Native T1 Mapping as an In Vivo Biomarker for the Identification of Higher-Grade Renal Cell Carcinoma

Adams, Lisa C.; Ralla, Bernhard; Jurmeister, Philipp; Bressem, Keno K.; Fahlenkamp, Ute Lina; Hamm, Bernd; Busch, Jonas; Makowski, Marcus R.

doi:10.1097/rli.0000000000000515

Cited by 38 publications

(40 citation statements)

References 41 publications

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“…Techniques using at least two acquisitions with different flip angles are commonly used for this purpose 32 but other techniques have also been evaluated in order to further optimize the accuracy of T1 mapping 33 . Furthermore, pathological tissue alterations as a result of disease processes such as extracellular matrix expression and tissue fibrosis can be noninvasively visualized and quantified based on changes in T1 relaxation properties 13,14,34,35 . Few studies have already evaluated non-contrast-enhanced T1 mapping for the diagnosis of PCa using different technical approaches.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of T1 relaxation time in prostate cancer and benign prostate tissue using a Modified Look-Locker inversion recovery sequence

Baur

Hansen

Rogasch

et al. 2020

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Purpose of this study was to evaluate the diagnostic performance of T1 relaxation time (T1) for differentiating prostate cancer (PCa) from benign tissue as well as high-from low-grade PCa. Twentythree patients with suspicion for PCa were included in this prospective study. 3 T MRI including a Modified Look-Locker inversion recovery sequence was acquired. Subsequent targeted and systematic prostate biopsy served as a reference standard. T1 and apparent diffusion coefficient (ADC) value in PCa and reference regions without malignancy as well as high-and low-grade PCa were compared using the Mann-Whitney U test. The performance of T1, ADC value, and a combination of both to differentiate PCa and reference regions was assessed by receiver operating characteristic (ROC) analysis. T1 and ADC value were lower in PCa compared to reference regions in the peripheral and transition zone (p < 0.001). ROC analysis revealed high AUCs for T1 (0.92; 95%-CI, 0.87-0.98) and ADC value (0.97; 95%-CI, 0.94 to 1.0) when differentiating PCa and reference regions. A combination of T1 and ADC value yielded an even higher AUC. The difference was statistically significant comparing it to the AUC for ADC value alone (p = 0.02). No significant differences were found between high-and low-grade PCa for T1 (p = 0.31) and ADC value (p = 0.8). T1 relaxation time differs significantly between PCa and benign prostate tissue with lower T1 in PCa. It could represent an imaging biomarker for PCa. Magnetic resonance imaging (MRI) has proven its potential to detect clinically significant prostate cancer (PCa) with high accuracy and provide information regarding local tumor staging 1-4. According to current guidelines, multiparametric MRI (mpMRI) combining high-resolution T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI should be evaluated semi-quantitatively using the prostate imaging-reporting and data system (PI-RADS) 5. In addition, DWI and DCE can be evaluated quantitatively, and selected derived parameters have proven promising imaging biomarkers for the characterization of cancerous tissues within the prostate 6-9. Non-contrast-enhanced T1-weighted imaging (T1WI) currently only is used for detection of hemorrhage and no information regarding tumor characterization is derived from this sequence type 5,10. T1 mapping enables the reliable evaluation of the spin-lattice relaxation time (T1) and thus provides reproducible data on intrinsic

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Section: Discussionmentioning

confidence: 99%

“…To our best knowledge, any further use of MOLLI for prostate imaging has not been reported yet. T1 measured with MOLLI has proven to be a robust imaging biomarker in cardiac MRI 13,14 as well as selected malignancies such as renal cell cancer with an excellent interreader agreement 35 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of T1 relaxation time in prostate cancer and benign prostate tissue using a Modified Look-Locker inversion recovery sequence

