Elliott Jonathan T, Samkoe Kimberley S, Gunn Jason R, Stewart Errol E, Gardner Timothy B, Tichauer Kenneth M, Lee Ting-Yim, Hoopes P Jack, Pereira Stephen P, Hasan Tayyaba, Pogue Brian W
Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755-8000.
Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755-8000; Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
Acad Radiol. 2015 May;22(5):572-9. doi: 10.1016/j.acra.2014.12.014. Epub 2015 Feb 14.
It was hypothesized that perfusion computed tomography (CT), blood flow (BF), blood volume (BV), and vascular permeability surface area (PS) product parameters would be predictive of therapeutic anticancer agent uptake in pancreatic cancer, facilitating image-guided interpretation of human treatments. The hypothesis was tested in an orthotopic rabbit model of pancreatic cancer, by establishing the model, imaging with endoscopic ultrasound (EUS) and contrast CT, and spatially comparing the perfusion maps to the ex vivo uptake values of the injected photosensitizer, verteporfin.
Nine New Zealand white rabbits underwent direct pancreas implantation of VX2 tumors, and CT perfusion or EUS was performed 10 days postimplantation. Verteporfin was injected during CT imaging, and the tissue was removed 1 hour postinjection for frozen tissue fluorescence scanning. Region-of-interest comparisons of CT data with ex vivo fluorescence and histopathologic staining were performed.
Dynamic contrast-enhanced CT showed enhanced BF, BV, and PS in the tumor rim and decreased BF, BV, and PS in the tumor core. Significant correlations were found between ex vivo verteporfin concentration and each of BF, BV, and PS.
The efficacy of verteporfin delivery in tumors is estimated by perfusion CT, providing a noninvasive method of mapping photosensitizer dose.
据推测,灌注计算机断层扫描(CT)、血流量(BF)、血容量(BV)以及血管通透性表面积(PS)乘积参数可预测胰腺癌中抗癌治疗药物的摄取情况,有助于对人体治疗进行图像引导的解读。通过建立原位兔胰腺癌模型、使用内镜超声(EUS)和对比增强CT成像,并将灌注图与注射的光敏剂维替泊芬的离体摄取值进行空间比较,在该模型中对这一推测进行了验证。
9只新西兰白兔接受了VX2肿瘤的胰腺直接植入,在植入后10天进行CT灌注或EUS检查。在CT成像期间注射维替泊芬,注射后1小时取出组织进行冷冻组织荧光扫描。对CT数据与离体荧光和组织病理学染色进行感兴趣区域比较。
动态对比增强CT显示肿瘤边缘的BF、BV和PS增强,肿瘤核心的BF、BV和PS降低。在离体维替泊芬浓度与BF、BV和PS中的每一项之间均发现显著相关性。
通过灌注CT可评估维替泊芬在肿瘤中的递送效果,提供一种绘制光敏剂剂量的非侵入性方法。