Synopsis
Recently, a novel pattern recognition (PR) approach has been developed,
identifying extent and spatial distribution of tumor microenvironments based on
tumor vascularity. Here, our goal is to develop methods to minimize user
intervention and errors from model-based approaches by introducing an automated
algorithm for determining the number of classifiers. An SNR approach showed the
highest accuracy at ~97% along five different tumor cell models with 104 slices
total. The visualization of tumor heterogeneity (perfusion, hypoxia, necrosis) with
automated analysis of DCE-MRI can reduce the need for manual expert
intervention, extensive pharmacokinetic modeling, and could provide critical
information for treatment planning.Purpose
The tumor microenvironment is heterogeneous, exhibiting severe
structural and functional vascular abnormalities
1, 2. Specifically, tumor
hypoxia has been associated with aggressive tumor progression as well as
resistance to radiation and/or chemotherapy, resulting in poor clinical outcome
and prognosis
1-5. Thus, visualization
of the extent of hypoxia in tumors would provide critical information for
strategic treatment planning. Conventionally, dynamic contrast enhanced (DCE)-MRI
is used to investigate tumor perfusion by administration of Gd-DTPA with pharmacokinetic
modeling. Recently, features of the tumor microenvironment were classified by pattern recognition approaches, such as
Gaussian mixture model (GMM)
6 or constrained non-negative
matrix factorization (cNMF)
7. These approaches
minimize biases or errors from purely model-based fitting. However to-date, the
choice of number of classifiers has been predefined manually. Here, we focus on
developing and validating a robust algorithm for the automated determination of
the number of classifiers, characterizing heterogeneity of tumor vascular
features without subjective user intervention.
Methods
Different approaches of identifying
the number of classifiers automatically were tested on DCE-MRI data from 5
different preclinical tumor models – HEK, LAPC-4
8, Myc-CaP
9,
PC-3
10, and RM-1
11 flank tumors in Nod/SCID mice.
Experimental parameters for the DCE-MRI data acquisition: T
1-weighted
fast low-angle shot (FLASH) sequence with 3.2 ms echo time, minimum repetition
time (TR
min), 256 repetitions (NR
256, time points), 1
average, 15 mm x 15 mm FOV, 128x128 matrix, 1 mm slice thickness, and 5-7 slices
to cover the entire tumor. For 5, 6, and
7 slices respectively, the resulting TR
min were 42.875 ms, 51.450
ms, and 60.025 ms with a corresponding temporal resolution of 5.487 s, 6.585 s,
and 7.683 s. All animal experiments were performed according to protocols
approved by the Institutional Animal Care and Use Committee of Memorial Sloan
Kettering Cancer Center.
As the principal component analysis
(PCA, 1st analysis step) identifies the sources of largest
variations, the number of classifiers (NC) was evaluated by three different
criteria: signal enhancement, SNR, and half area under the curve (HAUC) of
principal components (PCs). Signal enhancement was calculated as (max(PCs) –
mean(PCs))/mean(PCs)×100 and a threshold for selecting significant PCs was set manually
to 6000. SNR was calculated as max(PCs)/(2×std(PCs of pre contrast agent
injection)) and a threshold set to 5 (SNR
Th5). Additionally, a threshold of 2 (SNR
Th2)was
considered for tumors with low SNR. HAUC was calculated by adding the signal
intensity during the initial half of total acquisition time (~10 mins) with a threshold
set to 0.5×first HAUC. To assess the performance of the approaches to
automatically determine NC, NC was also determined manually by an expert for
each tumor slice.
After selecting NC, cNMF was
accordingly performed as described previously
7. To generate pattern masks of tumor
microenvironments, the representative curve showing the maximum value of
normalized weights in a given pixel is allocated to each pattern mask. Also,
pattern masks of pixels associated with a mixture of features are generated for
pixels where the difference between maximum weight to other pattern weight is
lower than 25%.
Results
Three
criteria – signal enhancement, SNR, and HAUC - for determining NC automatically were
applied to five different preclinical tumor models with a total of 104 slices
(HEK n = 6, LAPC-4 n = 6, MycCaP n = 2, PC-3 n = 2, RM-1 n = 4). The NCs obtained
from these three criteria were compared to the NC determined by manual expert inspection
and the corresponding accuracy is shown in
Fig.
1. The accuracy was 75.00%, 86.54%, 97.12%, and 49.04% for enhancement, SNR
Th5, SNR
Th2 (considering necrotic tumor), and
HAUC, respectively. The cNMF-derived representative pattern curves and
corresponding weight maps are shown in
Fig.
