1
|
Tesfai A, Norori N, Harding TA, Wong YH, Hobbs MD. The impact of pre-biopsy MRI and additional testing on prostate cancer screening outcomes: A rapid review. BJUI Compass 2024; 5:426-438. [PMID: 38633829 PMCID: PMC11019254 DOI: 10.1002/bco2.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/26/2023] [Indexed: 04/19/2024] Open
Abstract
Objective This work aims to examine the latest evidence on the impact of pre-biopsy MRI, in addition to prostate-specific antigen (PSA) testing, on health outcomes and quality of life. Methods We conducted a literature search including PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases, with a limited scan of (i) guidelines and (ii) references from trial reports, from January 2005 to 25th January 2023. Two independent reviewers selected randomised controlled trials (RCT) and cohort studies which met our inclusion criteria. Results One hundred thirty-seven articles were identified, and seven trial articles were selected. Trial interventions were as follows: (i) PSA blood test, (ii) additional tests such as pre-biopsy multiparametric magnetic resonance imaging (mpMRI) and Biparametric MRI (bpMRI), and (iii) MRI targeted biopsy and standard biopsy. Compared with standard biopsy, MRI-based interventions led to increased detection of clinically significant cancers in three studies and decreased detection of clinically insignificant cancer (Gleason grade 3 + 3) in four studies. However, PROstate Magnetic resonance Imaging Study (PROMIS) and Stockholm3 with MRI (STHLM3-MRI) studies reported different trends depending on the scenario studied in PROMIS (MRI triage and MRI directed biopsy vs. MRI triage and standard biopsy) and thresholds used in STHLM3-MRI (≥0·11 and ≥0·15). MRI also helped 8%-49% of men avoid biopsy, in six out of seven studies, but not in STHLM3-MRI at ≥0.11. Interestingly, the proportion of men who experienced sepsis and UTI was low across studies. Conclusion This review found that a combination of approaches, centred on the use of pre-biopsy MRI, may improve the detection of clinically significant cancers and reduce (i) the diagnosis of clinically insignificant cancers and (ii) unnecessary biopsies, compared with PSA testing and standard biopsy alone. However, the impact of such interventions on longer term outcomes such as prostate cancer-specific mortality has not yet been assessed.
Collapse
|
2
|
Liu JTC, Chow SSL, Colling R, Downes MR, Farré X, Humphrey P, Janowczyk A, Mirtti T, Verrill C, Zlobec I, True LD. Engineering the future of 3D pathology. J Pathol Clin Res 2024; 10:e347. [PMID: 37919231 PMCID: PMC10807588 DOI: 10.1002/cjp2.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/06/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023]
Abstract
In recent years, technological advances in tissue preparation, high-throughput volumetric microscopy, and computational infrastructure have enabled rapid developments in nondestructive 3D pathology, in which high-resolution histologic datasets are obtained from thick tissue specimens, such as whole biopsies, without the need for physical sectioning onto glass slides. While 3D pathology generates massive datasets that are attractive for automated computational analysis, there is also a desire to use 3D pathology to improve the visual assessment of tissue histology. In this perspective, we discuss and provide examples of potential advantages of 3D pathology for the visual assessment of clinical specimens and the challenges of dealing with large 3D datasets (of individual or multiple specimens) that pathologists have not been trained to interpret. We discuss the need for artificial intelligence triaging algorithms and explainable analysis methods to assist pathologists or other domain experts in the interpretation of these novel, often complex, large datasets.
