iopromide. Combined with longer contrast retention within the kidney, this suggests that iodixanol may produce more severe and longer-lasting contrast-induced renal damage.
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