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Rickard AG, Mikati H, Mansourati A, Stevenson D, Krieger M, Rocke D, Esclamado R, Dewhirst MW, Ramanujam N, Lee WT, Palmer GM. A Clinical Study to Assess Diffuse Reflectance Spectroscopy with an Auto-Calibrated, Pressure-Sensing Optical Probe in Head and Neck Cancer. Curr Oncol 2023; 30:2751-2760. [PMID: 36975421 PMCID: PMC10047590 DOI: 10.3390/curroncol30030208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/03/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
Diffuse reflectance spectroscopy (DRS) is a powerful tool for quantifying optical and physiological tissue properties such as hemoglobin oxygen saturation and vascularity. DRS is increasingly used clinically for distinguishing cancerous lesions from normal tissue. However, its widespread clinical acceptance is still limited due to uncontrolled probe–tissue interface pressure that influences reproducibility and introduces operator-dependent results. In this clinical study, we assessed and validated a pressure-sensing and automatic self-calibration DRS in patients with suspected head and neck squamous cell carcinoma (HNSCC). The clinical study enrolled nineteen patients undergoing HNSCC surgical biopsy procedures. Patients consented to evaluation of this improved DRS system during surgery. For each patient, we obtained 10 repeated measurements on one tumor site and one distant normal location. Using a Monte Carlo-based model, we extracted the hemoglobin saturation data along with total hemoglobin content and scattering properties. A total of twelve cancer tissue samples from HNSCC patients and fourteen normal tissues were analyzed. A linear mixed effects model tested for significance between repeated measurements and compared tumor versus normal tissue. These results demonstrate that cancerous tissues have a significantly lower hemoglobin saturation compared to normal controls (p < 0.001), which may be reflective of tumor hypoxia. In addition, there were minimal changes over time upon probe placement and repeated measurement, indicating that the pressure-induced changes were minimal and repeated measurements did not differ significantly from the initial value. This study demonstrates the feasibility of conducting optical spectroscopy measurements on intact lesions prior to removal during HNSCC procedures, and established that this probe provides diagnostically-relevant physiologic information that may impact further treatment.
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Affiliation(s)
- Ashlyn G. Rickard
- Department of Radiation Oncology, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Husam Mikati
- Department of Radiation Oncology, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Antoine Mansourati
- Department of Radiation Oncology, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | | | - Marlee Krieger
- Zenalux Biomedical, Inc., Durham, NC 27705, USA
- Department of Biomedical Engineering, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Daniel Rocke
- Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Ramon Esclamado
- Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Mark W. Dewhirst
- Department of Radiation Oncology, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Nirmala Ramanujam
- Zenalux Biomedical, Inc., Durham, NC 27705, USA
- Department of Biomedical Engineering, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Walter T. Lee
- Department of Head and Neck Surgery & Communications Sciences, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
| | - Gregory M. Palmer
- Department of Radiation Oncology, Duke University Medical Center, Box 3455, Durham, NC 27710, USA
- Zenalux Biomedical, Inc., Durham, NC 27705, USA
- Correspondence: ; Tel.: +1-(919)613-5053
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Hong BJ, Kim J, Jeong H, Bok S, Kim YE, Ahn GO. Tumor hypoxia and reoxygenation: the yin and yang for radiotherapy. Radiat Oncol J 2016; 34:239-249. [PMID: 28030900 PMCID: PMC5207368 DOI: 10.3857/roj.2016.02012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/11/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
Tumor hypoxia, a common feature occurring in nearly all human solid tumors is a major contributing factor for failures of anticancer therapies. Because ionizing radiation depends heavily on the presence of molecular oxygen to produce cytotoxic effect, the negative impact of tumor hypoxia had long been recognized. In this review, we will highlight some of the past attempts to overcome tumor hypoxia including hypoxic radiosensitizers and hypoxia-selective cytotoxin. Although they were (still are) a very clever idea, they lacked clinical efficacy largely because of ‘reoxygenation’ phenomenon occurring in the conventional low dose hyperfractionation radiotherapy prevented proper activation of these compounds. Recent meta-analysis and imaging studies do however indicate that there may be a significant clinical benefit in lowering the locoregional failures by using these compounds. Latest technological advancement in radiotherapy has allowed to deliver high doses of radiation conformally to the tumor volume. Although this technology has brought superb clinical responses for many types of cancer, recent modeling studies have predicted that tumor hypoxia is even more serious because ‘reoxygenation’ is low thereby leaving a large portion of hypoxic tumor cells behind. Wouldn’t it be then reasonable to combine hypoxic radiosensitizers and/or hypoxia-selective cytotoxin with the latest radiotherapy? We will provide some preclinical and clinical evidence to support this idea hoping to revamp an enthusiasm for hypoxic radiosensitizers or hypoxia-selective cytotoxins as an adjunct therapy for radiotherapy.