Collapse
Affiliation(s)
- Jonathan TC Liu
- Department of Mechanical EngineeringUniversity of WashingtonSeattleWAUSA
- Department of Laboratory Medicine & PathologyUniversity of Washington School of MedicineSeattleUSA
- Department of BioengineeringUniversity of WashingtonSeattleUSA
| | - Sarah SL Chow
- Department of Mechanical EngineeringUniversity of WashingtonSeattleWAUSA
| | | | | | | | - Peter Humphrey
- Department of UrologyYale School of MedicineNew HavenCTUSA
| | - Andrew Janowczyk
- Wallace H Coulter Department of Biomedical EngineeringEmory University and Georgia Institute of TechnologyAtlantaGAUSA
- Geneva University HospitalsGenevaSwitzerland
| | - Tuomas Mirtti
- Helsinki University Hospital and University of HelsinkiHelsinkiFinland
- Emory University School of MedicineAtlantaGAUSA
| | - Clare Verrill
- John Radcliffe HospitalUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Inti Zlobec
- Institute for Tissue Medicine and PathologyUniversity of BernBernSwitzerland
| | - Lawrence D True
- Department of Laboratory Medicine & PathologyUniversity of Washington School of MedicineSeattleUSA
| |
Collapse
|
3
|
Shortall J, Vasquez Osorio E, Green A, McWilliam A, Elumalai T, Reeves K, Johnson-Hart C, Beasley W, Hoskin P, Choudhury A, van Herk M. Dose outside of the prostate is associated with improved outcomes for high-risk prostate cancer patients treated with brachytherapy boost. Front Oncol 2023; 13:1200676. [PMID: 37397380 PMCID: PMC10311256 DOI: 10.3389/fonc.2023.1200676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background One in three high-risk prostate cancer patients treated with radiotherapy recur. Detection of lymph node metastasis and microscopic disease spread using conventional imaging is poor, and many patients are under-treated due to suboptimal seminal vesicle or lymph node irradiation. We use Image Based Data Mining (IBDM) to investigate association between dose distributions, and prognostic variables and biochemical recurrence (BCR) in prostate cancer patients treated with radiotherapy. We further test whether including dose information in risk-stratification models improves performance. Method Planning CTs, dose distributions and clinical information were collected for 612 high-risk prostate cancer patients treated with conformal hypo-fractionated radiotherapy, intensity modulated radiotherapy (IMRT), or IMRT plus a single fraction high dose rate (HDR) brachytherapy boost. Dose distributions (including HDR boost) of all studied patients were mapped to a reference anatomy using the prostate delineations. Regions where dose distributions significantly differed between patients that did and did-not experience BCR were assessed voxel-wise using 1) a binary endpoint of BCR at four-years (dose only) and 2) Cox-IBDM (dose and prognostic variables). Regions where dose was associated with outcome were identified. Cox proportional-hazard models with and without region dose information were produced and the Akaike Information Criterion (AIC) was used to assess model performance. Results No significant regions were observed for patients treated with hypo-fractionated radiotherapy or IMRT. Regions outside the target where higher dose was associated with lower BCR were observed for patients treated with brachytherapy boost. Cox-IBDM revealed that dose response was influenced by age and T-stage. A region at the seminal vesicle tips was identified in binary- and Cox-IBDM. Including the mean dose in this region in a risk-stratification model (hazard ratio=0.84, p=0.005) significantly reduced AIC values (p=0.019), indicating superior performance, compared with prognostic variables only. The region dose was lower in the brachytherapy boost patients compared with the external beam cohorts supporting the occurrence of marginal misses. Conclusion Association was identified between BCR and dose outside of the target region in high-risk prostate cancer patients treated with IMRT plus brachytherapy boost. We show, for the first-time, that the importance of irradiating this region is linked to prognostic variables.
Collapse
Affiliation(s)
- Jane Shortall
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Eliana Vasquez Osorio
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Andrew Green
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Alan McWilliam
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Thriaviyam Elumalai
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Kimberley Reeves
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Corinne Johnson-Hart
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - William Beasley
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Peter Hoskin
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Ananya Choudhury
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Marcel van Herk
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
4
|
Rushworth LK, Loveridge C, Salji M, MacLeod M, Mui E, Sumpton D, Neilson M, Hedley A, Alexander L, McCartney E, Patel R, Wallace J, Delles C, Jones R, Leung HY. Phase II proof-of-concept study of atorvastatin in castration-resistant prostate cancer. BJU Int 2023; 131:236-243. [PMID: 35844167 PMCID: PMC10087532 DOI: 10.1111/bju.15851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To test for evidence of statin-mediated effects in patients with castration-resistant prostate cancer (CRPC) as post-diagnosis use of statins in patients with prostate cancer is associated with favourable survival outcome. PATIENTS AND METHODS The SPECTRE trial was a 6-weeks-long proof-of-concept single-arm Phase II treatment trial, combining atorvastatin and androgen deprivation therapy in patients with CRPC (regardless of metastatic status), designed to test for evidence of statin-mediated effects in patients with CRPC. The primary study endpoint was the proportion of patients achieving a ≥50% drop from baseline in prostate-specific antigen (PSA) levels at any time over the 6-week period of atorvastatin medication (PSA response). Exploratory endpoints include PSA velocity and serum metabolites identified by mass spectrometry . RESULTS At the scheduled interim analysis, one of 12 patients experienced a ≥50% drop in PSA levels (primary endpoint), with ≥2 patients satisfying the primary endpoint required for further recruitment. All 12 patients experienced substantial falls in serum cholesterol levels following statin treatment. While all patients had comparable pre-study PSA velocities, six of 12 patients showed decreased PSA velocities after statin treatment, suggestive of disease stabilization. Unbiased metabolomics analysis on serial weekly blood samples identified tryptophan to be the dominant metabolite associated with patient response to statin. CONCLUSIONS Data from the SPECTRE study provide the first evidence of statin-mediated effects on CRPC and early sign of disease stabilization. Our data also highlight the possibility of altered tryptophan metabolism being associated with tumour response.