2. Based on vascular features characterizing specific tumor
microenvironments
7, red, green, and blue plots represent
well-perfused, hypoxic, and necrotic tumor areas. Two different types of
pattern masks characterizing the tumor slice were generated: “Decision map 1”
was generated by finding maximum weight and allocating index as 1, 2, and 3 for
necrotic, hypoxic, and well-perfused, respectively; “Decision map 2” was
generated by adding the additional condition for mixtures.
Of the three
approaches tested, the SNR approach demonstrated to be the most useful strategy
to automatically determine NC and could be optimized to account for DCE-MRI
data with low contrast agent enhancement.
Conclusion
The visualization of tumor heterogeneity (perfusion, hypoxia, necrosis)
with automated analysis of DCE-MRI can reduce the need for manual expert
intervention, extensive pharmacokinetic modeling and could provide critical
information for treatment planning.
Acknowledgements
We
acknowledge support by NIH / NCI grants R01 CA163980 (RGB), R01 CA172846 (RGB,
JAK), R24 CA083084 (SAI Core) and P30 CA008748 (Cancer Center Support Grant),
the National Research Foundation of Korea (HJC) and Korean government grants No.
2010-0028684 (HJC) and No. 2014 R1A1A1 008255 (HJC).
The DCE-MRI data were
acquired in collaboration between Dr. Blasberg’s (Dr. Moroz, technical support
by Mr. Nisargbhai S. Shah) and Dr. Koutcher’s (Dr. Ackerstaff, technical
assistance by Ms. Natalia Kruchevsky) laboratory and we gratefully acknowledge
the permission to use these as testing data sets.
References
1. Vaupel P, Kallinowski F, Okunieff P.
Blood flow, oxygen and nutrient supply, and metabolic microenvironment of human
tumors: a review. Cancer Res. 1989;
49(23):6449-65.
2. Vaupel
P. Tumor microenvironmental physiology and its implications for radiation
oncology. Semin Radiat Oncol. 2004. Jul;
14(3):198-206.
3. Varlotto
J, Stevenson MA. Anemia, tumor hypoxemia, and the cancer patient. Int J Radiat
Oncol Biol Phys. 2005. Sep 1;
63(1):25-36.
4. Tatum
JL, Kelloff GJ, Gillies RJ, Arbeit JM, Brown JM, Chao KS, Chapman JD, Eckelman
WC, Fyles AW, Giaccia AJ, Hill RP, Koch CJ, Krishna MC, Krohn KA, Lewis JS,
Mason RP, Melillo G, Padhani AR, Powis G, Rajendran JG, Reba R, Robinson SP,
Semenza GL, Swartz HM, Vaupel P, Yang D, Croft B, Hoffman J, Liu G, Stone H,
Sullivan D. Hypoxia: importance in tumor biology, noninvasive measurement by
imaging, and value of its measurement in the management of cancer therapy. Int
J Radiat Biol. 2006. Oct;
82(10):699-757.
5. Bache
M, Kappler M, Said HM, Staab A, Vordermark D. Detection and specific targeting
of hypoxic regions within solid tumors: current preclinical and clinical
strategies. Curr Med Chem. 2008;
15(4):322-38.
6. Han
SH, Ackerstaff E, Stoyanova R, Carlin S, Huang W, Koutcher JA, Kim JK, Cho G,
Jang G, Cho H. Gaussian mixture model-based classification of dynamic contrast
enhanced MRI data for identifying diverse tumor microenvironments: preliminary
results. NMR Biomed. 2013. May;
26(5):519-32.
7. Stoyanova
R, Huang K, Sandler K, Cho H, Carlin S, Zanzonico PB, Koutcher JA, Ackerstaff
E. Mapping Tumor Hypoxia In Vivo
Using Pattern Recognition of Dynamic Contrast-enhanced MRI Data. Transl Oncol. 2012. Dec; 5(6):437-47.
8. Craft
N, Shostak Y, Carey M, Sawyers CL. A mechanism for hormone-independent prostate
cancer through modulation of androgen receptor signaling by the HER-2/neu
tyrosine kinase. Nat Med. 1999.
Mar; 5(3):280-5.
9. Watson
PA, Ellwood-Yen K, King JC, Wongvipat J, Lebeau MM, Sawyers CL.
Context-dependent hormone-refractory progression revealed through
characterization of a novel murine prostate cancer cell line. Cancer Res. 2005. Dec 15; 65(24):11565-71.
10. Webber MM, Bello D, Quader S.
Immortalized and tumorigenic adult human prostatic epithelial cell lines:
characteristics and applications. Part I. Cell markers and immortalized
nontumorigenic cell lines. The Prostate. 1996. Dec; 29(6):386-94.
11. Baley PA, Yoshida K, Qian W, Sehgal I,
Thompson TC. Progression to androgen insensitivity in a novel in vitro mouse
model for prostate cancer. J Steroid Biochem Mol Biol. 1995. May; 52(5):403-13.