Michal Tomaszewski1, William Dominguez Viqueira1, Bruna Victorasso Jardim Perassi1, Pravin Phadatare1, Robert J Gillies1, and Smitha Pillai1
1Cancer Physiology, H. Lee Moffitt Cancer Center, Tampa, FL, United States
Synopsis
Lipid deposition and metabolism is relevant for cancer
prognosis and treatment response. Imaging characterisation of the adipocyte
deposition patterns in breast cancer and its relationship with the
microenvironment may therefore provide valuable insight into the tumour. A Chemical selected saturation based MR technique was optimised and
validated in vivo and ex vivo to visualize adipocyte distribution in breast
cancer xenografts. The measurements
reveal clear differences in adipocyte accumulation between different breast
models. In the future this technique
will be applied to understand the role of adipocyte distribution in breast
cancer.
Introduction
The
importance of lipid deposition and metabolism in cancer is widely appreciated,
yet not fully understood. Lipid synthesis has been observed to be altered in
malignant cells of multiple cancer types, and the changes in lipid composition
has been linked to other hallmarks of cancer such as angiogenesis, hypoxia, and
cell migration1. In breast cancer, lipid deposition in
adipocytes has been shown to relate to tumour response to chemotherapy, as well
as being relevant to novel treatment strategies2. We have shown previously that diffusion
restriction in non-viable regions of breast cancer is spatially correlated to
the presence of adipocytes . Efficient
characterization of the adipocyte deposition patterns in breast cancer and its
relationship with the tumour microenvironment may therefore be valuable in
disease prognosis and treatment response evaluation. MRI methods are
particularly suitable for this application4 thanks to the multi-contrast information available
within one imaging session through different sequences. MR measurements of fat
deposits have been performed and validated particularly in liver diseases5,6, but rarely in breast cancer, where the spatial
distribution of lipid accumulation within tumours is likely to have significant
prognostic value.Methods
MDA-MB-231 human breast cancer cells were implanted into the
mammary fat pad of NSG mice (n=10). When the tumours reached 300mm3
volume, they were imaged with MRI (Bruker, 7T) including an optimized chemical
shift specific saturation based lipid imaging. An optimized FSE sequence
(2000/6ms TR/TE, RARE factor 16, 16 averages, 128x128 points, centric
encoding) with chemical selective saturation (CHESS, 1100 Hz bandwidth Gaussian
pulse with spoiler) based fat suppression was used to produce a fat suppressed
image, followed by the same sequence without fat suppression. The fat fraction (F)
in each voxel was then derived as F=(C(NoSup)-C(Sup))/C(NoSup) where C(Sup) and
C(NoSup) are the signal intensities in fat suppressed and non-fat suppressed
images. In vivo validation was performed with PRESS single voxel MR
spectroscopy (2 voxels/tumor). The lipid abundance in the voxel was quantified
as the ratio of the integrals for lipid (1.31±0.3ppm)
and water (4.70±0.7ppm). The sensitivity of imaging to presence of adipocytes
was further confirmed ex vivo by per-slice comparison with H&E stained
sections revealing the location and abundance of adipocytes, marked by circular
holes in the tissue, that were validated in parallel by staining for perilipin-1,
PLIN-1 (Figure 1), a protein characteristically expressed in cell membrane of
an adipocyte.
Two NSG mice were injected as above with
a slower growing, more differentiated MCF7 cells to compare the adipocyte
distribution.Results
Custom Matlab code was developed to co-localize and compare
the single voxel PRESS and imaging CHESS results. Highly significant
correlation was observed between them ( Pearson r=0.91, p<10-10,Figure 2).
The biological origin of the CHESS lipid signal was identified by histological
comparison. Pairing MRI images with corresponding H&E sections (Figure 3A,B)
reveals a clear co-localisation of the signal hotspots with adipocyte
depositions in H&E. A per-slice quantification of the adipocyte area shows
a strong significant correlation to the areas of high signal in CHESS images
(Pearson r=0.77, p=0.001, Figure 3 C), further strengthening the relationship.
Less aggressive MCF7 tumours showed a visibly different
distribution of Fat Fraction in MRI (Figure 4A), with weaker and less localised, yet still
present signal (Figure 4B). This observation was confirmed in histological
sections from the same tumour type, showing scattered low density adipocyte
deposits across the tumour (Figure 4C).
A more detailed examination of the ex vivo sections reveals that the
adipocyte depositions reside primarily in necrotic areas. Interestingly,
diffusion weighted imaging reveals a decreased Apparent Diffusion Coefficient (ADC)
in these areas (median
ADC in areas of high vs. low fat signal 0. 67±0.02 vs 0. 76±0.03 10-3 mm2/s, p=0.02, n=6).Discussion
Chemical
selective saturation MR imaging was shown to clearly delineate and measure
concentrations of adipocyte accumulation in mouse breast tumours. Extensive
quantitative in vivo and ex vivo validation is shown, highlighting the
robustness of the method. The importance of understanding tumor adipocyte
distribution is also shown, due to its influence on diffusion values within the
tumour. High intratumoural fat density causes significant local lowering of ADC
value in otherwise necrotic areas, and hence influencing the tissue viability
assessment. Preliminary measurements in different tumor types highlight the
heterogeneity of adipocyte deposits between tumors and its likely links to
disease characteristics.Conclusions
The result presented above show that chemical selective
saturation based fat imaging can be successfully used for delineation of fat
deposits in breast tumours, highly relevant in cancer. Future studies will
utilize the technique validated above to focus on detailed assessment between
the adipocyte deposition and the rest of the tumour microenvironment. This work
will help understand the links of intratumour fat to tumour physiology and
metabolism, as well as its postulated role in treatment response.Acknowledgements
We would like to acknowledge the support from the Analytical Microscopy, Small Animal Imaging and Tissue Core Facilities at Moffitt Cancer CenterReferences
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