Qiu Longhua, Zhang Feng, Shi Yaoping, Bai Zhibin, Wang Jianfeng, Li Yonggang, Lee Donghoon, Ingraham Christopher, Feng Xiaoyuan, Yang Xiaoming
From the Image-Guided Biomolecular Intervention Research, Department of Radiology, University of Washington School of Medicine, 850 Republican St, Seattle, WA 98109 (L.Q., F.Z., Y.S., Z.B., J.W., Y.L., D.L., C.I., X.Y.); and Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China (L.Q., X.F.).
Radiology. 2016 May;279(2):400-9. doi: 10.1148/radiol.2015150895. Epub 2015 Nov 24.
To investigate the possibility of using motexafin gadolinium (MGd)-enhanced molecular magnetic resonance (MR) imaging and optical imaging to identify the true margins of gliomas.
The animal protocol was approved by the institutional animal care and use committee. Thirty-six Sprague-Dawley rats with gliomas were randomized into six groups of six rats. Five groups were euthanized 15, 30, 60, 120, and 240 minutes after intravenous administration of 6 mg/kg of MGd, while one group received only saline solution as a control group. After craniotomy, optical imaging and T1-weighted MR imaging were performed to identify the tumor margins. One-way analysis of variance was used to compare optical photon intensity and MR imaging signal-to-noise ratios. Histologic analysis was performed to confirm the intracellular uptake of MGd by tumor cells and to correlate the tumor margins delineated on both optical and MR images.
Both optical imaging and T1-weighted MR imaging showed tumor margins. The highest optical photon intensity (2.6 × 10(8) photons per second per mm(2) ± 2.3 × 10(7); analysis of variance, P < .001) and MR signal-to-noise ratio (77.61 ± 2.52; analysis of variance, P = .006) were reached at 15-30 minutes after administration of MGd, with continued tumor visibility at 2-4 hours. Examination with confocal microscopy allowed confirmation that the fluorescence of optical images and MR imaging T1 enhancement exclusively originated from MGd that accumulated in the cytoplasm of tumor cells.
MGd-enhanced optical and MR imaging can allow determination of glioma tumor margins at the optimal time of 15-120 minutes after administration of MGd. Clinical application of these results may allow complete removal of gliomas in a hybrid surgical setting in which intraoperative optical and MR imaging are available.
探讨使用莫特沙芬钆（MGd）增强分子磁共振（MR）成像和光学成像来识别胶质瘤真正边界的可能性。
动物实验方案经机构动物护理和使用委员会批准。36只患有胶质瘤的Sprague-Dawley大鼠被随机分为6组，每组6只。5组在静脉注射6mg/kg的MGd后15、30、60、120和240分钟实施安乐死，而一组仅接受盐溶液作为对照组。开颅术后，进行光学成像和T1加权MR成像以识别肿瘤边界。采用单因素方差分析比较光学光子强度和MR成像信噪比。进行组织学分析以确认肿瘤细胞对MGd的细胞内摄取，并将光学和MR图像上描绘的肿瘤边界进行关联。
光学成像和T1加权MR成像均显示出肿瘤边界。在注射MGd后15 - 30分钟达到最高光学光子强度（每秒每平方毫米2.6×10(8)个光子±2.3×10(7)；方差分析，P <.001）和MR信噪比（77.61±2.52；方差分析，P =.006），在2 - 4小时仍可见肿瘤。共聚焦显微镜检查证实光学图像的荧光和MR成像T1增强仅源于积聚在肿瘤细胞质中的MGd。
MGd增强的光学和MR成像能够在注射MGd后15 - 120分钟的最佳时间确定胶质瘤的肿瘤边界。这些结果的临床应用可能允许在可进行术中光学和MR成像的混合手术环境中完全切除胶质瘤。