Collapse
Affiliation(s)
- Linda K. Rushworth
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Carolyn Loveridge
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Mark Salji
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Martin MacLeod
- Beatson West of Scotland Cancer CentreGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Ernest Mui
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | | | | | | | - Laura Alexander
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Elaine McCartney
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | | | - Jan Wallace
- Beatson West of Scotland Cancer CentreGlasgowUK
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Rob Jones
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- Beatson West of Scotland Cancer CentreGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Hing Y. Leung
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| |
Collapse
|
5
|
Metzler VM, de Brot S, Haigh DB, Woodcock CL, Lothion-Roy J, Harris AE, Nilsson EM, Ntekim A, Persson JL, Robinson BD, Khani F, Laursen KB, Gudas LJ, Toss MS, Madhusudan S, Rakha E, Heery DM, Rutland CS, Mongan NP, Jeyapalan JN. The KDM5B and KDM1A lysine demethylases cooperate in regulating androgen receptor expression and signalling in prostate cancer. Front Cell Dev Biol 2023; 11:1116424. [PMID: 37152294 PMCID: PMC10154691 DOI: 10.3389/fcell.2023.1116424] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Histone H3 lysine 4 (H3K4) methylation is key epigenetic mark associated with active transcription and is a substrate for the KDM1A/LSD1 and KDM5B/JARID1B lysine demethylases. Increased expression of KDM1A and KDM5B is implicated in many cancer types, including prostate cancer (PCa). Both KDM1A and KDM5B interact with AR and promote androgen regulated gene expression. For this reason, there is great interested in the development of new therapies targeting KDM1A and KDM5B, particularly in the context of castrate resistant PCa (CRPC), where conventional androgen deprivation therapies and androgen receptor signalling inhibitors are no longer effective. As there is no curative therapy for CRPC, new approaches are urgently required to suppress androgen signalling that prevent, delay or reverse progression to the castrate resistant state. While the contribution of KDM1A to PCa is well established, the exact contribution of KDM5B to PCa is less well understood. However, there is evidence that KDM5B is implicated in numerous pro-oncogenic mechanisms in many different types of cancer, including the hypoxic response, immune evasion and PI3/AKT signalling. Here we elucidate the individual and cooperative functions of KDM1A and KDM5B in PCa. We show that KDM5B mRNA and protein expression is elevated in localised and advanced PCa. We show that the KDM5 inhibitor, CPI-455, impairs androgen regulated transcription and alternative splicing. Consistent with the established role of KDM1A and KDM5B as AR coregulators, we found that individual pharmacologic inhibition of KDM1A and KDM5 by namoline and CPI-455 respectively, impairs androgen regulated transcription. Notably, combined inhibition of KDM1A and KDM5 downregulates AR expression in CRPC cells. Furthermore, combined KDM1A and KDM5 inhibition impairs PCa cell proliferation and invasion more than individual inhibition of KDM1A and KDM5B. Collectively our study has identified individual and cooperative mechanisms involving KDM1A and KDM5 in androgen signalling in PCa. Our findings support the further development of KDM1A and KDM5B inhibitors to treat advanced PCa. Further work is now required to confirm the therapeutic feasibility of combined inhibition of KDM1A and KDM5B as a novel therapeutic strategy for targeting AR positive CRPC.
