Monitoring tumour microenvironment changes during anti-angiogenesis therapy using functional MRI

Liang, Jianye; Cheng, Qingqing; Huang, Jiaxi; Ma, Mengjie; Zhang, Dong; Lei, Xueping; Xiao, Zeyu; Zhang, Dongmei; Shi, Changzheng; Luo, Liangping

doi:10.1007/s10456-019-09670-4

Cited by 47 publications

(44 citation statements)

References 30 publications

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“…First, as b -value <200 mm 2 /s is referred to low b-value where mainly reflects the pseudodiffusion, and the data in this range are fitted to the bi-exponential model for acquiring D * and f values. Then, the data of b-value higher than 200 mm 2 /s are used to calculate D value using a monoexponential model as the pseudodiffusion from blood flow is negligible in this range ( 34 ). Therefore, the monoexponential model is expressed as SI/SI 0 = exp(–bD) and generates D or ADC value.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel Incoherent Motion Diffusion-Weighted Imaging Used to Detect Prostate Cancer and Stratify Tumor Grade: A Meta-Analysis

Xie³

et al. 2020

Front. Oncol.

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Objectives: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) is a promising non-invasive imaging technique to detect and grade prostate cancer (PCa). However, the results regarding the diagnostic performance of IVIM-DWI in the characterization and classification of PCa have been inconsistent among published studies. This meta-analysis was performed to summarize the diagnostic performance of IVIM-DWI in the differential diagnosis of PCa from non-cancerous tissues and to stratify the tumor Gleason grades in PCa. Materials and Methods: Studies concerning the differential diagnosis of prostate lesions using IVIM-DWI were systemically searched in PubMed, Embase, and Web of Science without time limitation. Review Manager 5.3 was used to calculate the standardized mean difference (SMD) and 95% confidence intervals of the apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudodiffusivity (D * ), and perfusion fraction (f). Stata 12.0 was used to pool the sensitivity, specificity, and area under the curve (AUC), as well as publication bias and heterogeneity. Fagan's nomogram was used to predict the post-test probabilities. Results: Twenty studies with 854 patients confirmed with PCa were included. Most of the included studies showed a low to unclear risk of bias and low concerns regarding applicability. PCa showed a significantly lower ADC (SMD = −2.34; P < 0.001) and D values (SMD = −1.86; P < 0.001) and a higher D * value (SMD = 0.29; P = 0.01) than non-cancerous tissues, but no difference was noted with the f value (SMD = −0.16; P = 0.50). Low-grade PCa showed higher ADC (SMD = 0.63; P < 0.001) and D values (SMD = 0.80; P < 0.001) than the high-grade lesions. ADC showed comparable diagnostic performance (sensitivity = 86%; specificity = 86%; AUC = 0.87) but higher post-test probabilities (60, 53, 36, and 36% for ADC, D, D * , and f values, respectively) compared with the D (sensitivity = 82%; specificity = 82%; AUC = 0.85), D * (sensitivity = 70%; specificity = 70%; AUC = 0.75), and f values (sensitivity = 73%; specificity = 68%; AUC = 0.76). Conclusion: IVIM parameters are adequate to differentiate PCa from non-cancerous tissues with good diagnostic performance but are not superior to the ADC value. Diffusion coefficients can further stratify the tumor Gleason grades in PCa.

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Section: Discussionmentioning

confidence: 99%

Intravoxel Incoherent Motion Diffusion-Weighted Imaging Used to Detect Prostate Cancer and Stratify Tumor Grade: A Meta-Analysis

Xie³

et al. 2020

Front. Oncol.

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“…The MRI examination was conducted on a 1.5 T Signa HDxt superconductor MR system (GE Healthcare, Milwaukee, WI) with an eight-channel wrist coil. The four groups of mice were intraperitoneally administered with 0.1% pentobarbital solution and scanned in the supine position prior to and on days 3, 6, 9, 12, and 15 after therapy (5). The interval of 3 days between the scans was made under the consideration for the relatively long period of recovery from anesthetizations, the high survival rate for the nude mice, and as well as the slow efficacy of bevacizumab to manifest antiangiogenic effects during the scan period.…”

Section: Mri Examinationsmentioning

confidence: 99%

“…Jain (4) proposed the concept of "normalizing tumor vasculature" in 2001, which is dedicated to improve the blood supply and relieve tumor hypoxia by repairing immature tumor vessels. This could further relieve the tumor invasiveness and improve treatment response (5). However, antiangiogenesis monotherapy seemed inadequate since it neither enhanced the tumor response rate nor significantly prolonged the overall survival in most tumors (6), largely due to rapid revascularization in new angiogenic modes including glomeruloid angiogenesis, vessel co-option, intussusceptive microvascular growth, looping angiogenesis, and vasculogenic mimicry (VM) via alternative proangiogenic signaling pathways (7,8).…”

Section: Introductionmentioning

confidence: 99%

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

Liang

et al. 2020

Front. Oncol.

