Subashi Ergys, Qi Yi, Johnson G Allan
Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 and Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Med Phys. 2015 May;42(5):2482-8. doi: 10.1118/1.4917525.
A typical dynamic contrast-enhanced (DCE)-MRI study often compares the derived pharmacokinetic parameters on manually selected tumor regions or over the entire tumor volume. These measurements include domains where the interpretation of the biomarkers may be unclear (such as in necrotic areas). Here, the authors describe a technique for increasing the sensitivity and specificity of DCE-MRI by identifying tumor regions with a variable response to therapy.
Two cohorts (n = 8/group) of nu/nu mice with LS-174T implanted in the mammary fat pad were imaged at five time points over four weeks. The treatment/control group received bevacizumab/saline at a dose of 5 mg/kg or 5 ml/kg twice weekly; imaging experiments were performed weekly. MR images were acquired at an isotropic resolution of 156 μm(3)(2.4 nl) and with a sampling rate of 9.9 s. The histogram of the time-to-peak (TTP) was used to identify two (fast- and slow-enhancing) regions based on a threshold of TTP = 1000 s. The regions were correlated with histology, and the effect of therapy was locally examined.
Tumors in the treatment group had a significantly longer doubling time. The regions defined by thresholding the TTP histogram identified two distinct domains correlating significantly with tumor permeability and microvessel density. In the fast-enhancing region, the mean permeability constant (K(trans)) was significantly lower in the treatment group at day 9; in the slow-enhancing region, K(trans) was not different between the control and treatment groups. At day 9, the relative volume of the fast-enhancing region was significantly lower in the treatment group, while that of the slow-enhancing region was significantly higher.
Two regions with distinct kinetic parameters were identified based on the histogram of TTP. The effect of bevacizumab, as measured by a decrease in K(trans), was confined to one of these regions. High spatiotemporal resolution MR studies may contribute unique insights into the response of the tumor microenvironment to therapy.
典型的动态对比增强(DCE)-MRI研究通常会比较在手动选择的肿瘤区域或整个肿瘤体积上得出的药代动力学参数。这些测量包括生物标志物解释可能不明确的区域(如坏死区域)。在此,作者描述了一种通过识别对治疗反应可变的肿瘤区域来提高DCE-MRI敏感性和特异性的技术。
将两组(每组n = 8)在乳腺脂肪垫植入LS-174T的裸鼠在四周内的五个时间点进行成像。治疗/对照组每周两次接受剂量为5 mg/kg或5 ml/kg的贝伐单抗/生理盐水;每周进行成像实验。以156 μm³(2.4 nl)的各向同性分辨率和9.9 s的采样率采集MR图像。使用达峰时间(TTP)直方图基于TTP = 1000 s的阈值识别两个区域(快速增强和缓慢增强)。将这些区域与组织学相关联,并局部检查治疗效果。
治疗组肿瘤的倍增时间显著更长。通过对TTP直方图进行阈值化定义的区域识别出两个与肿瘤通透性和微血管密度显著相关的不同区域。在快速增强区域,治疗组在第9天的平均通透常数(Ktrans)显著更低;在缓慢增强区域,对照组和治疗组之间的Ktrans没有差异。在第9天,治疗组快速增强区域的相对体积显著更低,而缓慢增强区域的相对体积显著更高。
基于TTP直方图识别出了具有不同动力学参数的两个区域。贝伐单抗通过Ktrans降低所测量的效果局限于其中一个区域。高时空分辨率的MR研究可能为肿瘤微环境对治疗的反应提供独特见解。