Collapse
Affiliation(s)
- Veronika M. Metzler
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Simone de Brot
- COMPATH, Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - Daisy B. Haigh
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Corinne L. Woodcock
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | | | - Anna E. Harris
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Emeli M. Nilsson
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Atara Ntekim
- Department of Oncology, University Hospital Ibadan, Ibadan, Nigeria
| | - Jenny L. Persson
- Department of Molecular Biology, Umeå University, Umeå, Sweden
- Department of Biomedical Sciences, Malmö Universitet, Malmö, Sweden
| | - Brian D. Robinson
- Department of Urology, Weill Cornell Medicine, New York, NY, United States
| | - Francesca Khani
- Department of Urology, Weill Cornell Medicine, New York, NY, United States
| | - Kristian B. Laursen
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, United States
| | - Lorraine J. Gudas
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, United States
| | - Michael S. Toss
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | | | - Emad Rakha
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - David M. Heery
- School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
| | - Catrin S. Rutland
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Nigel P. Mongan
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, United States
- *Correspondence: Nigel P. Mongan, , ; Jennie N. Jeyapalan,
| | - Jennie N. Jeyapalan
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Nigel P. Mongan, , ; Jennie N. Jeyapalan,
| |
Collapse
|
6
|
Robinson P, Bacon CM, Lim SJ, Shaaban AM, Brierley D, Lewis I, Harrison DJ, Kendall TJ, Robinson M. Assessment of clinical trial protocols for pathology content using the SPIRIT-Path guidelines highlights areas for improvement. J Pathol Clin Res 2022; 8:411-421. [PMID: 35638866 PMCID: PMC9353656 DOI: 10.1002/cjp2.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/24/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022]
Abstract
The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Statement provides evidence-based recommendations for the minimum content of clinical trial protocols. The Cellular Molecular Pathology Initiative, hosted by the UK National Cancer Research Institute, developed an extension, SPIRIT-Path, describing how to effectively incorporate pathology support into clinical trial protocols. The current study assessed the inclusion of SPIRIT-Path items in protocols of active clinical trials. Publicly available clinical trial protocols were identified for assessment against the new guidelines using a single UK hospital as the 'test site'. One hundred and ninety interventional clinical trials were identified as receiving support from the pathology department. However, only 38 had publicly available full trial protocols (20%) and following application of the inclusion/exclusion criteria, 19 were assessed against the SPIRIT-Path guidelines. The reviewed clinical trial protocols showed some areas of compliance and highlighted other items that were inadequately described. The latter lacked information about the individuals responsible for the pathology content of the trial protocol, how pathology activities and roles were organised in the trial, where the laboratory work would be carried out, and the accreditation status of the laboratory. Only one trial had information specific to digital pathology, a technology certain to become more prevalent in the future. Adoption of the SPIRIT-Path checklist will facilitate comprehensive trial protocols that address all the key cellular and molecular pathology aspects of interventional clinical trials. This study highlights once again the lack of public availability of trial protocols. Full trial protocols should be available for scrutiny by the scientific community and the public who participate in the studies, increasing the transparency of clinical trial activity and improving quality.
Collapse
Affiliation(s)
- Peter Robinson
- School of Medical EducationNewcastle UniversityNewcastle upon TyneUK
| | - Chris M Bacon
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
- Department of Cellular PathologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Shujing J Lim
- Department of Cellular PathologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Abeer M Shaaban
- Department of HistopathologyQueen Elizabeth HospitalBirminghamUK
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Daniel Brierley
- Unit of Oral and Maxillofacial PathologyUniversity of SheffieldSheffieldUK
| | - Ian Lewis
- National Cancer Research InstituteLondonUK
| | | | | | - Max Robinson
- Department of Cellular PathologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| |
Collapse
|
7
|
Guerra Liberal FDC, Moreira H, Redmond KM, O’Sullivan JM, Alshehri AHD, Wright TC, Dunne VL, Campfield C, Biggart S, McMahon SJ, Prise KM. Differential responses to 223Ra and Alpha-particles exposure in prostate cancer driven by mitotic catastrophe. Front Oncol 2022; 12:877302. [PMID: 35965568 PMCID: PMC9367686 DOI: 10.3389/fonc.2022.877302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionRadium-223 (223Ra) has been shown to have an overall survival benefit in metastatic castration-resistant prostate cancer (mCRPC) involving bone. Despite its increased clinical usage, relatively little is known regarding the mechanism of action of 223Ra at the cellular level.MethodsWe evaluated the effects of 223Ra irradiation in a panel of cell lines and then compared them with standard X-ray and external alpha-particle irradiation, with a particular focus on cell survival and DNA damage repair kinetics.Results223Ra exposures had very high, cell-type-dependent RBE50% ranging from 7 to 15. This was significantly greater than external alpha irradiations (RBE50% from 1.4 to 2.1). These differences were shown to be partially related to the volume of 223Ra solution added, independent of the alpha-particle dose rate, suggesting a radiation-independent mechanism of effect. Both external alpha particles and 223Ra exposure were associated with delayed DNA repair, with similar kinetics. Additionally, the greater treatment efficacy of 223Ra was associated with increased levels of residual DNA damage and cell death by mitotic catastrophe.ConclusionsThese results suggest that 223Ra exposure may be associated with greater biological effects than would be expected by direct comparison with a similar dose of external alpha particles, highlighting important challenges for future therapeutic optimization.
