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Vessel caliber--a potential MRI biomarker of tumour response in clinical trials.

ABSTRACT: Our understanding of the importance of blood vessels and angiogenesis in cancer has increased considerably over the past decades, and the assessment of tumour vessel calibre and structure has become increasingly important for in vivo monitoring of therapeutic response. The preferred method for in vivo imaging of most solid cancers is MRI, and the concept of vessel-calibre MRI has evolved since its initial inception in the early 1990s. Almost a quarter of a century later, unlike traditional contrast-enhanced MRI techniques, vessel-calibre MRI remains widely inaccessible to the general clinical community. The narrow availability of the technique is, in part, attributable to limited awareness and a lack of imaging standardization. Thus, the role of vessel-calibre MRI in early phase clinical trials remains to be determined. By contrast, regulatory approvals of antiangiogenic agents that are not directly cytotoxic have created an urgent need for clinical trials incorporating advanced imaging analyses, going beyond traditional assessments of tumour volume. To this end, we review the field of vessel-calibre MRI and summarize the emerging evidence supporting the use of this technique to monitor response to anticancer therapy. We also discuss the potential use of this biomarker assessment in clinical imaging trials and highlight relevant avenues for future research.

SUBMITTER: Emblem KE

PROVIDER: S-EPMC4445139 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Vessel caliber--a potential MRI biomarker of tumour response in clinical trials.

Emblem Kyrre E KE Farrar Christian T CT Gerstner Elizabeth R ER Batchelor Tracy T TT Borra Ronald J H RJ Rosen Bruce R BR Sorensen A Gregory AG Jain Rakesh K RK

Nature reviews. Clinical oncology 20140812 10

Our understanding of the importance of blood vessels and angiogenesis in cancer has increased considerably over the past decades, and the assessment of tumour vessel calibre and structure has become increasingly important for in vivo monitoring of therapeutic response. The preferred method for in vivo imaging of most solid cancers is MRI, and the concept of vessel-calibre MRI has evolved since its initial inception in the early 1990s. Almost a quarter of a century later, unlike traditional contr ...[more]

PMID: 25113840

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Project description:PurposeTo compare three commonly used retinal vessel caliber measurement software systems, and propose an algorithm for conversion between measurement systems.MethodsWe used 120 retinal photographs to evaluate the agreement between three commonly used software (Retinal Analysis [RA], Integrative Vessel Analysis [IVAN], and Singapore I Vessel Assessment [SIVA]). Bland-Altman plots were used to evaluate agreement of retinal arteriolar (central retinal artery equivalent, CRAE) and venular (central retinal vein equivalent, CRVE) calibers. Pearson's correlation was used to assess the associations between systemic factors and retinal vessel calibers, and Z-test was used to compare the strength of the correlation coefficients across the three software systems. An algorithm was created to convert measurements, with paired t-test performed to evaluate the differences between SIVA-measured retinal calibers and SIVA-approximates converted from RA- and IVAN-measurements using the algorithm.ResultsDifferences between SIVA- and RA-measured calibers (CRAE: mean difference [MD] = -21.8 ?m, 95% limits of agreement [LOA], -47.3 to 3.7 ?m; CRVE: MD = -7.7 ?m, 95% LOA, -28.0 to 12.6 ?m), SIVA- and IVAN-measured calibers (CRAE: MD = -6.7 ?m, 95% LOA, -23.8 to 10.4 ?m; CRVE: MD = -18.2 ?m 95% LOA, -36.7 to 0.4 ?m) were large. However, the strength of correlations between systemic factors with SIVA-measured retinal calibers was not significantly different to that measured using RA and IVAN (P ? 0.332). SIVA-approximates converted from RA and IVAN measurements using the proposed algorithm was not significantly different from SIVA-measured calibers (P ? 0.20).ConclusionAbsolute measurements of retinal vessel calibers vary between three common software systems but associations with systemic factors were similar.Translational relevanceThe proposed algorithm allowed conversions of RA and IVAN measurements to SIVA-approximates. This conversion is important for future data pooling and establishment of normative values for retinal vascular caliber measurements.

Project description:Background: The dilation of intracranial large arteries caliber, may transfer more hemodynamic burden to the downstream brain capillaries, which, in the long run, results in cerebral small vessel disease (CSVD). This study aimed to investigate the relationship between intracranial artery calibers and small vessel disease. Methods: Patients with first-ever ischemic stroke of lacunar infarction subtype were enrolled via Nanjing Stroke Registry Program. An intracranial arterial Z-score, named the brain arterial remodeling (BAR) score, was calculated by averaging the calibers of the seven main intracranial arteries. Among the enrolled patients, those with a BAR score < -1 SD were deemed to have small intracranial artery calibers; those with a BAR score >1 SD were deemed to have large intracranial artery calibers and those with a between BAR score were deemed to have normal intracranial artery calibers. Imaging markers of CSVD, including lacuna, white matter hyperintensity (WMH), enlarged perivascular spaces (EPVS) and cerebral microbleeds (CMBs) were rated and then summed to obtain a total CSVD score. Results: A total of 312 patients were involved in this study, patients with BAR score >1 SD were older (P = 0.039), and more prone to having a history of myocardial infarction (P = 0.033). The Spearman's rank correlation coefficient between the BAR score and total CSVD score is 0.320 (P < 0.001). Binary logistic regression found that BAR score >1 SD was correlated with lacuna (OR = 1.987; 95% CI, 1.037-3.807; P = 0.039); severe WMH (OR = 1.994; 95% CI, 1.003-3.964; P = 0.049); severe EPVS (OR = 2.544; 95% CI, 1.299-4.983; P = 0.006) and CSVD (OR = 2.997; 95% CI 1.182-7.599; P = 0.021). Ordinal logistic regression analysis found that age (OR = 1.028; 95% CI, 1.007-1.049; P = 0.009), hypertension (OR = 3.514; 95% CI, 2.114-5.769; P < 0.001) and BAR score >1 SD (OR = 2.418; 95% CI, 1.350-4.330; P = 0.003) were correlated with the total CSVD score. Conclusions: Patients with large intracranial arterial calibers may have heavier CSVD burden. The mechanisms of this association warrant further study.

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Vessel caliber--a potential MRI biomarker of tumour response in clinical trials.

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Vessel caliber--a potential MRI biomarker of tumour response in clinical trials.

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