Death from cancer is usually the result of dissemination of cancer cells from a primary tumor to secondary vital organs, and the formation of metastases. This process involves a series of steps, each of which have become targets of anticancer therapies such as intravasation of cancer cells into the bloodstream or lymphatics, delivery to organs (e.g., liver, lung, bone, brain, and lymph nodes), extravasation of cells into the organ parenchyma, cell proliferation to form secondary tumors, and development of new blood vessels to sustain continued growth (1). Importantly, single metastatic cells (2,3) or prevascular micrometastases (4) may also remain dormant within an organ, persisting until conditions are suitable for proliferation. Therefore, while surgical treatment of the primary tumor may be successful, undetectable dormant single metastatic cells or prevascular micrometastases can remain clinically silent for long periods and may eventually result in tumor formation and patient relapse (3,4).Metastasis to the brain can occur with many tumor types, including breast cancer, lung cancer, and melanoma. For breast cancer patients, the prevalence of brain metastases was historically estimated at 10 -16% with a 1-year survival rate of 20% (5). More recent studies, however, have demonstrated the prevalence of brain metastases in breast cancer patients to be closer to 22-30% (6), suggesting that its incidence may be increasing as a sanctuary site as systemic control improves. Brain metastases are typically treated with stereotactic radiosurgery or surgery with whole-brain radiation, supplemented with corticosteroid therapy for symptomatic relief. Patchell et al. (7) reported that surgery and whole-brain radiation can cure up to 90% of solitary brain metastases, which suggests that undiagnosed micrometastases or dormant cells are responsible for treatment failure. Thus, identification of micrometastatic and dormant brain metastatic tumor cells may facilitate an understanding of their biology and development of therapeutic interventions.For brain metastases of breast cancer, only a handful of experimental model systems have been reported. Yoneda et al. (8) performed six rounds of selection of human MDA-MB-231 breast carcinoma cells for brain metastasis in mice, followed by excision of the lesion and establishment of a cell culture. The resulting MDA-MB-231BR "brain-seeking" clone metastasized to the brain following intracardiac injection in 100% of the mice. Metastasis was identified histologically, which provided only one time point per animal. Clearly, studies of the metastatic process would greatly benefit from techniques that could dynamically monitor metastases from their earliest stage to endstage growth throughout entire organs or animals. This
We have developed a magnetic resonance imaging (MRI) technique for imaging Feridex (superparamagnetic iron oxide [SPIO])-labeled islets of Langerhans using a standard clinical 1.5-Tesla (T) scanner and employing steadystate acquisition imaging sequence (3DFIESTA). Both porcine and rat islets were labeled with SPIO by a transfection technique using a combination of poly-L-lysine and electroporation. Electron microscopy demonstrated presence of SPIO particles within the individual islet cells, including -cells and particles trapped between cell membranes. Our labeling method produced a transfection rate of 860 pg to 3.4 ng iron per islet, dependent on the size of the islet. The labeling procedure did not disrupt either the function or viability of the islets. In vitro 3DFIESTA magnetic resonance images of single-labeled islets corresponded with their optical images. In vivo T2*-weighted scan using 1.5 T detected as few as 200 SPIO-labeled islets transplanted under rat kidney capsule, which correlated with immunohistochemistry of the transplant for insulin and iron. Ex vivo 3DFIESTA images of kidneys containing 200, 800 or 2,000 SPIO-labeled islet isografts showed good correlation between signal loss and increasing numbers of islets. These data provide evidence that islets can be labeled with SPIO and imaged using clinically available 1.5-T MRI. Diabetes
Despite recent therapeutic advances, including the introduction of novel cytostatic drugs and therapeutic antibodies, many cancer patients will experience recurrent or metastatic disease. Current treatment options, particularly for those patients with metastatic breast, prostate, or skin cancers, are complex and have limited curative potential. Recent clinical trials, however, have shown that cell-based therapeutic vaccines may be used to generate broad-based, antitumor immune responses. Dendritic cells (DC) have proved to be the most efficacious cellular component for therapeutic vaccines, serving as both the adjuvant and antigen delivery vehicle. At present it is not possible to noninvasively determine the fate of DC-based vaccines after their administration to human subjects. In this study, we demonstrate that in vitro-generated mouse DC can be readily labeled with superparamagnetic iron oxide nanoparticles, Feridex, without altering cell morphology, or their phenotypic and functional maturation. Feridex-labeling enables the detection of DC in vivo after their migration to draining lymph nodes using a 1.5 T clinical magnetic resonance scanner. In addition, we report a semiquantitative approach for analysis of magnetic resonance images and show that the Feridex-induced signal void volume, and fractional signal loss, correlates with the delivery and migration of small numbers of in vitro-generated DC. These findings, together with ongoing preclinical studies, are key to gaining information critical for improving the efficacy of therapeutic vaccines for the treatment cancer, and potentially, chronic infectious diseases.
Metastasis is responsible for most deaths due to malignant melanoma. The clinical significance of micrometastases in the lymph is a hotly debated topic, but an improved understanding of the lymphatic spread of cancer remains important for improving cancer survival. Cellular magnetic resonance imaging (MRI) is a newly emerging field of imaging research that is expected to have a large impact on cancer research. In this study, we demonstrate the cellular MRI technology required to reliably image the lymphatic system in mice and to detect iron-labeled metastatic melanoma cells within the mouse lymph nodes. Melanoma cells were implanted directly into the inguinal lymph nodes in mice, and micro-MRI was performed using a customized 1.5-T clinical MRI system. We show cell detection of as few as 100 iron-labeled cells within the lymph node, with injections of larger cell numbers producing increasingly obvious regions of signal void. In addition, we show that cellular MRI allows monitoring of the fate of these cells over time as they develop into intranodal tumors. This technology will allow noninvasive investigations of cellular events in cancer metastasis within an entire animal and will facilitate progress in understanding the mechanisms of metastasis within the lymphatic system.
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