Hypoxia Detection in Infiltrative Astrocytoma: Ferumoxytol-based Quantitative BOLD MRI with Intraoperative and Histologic Validation
| Autor: | Aditya Bharatha, Sarah Ironside, Paula Alcaide-Leon, Zahra Faraji-Dana, Todd G. Mainprize, Eshetu G. Atenafu, Omid Shearkhani, Julia Keith, David J. Mikulis, Sean P. Symons, Nicolas Phan, Aimee Chan, Armin Eilaghi, Sunit Das, Arjun Sahgal, David G. Munoz, Raphael Jakubovic, Greg Zaharchuk, Pejman Jabehdar Maralani |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Neuronavigation Pilot Projects Astrocytoma 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Hypoxia Prospective cohort study Aged Intraoperative Care medicine.diagnostic_test Brain Neoplasms business.industry Brain Reproducibility of Results Magnetic resonance imaging Oxygenation Middle Aged Hypoxia (medical) medicine.disease Magnetic Resonance Imaging Ferrosoferric Oxide Ferumoxytol 030220 oncology & carcinogenesis Female medicine.symptom Nuclear medicine business |
| Zdroj: | Radiology. 288:821-829 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2018172601 |
| Popis: | Purpose To validate ferumoxytol-based quantitative blood oxygenation level-dependent (BOLD) MRI for mapping oxygenation of human infiltrative astrocytomas by using intraoperative measurement of tissue oxygen tension and histologic staining. Materials and Methods Fifteen patients with infiltrative astrocytomas were recruited into this prospective multicenter study between July 2014 and December 2016. Prior to treatment, participants underwent preoperative quantitative BOLD MRI with ferumoxytol to generate tissue oxygen saturation (StO2) maps. Two intratumoral sites were identified, one with low StO2 and one with high StO2. Neuronavigation was used to locate sites intraoperatively for insertion of oxygen-sensing probes to measure local tissue oxygen tension (PtO2). Biopsies from both sites were taken and stained for markers of hypoxia (hypoxia-inducible factor 1α, carbonic anhydrase IX) and neoangiogenesis (vascular endothelial growth factor, endoglin [CD105]). Spearman correlation and nonparametric sign-rank tests were used to analyze data. Results Ten patients with median age of 58.5 years (interquartile range, 25 years; four men and six women) completed the study. Because there is no linear relationship between StO2 and PtO2, the ratios of low to high StO2 versus low to high PtO2 in each patient were compared and a significant correlation was found (r = 0.73; P = .01). Pathologic analyses revealed differences between carbonic anhydrase IX (P = .03) for sites of low StO2 versus high StO2. CD105 displayed a similar trend but was not significant (P = .09). Conclusion Ferumoxytol-based quantitative blood oxygenation level-dependent MRI can potentially be used as a noninvasive surrogate for oxygenation mapping in infiltrative astrocytomas. This technique can potentially be integrated in treatment planning for aggressive targeting of hypoxic areas in tumors. |
| Databáze: | OpenAIRE |
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