Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.
Invest Radiol. 2011 Nov;46(11):718-25. doi: 10.1097/RLI.0b013e318226c427.
The current lack of efficacy for any chemo- or molecular therapeutic in the treatment of brain metastases is thought to be due, in part, to the heterogeneous permeability of the blood-brain-barrier (BBB). Little is known about how heterogeneous permeability develops, or how it varies among individual metastases. Understanding the BBB's role in metastasis will be crucial to the development of new, more effective therapies. In this article, we developed the first magnetic resonance imaging-based strategy to detect and measure the volumes of BBB permeable and nonpermeable metastases and studied the development of altered BBB permeability in metastases in vivo, over time in a mouse model of breast cancer metastasis to the brain.
Animals bearing human experimental brain metastases of breast cancer (231-BR cells) were imaged, using 3-dimensional balanced steady-state free precession to visualize total metastases, and contrast-enhanced T1-weighted spin echo with gadopentetic acid (Gd-DTPA) to visualize which of these displayed contrast enhancement, as Gd-DTPA leakage is indicative of altered BBB permeability.
Metastases detected 20 days after injection showed no Gd-DTPA enhancement. At day 25, 6.1% ± 6.3% (mean ± standard deviation) of metastases enhanced, and by day 30, 28.1% ± 14.2% enhanced (P < 0.05). Enhancing metastases (mid: 0.14 ± 0.18 mm, late: 0.24 ± 0.32 mm) had larger volumes than nonenhancing (mid: 0.04 ± 0.04 mm, late: 0.09 ± 0.09 mm, P < 0.05); however, there was no significant difference between the growth rates of the 2.
A significant number of brain metastases were uniformly nonpermeable, which highlights the need for developing treatment strategies that can overcome the permeability of the BBB. The model developed herein can provide the basis for in vivo evaluation of both BBB permeable and nonpermeable metastases response to therapy.
目前,任何化疗或分子治疗在治疗脑转移方面都没有效果,这部分原因是血脑屏障(BBB)的通透性存在异质性。对于通透性的异质性如何发展,以及在个体转移灶之间如何变化,我们知之甚少。了解 BBB 在转移中的作用对于开发新的、更有效的治疗方法至关重要。在本文中,我们开发了第一种基于磁共振成像的策略,用于检测和测量 BBB 通透性和非通透性转移灶的体积,并研究了在乳腺癌脑转移的小鼠模型中,随时间推移,转移灶中 BBB 通透性改变的情况。
使用 3 维平衡稳态自由进动序列(3D-balanced steady-state free precession)可视化总转移灶,用对比增强 T1 加权自旋回波序列加钆喷替酸(gadopentetic acid,Gd-DTPA)可视化其中哪些显示对比增强,因为 Gd-DTPA 渗漏表明 BBB 通透性改变,对荷有人乳腺癌实验性脑转移的动物进行成像。
注射后 20 天检测到的转移灶没有 Gd-DTPA 增强。第 25 天,6.1%±6.3%(平均值±标准差)的转移灶增强,第 30 天,28.1%±14.2%增强(P<0.05)。增强的转移灶(中期:0.14±0.18mm,晚期:0.24±0.32mm)体积大于非增强的转移灶(中期:0.04±0.04mm,晚期:0.09±0.09mm,P<0.05);然而,两者的生长速度没有显著差异。
大量脑转移灶均匀地不可渗透,这突出表明需要开发能够克服 BBB 通透性的治疗策略。本文建立的模型可以为 BBB 通透性和非通透性转移灶对治疗反应的体内评估提供基础。