Ravoori Murali K, Singh Sheela P, Lee Jaehyuk, Bankson James A, Kundra Vikas
From the Departments of Cancer Systems Imaging (M.K.R., S.P.S., V.K.), Imaging Physics (J.L., J.A.B.), and Diagnostic Radiology (V.K.), University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
Radiology. 2017 Dec;285(3):830-838. doi: 10.1148/radiol.2017161772. Epub 2017 Jul 13.
Purpose To assess in a mouse model whether early or late components of glucose metabolism, exemplified by fluorine 18 (F) fluorodeoxyglucose (FDG) positron emission tomography (PET) and hyperpolarized carbon 13 (C)-pyruvate magnetic resonance (MR) spectroscopy, can serve as indicators of response in ovarian cancer to multityrosine kinase inhibitor pazopanib. Materials and Methods In this Animal Care and Use Committee approved study, 17 days after the injection of 2 × 10 human ovarian SKOV3 tumors cells into 14 female nude mice, treatment with vehicle or pazopanib (2.5 mg per mouse peroral every other day) was initiated. Longitudinal T2-weighted MR imaging, dynamic MR spectroscopy of hyperpolarized pyruvate, and F-FDG PET/computed tomographic (CT) imaging were performed before treatment, 2 days after treatment, and 2 weeks after treatment. Results Pazopanib inhibited ovarian tumor growth compared with control (0.054 g ± 0.041 vs 0.223 g ± 0.112, respectively; six mice were treated with pazopanib and seven were control mice; P < .05). Significantly higher pyruvate-to-lactate conversion (lactate/pyruvate + lactate ratio) was found 2 days after treatment with pazopanib than before treatment (0.46 ± 0.07 vs 0.31 ± 0.14, respectively; P < .05; six tumors after treatment, seven tumors before treatment). This was not observed with the control group or with F-FDG PET/CT imaging. Conclusion The findings suggest that hyperpolarized C-pyruvate MR spectroscopy may serve as an early indicator of response to tyrosine kinase (angiogenesis) inhibitors such as pazopanib in ovarian cancer even when F-FDG PET/CT does not indicate a response. RSNA, 2017 Online supplemental material is available for this article.
目的 在小鼠模型中评估以氟18(F)氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)和超极化碳13(C)-丙酮酸磁共振(MR)波谱为代表的葡萄糖代谢早期或晚期成分是否可作为卵巢癌对多酪氨酸激酶抑制剂帕唑帕尼反应的指标。材料与方法 在本经动物护理和使用委员会批准的研究中,将2×10个人卵巢SKOV3肿瘤细胞注射到14只雌性裸鼠体内17天后,开始用赋形剂或帕唑帕尼(每只小鼠每隔一天口服2.5 mg)进行治疗。在治疗前、治疗后2天和治疗后2周进行纵向T2加权MR成像、超极化丙酮酸的动态MR波谱分析以及F-FDG PET/计算机断层扫描(CT)成像。结果 与对照组相比,帕唑帕尼抑制了卵巢肿瘤生长(分别为0.054 g±0.041和0.223 g±0.112;6只小鼠接受帕唑帕尼治疗,7只为对照小鼠;P<.05)。帕唑帕尼治疗2天后发现丙酮酸向乳酸的转化率(乳酸/丙酮酸+乳酸比值)显著高于治疗前(分别为0.46±0.07和0.31±0.14;P<.05;治疗后6个肿瘤,治疗前7个肿瘤)。对照组或F-FDG PET/CT成像未观察到这种情况。结论 研究结果表明,即使F-FDG PET/CT未显示反应,超极化C-丙酮酸MR波谱也可能作为卵巢癌对酪氨酸激酶(血管生成)抑制剂如帕唑帕尼反应的早期指标。RSNA,2017 本文提供在线补充材料。