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基于菲立磁的血管大小成像(VSI)的临床转化:在一项I期肿瘤学临床试验人群中的可行性。

Clinical translation of ferumoxytol-based vessel size imaging (VSI): Feasibility in a phase I oncology clinical trial population.

作者信息

Fredrickson Jill, Serkova Natalie J, Wyatt Shelby K, Carano Richard A D, Pirzkall Andrea, Rhee Ina, Rosen Lee S, Bessudo Alberto, Weekes Colin, de Crespigny Alex

机构信息

Clinical Imaging Group, Genentech, Inc., South San Francisco, California, USA.

Oncology Clinical Development, Genentech, Inc., South San Francisco, California, USA.

出版信息

Magn Reson Med. 2017 Feb;77(2):814-825. doi: 10.1002/mrm.26167. Epub 2016 Feb 26.

Abstract

PURPOSE

To assess the feasibility of acquiring vessel size imaging (VSI) metrics using ferumoxytol injections and stock pulse sequences in a multicenter Phase I trial of a novel therapy in patients with advanced metastatic disease.

METHODS

Scans were acquired before, immediately after, and 48 h after injection, at screening and after 2 weeks of treatment. ΔR , ΔR2*, vessel density (Q), and relative vascular volume fractions (VVF) were estimated in both normal tissue and tumor, and compared with model-derived theoretical and experimental estimates based on preclinical murine xenograft data.

RESULTS

R and R2* relaxation rates were still significantly elevated in tumors and liver 48 h after ferumoxytol injection; liver values returned to baseline by week 2. Q was relatively insensitive to changes in ΔR2*, indicating lack of dependence on contrast agent concentration. Variability in Q was higher among human tumors compared with xenografts and was mostly driven by ΔR . Relative VVFs were higher in human tumors compared with xenografts, while values in muscle were similar between species.

CONCLUSION

Clinical ferumoxytol-based VSI is feasible using standard MRI techniques in a multicenter study of patients with lesions outside of the brain. Ferumoxytol accumulation in the liver does not preclude measurement of VSI parameters in liver metastases. Magn Reson Med 77:814-825, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

摘要

目的

在一项针对晚期转移性疾病患者的新型疗法的多中心I期试验中,评估使用铁羧麦芽糖注射剂和常规脉冲序列获取血管大小成像(VSI)指标的可行性。

方法

在注射前、注射后即刻以及注射后48小时、筛查时和治疗2周后进行扫描。在正常组织和肿瘤中估计ΔR、ΔR2*、血管密度(Q)和相对血管体积分数(VVF),并与基于临床前小鼠异种移植数据的模型推导理论和实验估计值进行比较。

结果

铁羧麦芽糖注射后48小时,肿瘤和肝脏中的R和R2弛豫率仍显著升高;到第2周时,肝脏值恢复到基线水平。Q对ΔR2的变化相对不敏感,表明其不依赖于造影剂浓度。与异种移植相比,人类肿瘤中Q的变异性更高,且主要由ΔR驱动。与异种移植相比,人类肿瘤中的相对VVF更高,而不同物种肌肉中的值相似。

结论

在一项针对脑外病变患者的多中心研究中,使用标准MRI技术基于铁羧麦芽糖的临床VSI是可行的。铁羧麦芽糖在肝脏中的蓄积并不妨碍对肝转移瘤VSI参数的测量。《磁共振医学》77:814 - 825, 2017。© 2016国际磁共振医学学会。

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