Synopsis
Hyperpolarized (HP) 13C MRSI, dynamic
contrast-enhanced (DCE) MRI, and blood-oxygen-level dependent (BOLD) MRI have
the potential to non-invasively characterize tumor metabolism, perfusion, and
oxygenation, respectively, and aid in the development of individualized treatment
plans for cancer patients. However, a regional comparison of these non-invasive
techniques for probing the tumor microenvironment has not been explored. This
work aims to test the feasibility of performing quantitative, spatial analysis
and comparison of HP 13C MRSI and BOLD and DCE MRI in a murine
breast cancer model. Purpose
Developing individualized treatment plans for
breast cancer patients necessitates improved characterization of tumor
microenvironment to predict tumor progression and response to treatment.
Factors implicated in tumor progression include perfusion, oxygenation, and
metabolism. Due to the poorly structured vasculature associated with oncologic
angiogenesis, it is hypothesized that dynamic contrast-enhanced (DCE) and
blood-oxygen-level dependent (BOLD) MRI can be used to characterize associations
between regional vascular supply and oxygen availability in breast cancer. DCE
parameters have been successfully correlated with exogenous hypoxia markers in
cancerous tumors
1 and it is suggested that BOLD parameters provide
additional tissue oxygenation information not solely controlled by perfusion
2.
Additionally, aerobic glycolysis (Warburg Effect) is postulated to be upregulated
in cancerous tumors
3 and has the potential for
in vivo interrogation using hyperpolarized (HP)
13C
magnetic resonance spectroscopic imaging (MRSI) of [1-
13C]pyruvate
and its downstream metabolites
4. In this study, murine mammary
adenocarcinomas were imaged using DCE, BOLD, and HP
13C MRI to
assess their viability to spatially and quantitatively evaluate tumor
vasculature, oxygenation, and metabolism.
Methods
A pilot study complying with institutional animal
care and use committee regulations was conducted using a murine breast cancer
model. Cells from ethylnitrosourea-induced mammary adenocarcinomas developed in
FVB.B6-
ApcMin/+ mice were
injected into axillary fat pads of syngeneic FVB/Tac mice. Mice with both moderately
aggressive (fast-growing) and markedly aggressive (very fast-growing) tumor
lines were imaged. Imaging was performed on a 4.7T small animal scanner
(Agilent, Palo Alto, CA) with a
1H/
13C dual-tuned volume
coil and
13C surface coil (Doty Scientific, Columbia, SC). A high-resolution
(0.25×0.25×2mm
3) T
2-weighted FSE sequence was acquired
for anatomical reference (TR/TEĀ
eff= 3500/66ms) followed by a multi-echo
SPGR T
2*-weighted BOLD sequence (TR/TE/ΔTE= 350/2/2.8ms, 32 echoes)
with identical resolution. [1-
13C]pyruvate was polarized (10-20%)
via dynamic nuclear polarization (HyperSense, Oxford Instruments, UK) and
10μL/g was injected into the tail vein for imaging. A single-shot spiral
acquisition (3×3×5mm
3, TR/TE/ΔTE=90/1.00/1.19ms, echoes=5, FA=10°)
acquired dynamic
13C images interleaved with slice-selective spectra
(FA=5°) at ~5s temporal resolution. Spiral image reconstruction used an
iterative, least-squares estimation technique
5. Actual flip-angle
imaging (AFI) and T
1 maps were generated from 3D SPGR sequences
(TR/TE= 6.1/1.2ms and 5.9/1.7ms, respectively) with 0.5×0.5×0.5mm
3
resolution. Finally, a T
1-weighted DCE SPGR sequence was acquired
(TR/TE=20.5/2.9ms, 0.25×0.25×2mm
3) with ~5s temporal resolution. 10
frames were acquired prior to IV injection of 0.15mmol/kg of gadodiamide
followed by a 10min acquisition. R
2* maps were generated by fitting
BOLD data to a linearized exponential decay model. Ratio maps of the volume transfer
constant (K
trans) to extravascular-extracellular volume fraction (v
e)
were developed by converting DCE signal to gadodiamide concentration using
AFI-corrected T
1-maps
6, then fitting to a linearized
reference region model
7,8. Voxel-wise ratio maps of the area-under-the-curve
(AUC) of HP lactate-to-pyruvate signal were also generated. R
2* and K
trans/v
e
were corrected for major outliers with removal of values greater than three
times the inter-quartile range. Mean R
2* and K
trans/v
e
values were calculated for the total volume of tumor present in each slice.
Results
Three mice each hosting markedly and moderately
aggressive tumor lines underwent HP
13C, DCE, and BOLD MRI. K
trans/v
e
and R
2* maps displayed heterogeneity in both tumor strains, with a
tendency of K
trans/v
e to be larger towards tumor peripheries
and R
2* to be largest towards the tumor core or air-tissue
interfaces secondary to susceptibility (
Figure
1). Mean R
2* and K
trans/v
e
values were similar for both tumor lines (
Figure
2). The
13C AUC ratio map (
Figure
3) displayed heterogeneous lactate/pyruvate signal within the tumors.
Discussion
R
2* indicates tissue deoxyhemoglobin
concentration, with higher R
2* values indicating relative hypoxia,
while K
trans/v
e indicates perfusion/permeability of the
vasculature. Larger K
trans/v
e values were observed around
the tumor periphery, suggesting more leaky, perfused vasculature in this region
compared with the core. High R
2* values near the tumor core may
indicate the local oxygenated hemoglobin content is low, likely due to a
combination of rapid proliferation inhibiting oxygen diffusion and necrosis.
Follow-up histology will reveal the degree of necrosis and predominance of
tissue oxygen stress markers.
13C AUC maps demonstrated higher
pyruvate and lactate values along the medial tumor, possibly due to more HP
substrate delivery via native vasculature from the abdominal region. The
13C
AUC ratio map demonstrates heterogeneous distribution of lactate-to-pyruvate.
Ongoing studies will allow comparisons of patterns of angiogenesis,
oxygen availability, and metabolism with tissue histology to better understand
the role of these processes in tumor models of breast cancer.
Conclusion
This study demonstrates the technical feasibility
of using BOLD, DCE, and HP
13C MRI to characterize mammary
carcinomas. Future studies are planned to investigate regional associations of
elevated R
2*, perfusion/permeability, and glycolytic flux with
tissue histology for different breast cancer models.
Acknowledgements
This
project was supported by the RSNA Research & Education Foundation, the Department
of Radiology Research and Development fund, and the Department of Medical
Physics at the author’s institution. This project also received support from an
AAPM Graduate Fellowship and GE Healthcare. References
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