Collapse
Affiliation(s)
- Francisco D. C. Guerra Liberal
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
- *Correspondence: Francisco D. C. Guerra Liberal,
| | - Hugo Moreira
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Kelly M. Redmond
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Joe M. O’Sullivan
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
- Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Ali H. D. Alshehri
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Timothy C. Wright
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Victoria L. Dunne
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Caoimhghin Campfield
- Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Sandra Biggart
- Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Stephen J. McMahon
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Kevin M. Prise
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| |
Collapse
|
8
|
Ng A, V WC, Asif A, Light A, Lam CM, Jayaraajan K, Cambridge WA, Matthews MG, Kulkarni M, S ZYO, Nathan A, Ahmed N, Gadhia S, Morka N, Hinchcliffe Z, Chen W, Yoon WY, Das K, Kufuor RA, Patel K, Ayres B, Dacre J, Harding C, Page T, Pearce I, Bhatt NR, Khadhouri S, Kasivisvanathan V. LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools. BJU Int 2022; 130:676-687. [PMID: 35488402 PMCID: PMC9796355 DOI: 10.1111/bju.15758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures.
Collapse
Affiliation(s)
- Alexander Ng
- University College London (UCL) Medical SchoolUCLLondonUK
- British Urology Researchers in Surgical Training (BURST)LondonUK
| | - Wai‐Shun Chan V
- British Urology Researchers in Surgical Training (BURST)LondonUK
- School of Medicine, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Aqua Asif
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Leicester Medical SchoolUniversity of LeicesterLeicesterUK
| | - Alexander Light
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Department of Surgery and CancerImperial College LondonLondonUK
| | - Chon Meng Lam
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Bronglais General HospitalAberystwythUK
| | - Keerthanaa Jayaraajan
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Faculty of MedicineImperial College LondonLondonUK
| | - William A. Cambridge
- British Urology Researchers in Surgical Training (BURST)LondonUK
- University of EdinburghEdinburghUK
| | | | - Meghana Kulkarni
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Department of UrologyUrology Centre, Guy’s and St Thomas’ NHS Foundation TrustLondonUK
- Cancer Imaging Department, School of Biomedical Engineering and Imaging SciencesKing’s College LondonLondonUK
| | - Zhi Yang Ooi S
- Cardiff University School of MedicineUniversity Hospital WalesCardiffUK
| | - Arjun Nathan
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Division of Surgery and Interventional ScienceUCLLondonUK
| | - Najma Ahmed
- GKT School of Medicine, Faculty of Life Sciences and MedicineKing’s College LondonLondonUK
| | - Shivali Gadhia
- Sheffield Medical SchoolUniversity of SheffieldSheffieldUK
| | - Naomi Morka
- University College London (UCL) Medical SchoolUCLLondonUK
| | | | - Wentin Chen
- Birmingham Medical School, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Won Young Yoon
- School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Department of BioengineeringImperial College LondonLondonUK
| | - Kieran Das
- School of MedicineUniversity of NottinghamNottinghamUK
| | | | - Kenal Patel
- School of Medicine, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Ben Ayres
- Department of UrologySt George’s University Hospitals NHS TrustLondonUK
| | | | - Chris Harding
- Department of UrologyFreeman HospitalNewcastle upon TyneUK
- Translational and Clinical Research Institute Newcastle UniversityNewcastle upon TyneUK
| | - Toby Page
- Department of UrologyFreeman Hospital, Newcastle upon Tyne Hospitals TrustNewcastle upon TyneUK
| | - Ian Pearce
- Manchester University NHS Foundation TrustManchesterUK
| | - Nikita R. Bhatt
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Department of UrologyNorfolk and Norwich University HospitalNorwichUK
| | - Sinan Khadhouri
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Health Science Research Unit, The School of Medicine, Medical Sciences and Nutrition, Aberdeen Royal InfirmaryUniversity of AberdeenAberdeenUK
| | - Veeru Kasivisvanathan
- British Urology Researchers in Surgical Training (BURST)LondonUK
- Division of Surgery and Interventional ScienceUCLLondonUK
| | | |
Collapse
|
9
|
Archer LK, Frame FM, Walker HF, Droop AP, McDonald GLK, Kucko S, Berney DM, Mann VM, Simms MS, Maitland NJ. ETS transcription factor ELF3 (ESE-1) is a cell cycle regulator in benign and malignant prostate. FEBS Open Bio 2022; 12:1365-1387. [PMID: 35472129 PMCID: PMC9249341 DOI: 10.1002/2211-5463.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/23/2022] [Accepted: 04/25/2022] [Indexed: 11/07/2022] Open
Abstract
This study aimed to elucidate the role of ELF3, an ETS family member in normal prostate growth and prostate cancer. Silencing ELF3 in both benign prostate (BPH-1) and prostate cancer (PC3) cell lines resulted in decreased colony forming ability, inhibition of cell migration and reduced cell viability due to cell cycle arrest, establishing ELF3 as a cell cycle regulator. Increased ELF3 expression in more advanced prostate tumours was shown by immunostaining of tissue microarrays and from analysis of gene expression and genetic alteration studies. This study indicates that ELF3 functions as part of normal prostate epithelial growth but also as a potential oncogene in advanced prostate cancers.