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Objectives: This study aimed to detect the time window of vascular normalization during anti-vascular treatment using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Simultaneously, we evaluated the tumor invasiveness and vasculogenic mimicry and performed synthetic assessment of treatment efficacy of angiogenesis inhibitor combined with conventional chemotherapy using IVIM-DWI. Materials and Methods: HCT116 cells were subcutaneously administered into the right flank of BALB/C nude mice to build a colon cancer xenograft model. Thirty-two tumor-bearing mice were randomly divided into four groups and intraperitoneally administered with normal saline (Group A or control group), bevacizumab (Group B), oxaliplatin monotherapy (Group C), and oxaliplatin combined with bevacizumab (Group D). The IVIM-DWI was performed on days 0, 3, 6, 9, 12, and 15 after the treatments. Another 51 tumor-bearing mice were included in the pathological examinations. α-Smooth muscle actin (SMA) and CD31 double-staining, periodic acid-Schiff (PAS) and CD31 double-staining, hematoxylin and eosin (HE), Ki-67, and E-cadherin staining were performed. The tumor growth and dynamic change of each parameter were noted. Results: The mice in Group D manifested the smallest tumor volume and highest tumor inhibition rate. Microvessel density was significantly decreased but accompanied by increased vasculogenic mimicry after antiangiogenic treatment. The trend was reversed by oxaliplatin treatment. Treated with bevacizumab, the vessel maturity index shared a similar trend with D * and f-values during days 3-12, which slowly increased from days 0 to 9 and then decreased briefly. D-value significantly correlated with vasculogenic mimicry and Ki-67, while D * and f-values showed positive correlations with microvessel density and E-cadherin, an indicator of epithelial-mesenchymal transition. Liang et al. IVIM-DWI Used in Vasculogenic Mimicry Conclusion: Oxaliplatin performed an inhibited effect on vasculogenic mimicry. Bevacizumab can enhance the tumor chemotherapy through vascular normalization within a transient time period, which can be detected by IVIM-DWI. D * and f-values are able to predict the tumor invasiveness while D is superior in reflecting vasculogenic mimicry and Ki-67 expression during antitumor treatment.

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“…The true diffusion coefficient (D value), pseudo-diffusion coefficient (D* value) and perfusion fraction (f value) were generated using a biexponential model with multiple b-values expressed as SI / SI 0 = (1- f) · exp(−bD) + f · exp(−bD*) . The IVIM model can separate the pseudo-diffusion from pure molecular diffusion and independently reflect the microcirculation perfusion (D*) and tumor cellularity (D) based on that equation [ 6 ]. This model provides more detailed and accurate information, and can make a better interpretation for the microenvironment changes and characterization of tumor grades.…”

Section: Introductionmentioning

confidence: 99%

Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis

Liang

et al. 2020

BMC Cancer

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Background and objectives The diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis of pulmonary tumors remained debatable among published studies. This study aimed to pool and summary the relevant results to provide more robust evidence in this issue using a meta-analysis method. Materials and methods The researches regarding the differential diagnosis of lung lesions using IVIM-DWI were systemically searched in Pubmed, Embase, Web of science and Wangfang database without time limitation. Review Manager 5.3 was used to calculate the standardized mean difference (SMD) and 95% confidence intervals of apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f) . Stata 12.0 was used to pool the sensitivity, specificity, and area under the curve (AUC), as well as publication bias and heterogeneity. Fagan’s nomogram was used to predict the post-test probabilities. Results Eleven studies with 481 malignant and 258 benign lung lesions were included. Most include studies showed a low to unclear risk of bias and low concerns regarding applicability. Lung cancer demonstrated a significant lower ADC (SMD = -1.17, P < 0.001), D (SMD = -1.02, P < 0.001) and f values (SMD = -0.43, P = 0.005) than benign lesions, except D* value (SMD = 0.01, P = 0.96). D value demonstrated the best diagnostic performance (sensitivity = 89%, specificity = 71%, AUC = 0.90) and highest post-test probability (57, 57, 43 and 43% for D, ADC, f and D* values) in the differential diagnosis of lung tumors, followed by ADC (sensitivity = 85%, specificity = 72%, AUC = 0.86), f (sensitivity = 71%, specificity = 61%, AUC = 0.71) and D* values (sensitivity = 70%, specificity = 60%, AUC = 0.66). Conclusion IVIM-DWI parameters show potentially strong diagnostic capabilities in the differential diagnosis of lung tumors based on the tumor cellularity and perfusion characteristics, and D value demonstrated better diagnostic performance compared to mono-exponential ADC .

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Monitoring tumour microenvironment changes during anti-angiogenesis therapy using functional MRI

Cited by 47 publications

References 30 publications

Intravoxel Incoherent Motion Diffusion-Weighted Imaging Used to Detect Prostate Cancer and Stratify Tumor Grade: A Meta-Analysis

Intravoxel Incoherent Motion Diffusion-Weighted Imaging Used to Detect Prostate Cancer and Stratify Tumor Grade: A Meta-Analysis

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis

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