2015
DOI: 10.1155/2015/206405
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Evaluating pH in the Extracellular Tumor Microenvironment Using CEST MRI and Other Imaging Methods

Abstract: Tumor acidosis is a consequence of altered metabolism, which can lead to chemoresistance and can be a target of alkalinizing therapies. Noninvasive measurements of the extracellular pH (pHe) of the tumor microenvironment can improve diagnoses and treatment decisions. A variety of noninvasive imaging methods have been developed for measuring tumor pHe. This review provides a detailed description of the advantages and limitations of each method, providing many examples from previous research reports. A substanti… Show more

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Cited by 106 publications
(90 citation statements)
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References 106 publications
(141 reference statements)
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“…Overall, these results showed that stronger CEST signals can be detected under mildly acidic or neutral physiological conditions, relative to strongly acidic physiological conditions. Solid tumors are often mildly acidic, because tumor cells often have enhanced aerobic glycolysis that produces excess lactic acid, known as the Warburg effect . Therefore, the CEST effect of GR‐4Am‐SA has a dependence on pH that is well suited for the study of solid tumors.…”
Section: Resultsmentioning
confidence: 99%
“…Overall, these results showed that stronger CEST signals can be detected under mildly acidic or neutral physiological conditions, relative to strongly acidic physiological conditions. Solid tumors are often mildly acidic, because tumor cells often have enhanced aerobic glycolysis that produces excess lactic acid, known as the Warburg effect . Therefore, the CEST effect of GR‐4Am‐SA has a dependence on pH that is well suited for the study of solid tumors.…”
Section: Resultsmentioning
confidence: 99%
“…A lower saturation power during CEST MRI studies can cause the reaction coordinate to be underestimated, which may be addressed by performing additional MRI scans that map the variability in saturation power applied in vivo , known as a B 1 map [26]. Also, a lower pH causes the reaction coordinate to be underestimated, which should be addressed during in vivo studies of tumors with high metabolic acidosis [27]. For example, we estimated that the shKLK6 model would need to be ≥0.9 pH units lower than the HCT116 model to account for our in vivo catalyCEST MRI results described below, which is unrealistic for these similar tumor cell lines.…”
Section: Discussionmentioning
confidence: 99%
“…The first five repetitions of the post-injection scans of the patient with metastatic ovarian cancer had CEST contrast greater than 2*sqrt (2)*noise, which was approximately 2 %. Contrast greater than this threshold has a 95 % probability of arising from the agent [2]. The remaining 10 repetitions had CEST contrast less than 2*sqrt (2)*noise so those repetitions were discarded from data analysis and we only averaged the first five repetitions of the post-injection scans for our average post-injection image.…”
Section: Methodsmentioning
confidence: 99%
“…An increased glycolysis leads to increased production of lactic acid, which causes the extracellular pH (pHe) to become lower in the tumor microenvironment [2]. Aggressive tumors are often more metabolically active, and therefore, the tumor pHe may be used to evaluate tumor aggressiveness [3, 4].…”
Section: Introductionmentioning
confidence: 99%