Collapse
Affiliation(s)
- Leanne K. Archer
- Cancer Research UnitDepartment of BiologyUniversity of YorkHeslingtonUK
| | - Fiona M. Frame
- Cancer Research UnitDepartment of BiologyUniversity of YorkHeslingtonUK
| | - Hannah F. Walker
- Cancer Research UnitDepartment of BiologyUniversity of YorkHeslingtonUK
| | | | | | - Samuel Kucko
- Cancer Research UnitDepartment of BiologyUniversity of YorkHeslingtonUK
| | - Daniel M. Berney
- Department of Molecular OncologyBarts Cancer InstituteQueen Mary University of LondonUK
| | - Vincent M. Mann
- Cancer Research UnitDepartment of BiologyUniversity of YorkHeslingtonUK
| | | | | |
Collapse
|
10
|
Blijdorp CJ, Hartjes TA, Wei K, van Heugten MH, Bovée DM, Budde RP, van de Wetering J, Hoenderop JG, van Royen ME, Zietse R, Severs D, Hoorn EJ. Nephron mass determines the excretion rate of urinary extracellular vesicles. J Extracell Vesicles 2022; 11:e12181. [PMID: 35064766 PMCID: PMC8783354 DOI: 10.1002/jev2.12181] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/15/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
Urinary extracellular vesicles (uEVs) are emerging as non-invasive biomarkers for various kidney diseases, but it is unknown how differences in nephron mass impact uEV excretion. To address this, uEV excretion was measured before and after human kidney donor nephrectomy and rat nephrectomy. In male and female donors, uEVs were quantified in cell-free spot and 24-h urine samples using nanoparticle tracking analysis (NTA), EVQuant, and CD9-time-resolved fluorescence immunoassay. Female donors had significantly lower total kidney volume (TKV) and excreted 49% fewer uEVs than male donors. uEV excretion correlated positively with estimated glomerular filtration rate (eGFR), creatinine clearance, and TKV (R's between 0.6 and 0.7). uEV excretion rate could also be predicted from spot urines after multiplying spot uEV/creatinine by 24-h urine creatinine. Donor nephrectomy reduced eGFR by 36% ± 10%, but the excretion of uEVs by only 16% (CD9+ uEVs -37%, CD9- uEVs no decrease). Donor nephrectomy increased the podocyte marker WT-1 and the proximal tubule markers NHE3, NaPi-IIa, and cubilin in uEVs two- to four-fold when correcting for the nephrectomy. In rats, the changes in GFR and kidney weight correlated with the changes in uEV excretion rate (R = 0.46 and 0.60, P < 0.01). Furthermore, the estimated degree of hypertrophy matched the change in uEV excretion rate (1.4- to 1.5-fold after uninephrectomy and four-fold after 5/6th nephrectomy). Taken together, our data show that uEV excretion depends on nephron mass, and that nephrectomy reduces uEV excretion less than expected based on nephron loss due to compensatory hypertrophy. The major implication of our findings is that a measure for nephron mass or uEV excretion rate should be included when comparing uEV biomarkers between individuals.