Baur

Hansen

Rogasch

et al. 2020

Sci Rep

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“…Very few studies have so far investigated native T1 mapping to characterize the degree of tumor differentiation in high-grade renal cell carcinoma and neuroblastoma [ 24 , 25 ]. Data on native T1 mapping in clinical or experimental HCC are poor, and studies on the characterization of ECM composition using the MOLLI sequence are missing.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent preclinical study, Zormpas-Petridis et al found T1 mapping to reliably distinguish regions with different levels of tumor cell differentiation in an experimental mouse model of neuroblastoma [ 24 ]. In patients, native T1 mapping was successfully used to identify higher-grade renal cell carcinoma histologically validated by the collagen volume fraction [ 25 ]. However, to the best of our knowledge, there is as yet no preclinical or clinical study that has systematically investigated native T1 mapping sequences to characterize liver tumors in terms of ECM composition.…”

Section: Introductionmentioning

confidence: 99%

Native T1 Mapping Magnetic Resonance Imaging as a Quantitative Biomarker for Characterization of the Extracellular Matrix in a Rabbit Hepatic Cancer Model

et al. 2020

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To characterize the tumor extracellular matrix (ECM) using native T1 mapping magnetic resonance imaging (MRI) in an experimental hepatic cancer model, a total of 27 female New Zealand white rabbits with hepatic VX2 tumors were examined by MRI at different time points following tumor implantation (day 14, 21, 28). A steady-state precession readout single-shot MOLLI sequence was acquired in a 3 T MRI scanner in prone position using a head-neck coil. The tumors were segmented into a central, marginal, and peritumoral region in anatomical images and color-coded T1 maps. In histopathological sections, stained with H&E and Picrosirius red, the regions corresponded to central tumor necrosis and accumulation of viable cells with fibrosis in the tumor periphery. Another region of interest (ROI) was placed in healthy liver tissue. T1 times were correlated with quantitative data of collagen area staining. A two-way repeated-measures ANOVA was used to compare cohorts and tumor regions. Hepatic tumors were successfully induced in all rabbits. T1 mapping demonstrated significant differences between the different tumor regions (F(1.43,34.26) = 106.93, p < 0.001) without interaction effects between time points and regions (F(2.86,34.26) = 0.74, p = 0.53). In vivo T1 times significantly correlated with ex vivo collagen stains (area %), (center: r = 0.78, p < 0.001; margin: r = 0.84, p < 0.001; peritumoral: r = 0.73, p < 0.001). Post hoc tests using Sidak’s correction revealed significant differences in T1 times between all three regions (p < 0.001). Native T1 mapping is feasible and allows the differentiation of tumor regions based on ECM composition in a longitudinal tumor study in an experimental small animal model, making it a potential quantitative biomarker of ECM remodeling and a promising technique for future treatment studies.

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“…On the contrary, low tumor T1 values have been correlated to increased necrosis, low water content, and high levels of proteins [59]. Native T1 mapping could also represent an in vivo biomarker for the differentiation of tumor grade [60]. Significant changes in T1 were shown in several pre-clinical models in response to therapy [59,61].…”

Section: Tissular Composition and Imagingmentioning

confidence: 99%

How clinical imaging can assess cancer biology

et al. 2019

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Human cancers represent complex structures, which display substantial inter-and intratumor heterogeneity in their genetic expression and phenotypic features. However, cancers usually exhibit characteristic structural, physiologic, and molecular features and display specific biological capabilities named hallmarks. Many of these tumor traits are imageable through different imaging techniques. Imaging is able to spatially map key cancer features and tumor heterogeneity improving tumor diagnosis, characterization, and management. This paper aims to summarize the current and emerging applications of imaging in tumor biology assessment.

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Native T1 Mapping as an In Vivo Biomarker for the Identification of Higher-Grade Renal Cell Carcinoma

Cited by 38 publications

References 41 publications

Evaluation of T1 relaxation time in prostate cancer and benign prostate tissue using a Modified Look-Locker inversion recovery sequence

Evaluation of T1 relaxation time in prostate cancer and benign prostate tissue using a Modified Look-Locker inversion recovery sequence

Native T1 Mapping Magnetic Resonance Imaging as a Quantitative Biomarker for Characterization of the Extracellular Matrix in a Rabbit Hepatic Cancer Model

How clinical imaging can assess cancer biology

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