Imaging hypoxia to improve radiotherapy outcome

Horsman, Michael R.; Mortensen, Lise Saksø; Petersen, Jørgen B. B.; Busk, Morten; Overgaard, Jens

doi:10.1038/nrclinonc.2012.171

Cited by 519 publications

(477 citation statements)

References 108 publications

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“…Magnetic resonance imaging (MRI) measurements of the transverse relaxation time (

T_{2}^{*}

) have been proposed as imaging biomarkers of tissue oxygenation status in both preclinical and clinical settings 3, 4, 6, 7. Paramagnetic deoxyhemoglobin increases the apparent MRI transverse relaxation rate

R_{2}^{*}

(=1/

T_{2}^{*}

) of water in blood and surrounding tissues, which provides the opportunity to image tissue oxygenation at high spatial resolution.…”

mentioning

confidence: 99%

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Panek

Welsh

Dunlop

et al. 2016

Magnetic Resonance Imaging

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PurposeTo determine whether quantitation of T2* is sufficiently repeatable and sensitive to detect clinically relevant oxygenation levels in head and neck squamous cell carcinoma (HNSCC) at 3T.Materials and MethodsTen patients with newly diagnosed locally advanced HNSCC underwent two magnetic resonance imaging (MRI) scans between 24 and 168 hours apart prior to chemoradiotherapy treatment. A multiple gradient echo sequence was used to calculate T2* maps. A quadratic function was used to model the blood transverse relaxation rate as a function of blood oxygenation. A set of published coefficients measured at 3T were incorporated to account for tissue hematocrit levels and used to plot the dependence of fractional blood oxygenation (Y) on T2* values, together with the corresponding repeatability range. Repeatability of T2* using Bland–Altman analysis, and calculation of limits of agreement (LoA), was used to assess the sensitivity, defined as the minimum difference in fractional blood oxygenation that can be confidently detected.Results T2* LoA for 22 outlined tumor volumes were 13%. The T2* dependence of fractional blood oxygenation increases monotonically, resulting in increasing sensitivity of the method with increasing blood oxygenation. For fractional blood oxygenation values above 0.11, changes in T2* were sufficient to detect differences in blood oxygenation greater than 10% (Δ T2* > LoA for ΔY > 0.1).ConclusionQuantitation of T2* at 3T can detect clinically relevant changes in tumor oxygenation within a wide range of blood volumes and oxygen tensions, including levels reported in HNSCC. J. Magn. Reson. Imaging 2016;44:72–80.

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“…Magnetic resonance imaging (MRI) measurements of the transverse relaxation time (

T_{2}^{*}

R_{2}^{*}

(=1/

T_{2}^{*}

) of water in blood and surrounding tissues, which provides the opportunity to image tissue oxygenation at high spatial resolution.…”

mentioning

confidence: 99%

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Panek

Welsh

Dunlop

et al. 2016

Magnetic Resonance Imaging

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“…In vivo experiments should be focussed on comparison of the effectiveness of radiotherapy and hyperthermia in aerobic and hypoxic tumour regions. The first important step to accomplish this is to visualise these hypoxic areas [170] to facilitate investigations whether hyperthermia indeed targets the cells in these areas. Imaging the dynamics of tumour responses in different parts of the tumour is also important.…”

Section: Summary and Future Perspectivesmentioning

confidence: 99%

Targeting therapy-resistant cancer stem cells by hyperthermia

Oei

Vriend

Krawczyk

et al. 2017

International Journal of Hyperthermia

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Eradication of all malignant cells is the ultimate but challenging goal of anti-cancer treatment; most traditional clinically-available approaches fail because there are cells in a tumour that either escape therapy or become therapy-resistant. A subpopulation of cancer cells, the cancer stem cells (CSCs), is considered to be of particular significance for tumour initiation, progression and metastasis. CSCs are considered in particular to be therapy-resistant and may drive disease recurrence, which positions CSCs in the focus of anti-cancer research, but successful CSC-targeting therapies are limited. Here, we argue that hyperthermia -a therapeutic approach based on local heating of a tumour -is potentially beneficial for targeting CSCs in solid tumours. First, hyperthermia has been described to target cells in hypoxic and nutrient-deprived tumour areas where CSCs reside and ionising radiation and chemotherapy are least effective. Second, hyperthermia can modify factors that are essential for tumour survival and growth, such as the microenvironment, immune responses, vascularisation and oxygen supply. Third, hyperthermia targets multiple DNA repair pathways, which are generally upregulated in CSCs and protect them from DNA-damaging agents. Addition of hyperthermia to the therapeutic armamentarium of oncologists may thus be a promising strategy to eliminate therapy-escaping and -resistant CSCs.ARTICLE HISTORY

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“…In recent years, several studies and metaanalyses have shown that modern molecular and functional imaging with PET, MRI, and functional MRI allows for imaging of prognostic parameters with respect to radiotherapy outcome (4,30).…”

Section: Pet For Radiation Treatment Adaptation and Normal-tissue Chamentioning

confidence: 99%

Imaging-Based Treatment Adaptation in Radiation Oncology

2015

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Learning Objectives: On successful completion of this activity, participants should be able to (1) understand the clinical implications of tumor characterization using different PET tracers before and during radiotherapy or chemoradiotherapy; (2) discuss the role of other functional imaging modalities (CT and MRI) in current oncology practice; and (3) introduce additional applications of PET imaging, such as in high-energy proton-beam therapy.

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Imaging hypoxia to improve radiotherapy outcome

Cited by 519 publications

References 108 publications

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Targeting therapy-resistant cancer stem cells by hyperthermia

Imaging-Based Treatment Adaptation in Radiation Oncology

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