Collapse
Affiliation(s)
- Charles J. Blijdorp
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Thomas A. Hartjes
- Department of PathologyErasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Kuang‐Yu Wei
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Martijn H. van Heugten
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Dominique M. Bovée
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Ricardo P.J. Budde
- Department of Radiology and Nuclear MedicineErasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Jacqueline van de Wetering
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Joost G.J. Hoenderop
- Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Martin E. van Royen
- Department of PathologyErasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Robert Zietse
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - David Severs
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Ewout J. Hoorn
- Department of Internal Medicine, Division of Nephrology and TransplantationErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| |
Collapse
|
11
|
Ryman‐Tubb T, Lothion‐Roy JH, Metzler VM, Harris AE, Robinson BD, Rizvanov AA, Jeyapalan JN, James VH, England G, Rutland CS, Persson JL, Kenner L, Rubin MA, Mongan NP, de Brot S. Comparative pathology of dog and human prostate cancer. Vet Med Sci 2022; 8:110-120. [PMID: 34628719 PMCID: PMC8788985 DOI: 10.1002/vms3.642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Though relatively rare in dogs, prostate cancer (PCa) is the most common non-cutaneous cancer in men. Human and canine prostate glands share many functional, anatomical and physiological features. Due to these similarities, canine PCa has been proposed as a model for PCa in men. PCa is typically androgen-dependent at diagnosis in men and for this reason, androgen deprivation therapies (ADT) are important treatments for advanced PCa in men. In contrast, there is some evidence that PCa is diagnosed more commonly in castrate dogs, at which point, limited therapeutic options are available. In men, a major limitation of current ADT is that progression to a lethal and incurable form of PCa, termed castrate-resistant prostate cancer (CRPC), is common. There is, therefore, an urgent need for a better understanding of the mechanism of PCa initiation and progression to CRPC to enable the development of novel therapeutic approaches. This review focuses on the functional, physiological, endocrine and histopathological similarities and differences in the prostate gland of these species. In particular, we focus on common physiological roles for androgen signalling in the prostate of men and dogs, we review the short- and longer-term effects of castration on PCa incidence and progression in the dog and relate how this knowledge may be relevant to understanding the mechanisms of CRPC in men.
Collapse
Affiliation(s)
- Toby Ryman‐Tubb
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Jennifer H. Lothion‐Roy
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Veronika M. Metzler
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Anna E. Harris
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | | | - Albert A. Rizvanov
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
- Institute of Fundamental Medicine and ScienceKazan Federal UniversityKazanTatarstanRussia
| | - Jennie N. Jeyapalan
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Victoria H. James
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Gary England
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Catrin S. Rutland
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Jenny L. Persson
- Department of Molecular BiologyUmeå UniversitetUmeåSweden
- Department of Biomedical SciencesMalmö UniversitetMalmöSweden
| | - Lukas Kenner
- Department of Experimental PathologyLaboratory Animal Pathology Medical University WienViennaAustria
| | - Mark A. Rubin
- Bern Center for Precision MedicineUniversity of Bern and InselspitalBernSwitzerland
- Department of BioMedical ResearchUniversity of Bern and InselspitalBernSwitzerland
| | - Nigel P. Mongan
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
- Department of PharmacologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Simone de Brot
- BioDiscovery InstituteSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
- COMPATH, Institute of Animal PathologyUniversity of BernBernSwitzerland
| |
Collapse
|
12
|
Shephard AP, Giles P, Mbengue M, Alraies A, Spary LK, Kynaston H, Gurney MJ, Falcón‐Pérez JM, Royo F, Tabi Z, Parthimos D, Errington RJ, Clayton A, Webber JP. Stroma-derived extracellular vesicle mRNA signatures inform histological nature of prostate cancer. J Extracell Vesicles 2021; 10:e12150. [PMID: 34596356 PMCID: PMC8485336 DOI: 10.1002/jev2.12150] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 08/25/2021] [Accepted: 09/13/2021] [Indexed: 12/11/2022] Open
Abstract
Histological assessment of prostate cancer is the key diagnostic test and can predict disease outcome. This is however an invasive procedure that carries associated risks, hence non-invasive assays to support the diagnostic pathway are much needed. A key feature of disease progression, and subsequent poor prognosis, is the presence of an altered stroma. Here we explored the utility of prostate stromal cell-derived vesicles as indicators of an altered tumour environment. We compared vesicles from six donor-matched pairs of adjacent-normal versus disease-associated primary stromal cultures. We identified 19 differentially expressed transcripts that discriminate disease from normal stromal extracellular vesicles (EVs). EVs isolated from patient serum were investigated for these putative disease-discriminating mRNA. A set of transcripts including Caveolin-1 (CAV1), TMP2, THBS1, and CTGF were found to be successful in discriminating clinically insignificant (Gleason = 6) disease from clinically significant (Gleason > 8) prostate cancer. Furthermore, correlation between transcript expression and progression-free survival suggests that levels of these mRNA may predict disease outcome. Informed by a machine learning approach, combining measures of the five most informative EV-associated mRNAs with PSA was shown to significantly improve assay sensitivity and specificity. An in-silico model was produced, showcasing the superiority of this multi-modal liquid biopsy compared to needle biopsy for predicting disease progression. This proof of concept highlights the utility of serum EV analytics as a companion diagnostic test with prognostic utility, which may obviate the need for biopsy.