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Affiliation(s)
- Beom-Ju Hong
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
| | - Jeongwoo Kim
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
| | - Hoibin Jeong
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
| | - Seoyeon Bok
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
| | - Young-Eun Kim
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
| | - G-One Ahn
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea
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Maeda A, Kulbatski I, DaCosta RS. Emerging Applications for Optically Enabled Intravital Microscopic Imaging in Radiobiology. Mol Imaging 2015. [DOI: 10.2310/7290.2015.00022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Azusa Maeda
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
| | - Iris Kulbatski
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
| | - Ralph S. DaCosta
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
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Butterworth KT, Redmond KM, McMahon SJ, Cole AJ, Jain S, McCarthy HO, O'Sullivan JM, Hounsell AR, Prise KM. Conventional in vivo irradiation procedures are insufficient to accurately determine tumor responses to non-uniform radiation fields. Int J Radiat Biol 2014; 91:257-61. [PMID: 25347147 DOI: 10.3109/09553002.2014.980468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To determine differences in overall tumor responses measured by volumetric assessment and bioluminescence imaging (BLI) following exposure to uniform and non-uniform radiation fields in an ectopic prostate tumor model. MATERIALS AND METHODS Bioluminescent human prostate tumor xenografts were established by subcutaneous implantation into male mice. Tumors were irradiated with uniform or non-uniform field configurations using conventional in vivo irradiation procedures performed using a 225 kVp generator with custom lead shielding. Tumor responses were measured using Vernier calipers and by BLI using an in vivo imaging system. Survival was defined as the time to quadroupling of pre-treatment tumor volume. RESULTS The correlation between BLI and tumor volume measurements was found to be different for un-irradiated (R = 0.61), uniformly irradiated (R = 0.34) and partially irradiated (R = 0.30) tumors. Uniformly irradiated tumors resulted in an average tumor growth delay of 60 days with median survival of 75 days, compared to partially irradiated tumors which showed an average growth delay of 24 days and median survival of 38 days. CONCLUSIONS Correlation between BLI and tumor volume measurements is lower for partially irradiated tumors than those exposed to uniform dose distributions. The response of partially irradiated tumors suggests non-uniformity in response beyond physical dose distribution within the target volume. Dosimetric uncertainty associated with conventional in vivo irradiation procedures prohibits their ability to accurately determine tumor response to non-uniform radiation fields and stresses the need for image guided small animal radiation research platforms.
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Affiliation(s)
- Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast
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Brogan J, Li F, Li W, He Z, Huang Q, Li CY. Imaging molecular pathways: reporter genes. Radiat Res 2012; 177:508-13. [PMID: 22348248 DOI: 10.1667/rr2918.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Molecular imaging is a rapidly advancing field that allows cancer biologists to look deeper into the complex inner workings of tumor cells, or whole tumors, in a non-invasive manner. In this review, we will summarize some recent advances that enable investigators to study various important biological processes in tumors in vivo. We will discuss novel imaging approaches that allow investigators to visualize and quantify molecular pathways, such as receptor tyrosine kinase activation, hypoxia signal transduction, apoptosis, and DNA double-strand breaks. Select examples of these applications will be discussed. Because of the limited scope of this review, we will only focus on natural reporters, such as bioluminescence and fluorescent proteins.
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Affiliation(s)
- John Brogan
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina 27710, USA
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