Collapse
Affiliation(s)
- Alex P. Shephard
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Peter Giles
- Wales Gene ParkHenry Welcome BuildingCardiff UniversityCardiffUK
| | - Mariama Mbengue
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Amr Alraies
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Lisa K. Spary
- Wales Cancer BankUniversity Hospital of WalesCardiffUK
| | - Howard Kynaston
- Section of Surgery, Division of Cancer and Genetics, School of MedicineCardiff UniversityCardiffUK
- Department of UrologyCardiff and Vale University Health Board, University Hospital of WalesCardiffUK
| | - Mark J. Gurney
- Division of Infection and Immunity, School of MedicineCardiff UniversityCardiffUK
| | - Juan M. Falcón‐Pérez
- Exosomes Lab. CICbioGUNE‐BRTAParque TecnologicoDerioSpain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd)MadridSpain
- IKERBASQUEBasque Foundation for ScienceBilbaoSpain
| | - Félix Royo
- Exosomes Lab. CICbioGUNE‐BRTAParque TecnologicoDerioSpain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd)MadridSpain
| | - Zsuzsanna Tabi
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Dimitris Parthimos
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Rachel J. Errington
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Aled Clayton
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
| | - Jason P. Webber
- Tissue Microenvironment GroupDivision of Cancer and GeneticsSchool of MedicineCardiff UniversityCardiffUK
- Institute of Life ScienceSwansea University Medical School, Swansea UniversitySwanseaUK
| |
Collapse
|
13
|
Grist JT, Hansen ES, Sánchez‐Heredia JD, McLean MA, Tougaard R, Riemer F, Schulte RF, Kaggie JD, Ardenkjaer‐Larsen JH, Laustsen C, Gallagher FA. Creating a clinical platform for carbon-13 studies using the sodium-23 and proton resonances. Magn Reson Med 2020; 84:1817-1827. [PMID: 32167199 PMCID: PMC8638662 DOI: 10.1002/mrm.28238] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/06/2020] [Accepted: 02/08/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE Calibration of hyperpolarized 13 C-MRI is limited by the low signal from endogenous carbon-containing molecules and consequently requires 13 C-enriched external phantoms. This study investigated the feasibility of using either 23 Na-MRI or 1 H-MRI to calibrate the 13 C excitation. METHODS Commercial 13 C-coils were used to estimate the transmit gain and center frequency for 13 C and 23 Na resonances. Simulations of the transmit B1 profile of a Helmholtz loop were performed. Noise correlation was measured for both nuclei. A retrospective analysis of human data assessing the use of the 1 H resonance to predict [1-13 C]pyruvate center frequency was also performed. In vivo experiments were undertaken in the lower limbs of 6 pigs following injection of hyperpolarized 13 C-pyruvate. RESULTS The difference in center frequencies and transmit gain between tissue 23 Na and [1-13 C]pyruvate was reproducible, with a mean scale factor of 1.05179 ± 0.00001 and 10.4 ± 0.2 dB, respectively. Utilizing the 1 H water peak, it was possible to retrospectively predict the 13 C-pyruvate center frequency with a standard deviation of only 11 Hz sufficient for spectral-spatial excitation-based studies. CONCLUSION We demonstrate the feasibility of using the 23 Na and 1 H resonances to calibrate the 13 C transmit B1 using commercially available 13 C-coils. The method provides a simple approach for in vivo calibration and could improve clinical workflow.
Collapse
Affiliation(s)
- James T. Grist
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUnited Kingdom
| | | | | | - Mary A. McLean
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
- CRUKCambridge InstituteCambridgeUnited Kingdom
| | | | - Frank Riemer
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | | | - Joshua D. Kaggie
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | | | | | | |
Collapse
|