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Biomedical subjects

Chrit T W Moonen

Publications and source records attributed to Chrit T W Moonen.

17 recordsLinked to original sources

Gene expression and gene therapy imaging.

The fast growing field of molecular imaging has achieved major advances in imaging gene expression, an important element of gene therapy. Gene expression imaging is based on specific probes or contrast agents that allow either direct or indirect spatio-temporal evaluation of gene expression. Direct evaluation is possible with, for example, contrast agents that bind directly to a specific target (e.g., receptor). Indirect evaluation may be achieved by using specific substrate probes for a target enzyme. The use of marker genes, also called reporter genes, is an essential element of MI approaches for gene expression in gene therapy. The marker gene may not have a therapeutic role itself, but by coupling the marker gene to a therapeutic gene, expression of the marker gene reports on the expression of the therapeutic gene. Nuclear medicine and optical approaches are highly sensitive (detection of probes in the picomolar range), whereas MRI and ultrasound imaging are less sensitive and require amplification techniques and/or accumulation of contrast agents in enlarged contrast particles. Recently developed MI techniques are particularly relevant for gene therapy. Amongst these are the possibility to track gene therapy vectors such as stem cells, and the techniques that allow spatiotemporal control of gene expression by non-invasive heating (with MRI guided focused ultrasound) and the use of temperature sensitive promoters.

Animals↗

Quantitative magnetic resonance temperature mapping for real-time monitoring of radiofrequency ablation of the liver: an ex vivo study.

We evaluated the feasibility and accuracy of real-time magnetic resonance (MR) thermometry for monitoring radiofrequency (RF) ablation in the liver. Continuous MR temperature mapping was used to monitor bipolar RF ablations performed in ex vivo livers with and without flow using two parallel electrodes. Macroscopic inspection of ablation zones was compared with thermal dose maps (TDm) and T1-weighted inversion recovery turbo spin echo (IR-TSE) images for their size and shape and the influence of flow. Pearson's correlation (r), Bland and Altman tests and kappa (chiK) tests were performed. The mean differences in ablation zone size between macroscopic and TDm and IR-TSE measurements were +4 mm and -2 mm, respectively. TDm was well correlated with macroscopy (r=0.77 versus r=0.44 for IR-TSE). TDm was found to be more precise for shape recognition (chiK=0.73 versus chiK=0.55 for IR-TSE) and for detection of an intact ring of liver due to the cooling effect of flow which was impossible with IR-TSE. Simultaneous monitoring of RF ablation by MR thermometry is feasible and reliable for predicting the shape of ablation zones and the impact of the heat-sink effect of flow. Further studies are needed to confirm these results in vivo.

Animals↗

Real-time monitoring of radiofrequency ablation of rabbit liver by respiratory-gated quantitative temperature MRI.

PURPOSE: To evaluate the feasibility and precision of magnetic resonance imaging (MRI) thermometry for monitoring radiofrequency (RF) liver ablation in vivo and predicting the size of the ablation zone. MATERIALS AND METHODS: At 1.5T, respiratory-triggered real-time MR temperature mapping (the proton resonance frequency (PRF) method) was used to monitor RF ablation in rabbit liver (N = 6) under free breathing. The size of the ablation zones, as assessed by histological analyses, was compared with that predicted from MR thermal dose (TD) maps or derived from conventional T1-weighted (T1w), T2-weighted (T2w), and T1w gadolinium (Gd)-enhanced (T1w-Gd) images acquired immediately after the ablation, and on days 4 and 8 postprocedure. RESULTS: MR temperature uncertainty remained under 1-2 degrees C even during RF deposition. The TD maps were shown to be more predictive and precise than the other MR images, with an average predictive precision for the final ablation zone size of about 1 mm as compared to the histologically proven lesion on day 8. CONCLUSION: Quantitative temperature MRI during RF ablation is feasible and offered a precise indication of the ablation zone size in this preclinical study based on the lethal dose threshold.

Animals↗

MRI-guided focused ultrasound: methodology and applications.

Focused ultrasound is very well suited for inducing noninvasive local hyperthermia. Since magnetic resonance imaging (MRI) may be employed to obtain real-time temperature maps noninvasively the combination of these two technologies offers great advantages specifically aimed toward oncological studies. Real-time identification of the target region and accurate control of the temperature evolution during the treatment has now become possible. Thermal ablation of pathological tissue, local drug delivery using thermosensitive micro-carriers and controlled transgene expression using thermosensitive promoters have recently been demonstrated with this unique technology. Based on these experiments combined focused ultrasound and MRI thermometry holds promise for future oncological diagnostics and treatment. In this paper, we review some of the recent methodological developments as well as experimental and first clinical studies using this approach.

Clinical Trials as Topic↗

MR evaluation of the glomerular homing of magnetically labeled mesenchymal stem cells in a rat model of nephropathy.

PURPOSE: To assess renal glomerular homing of intravenously injected superparamagnetic iron oxide (SPIO)-labeled mesenchymal stem cells (MSCs) at in vivo and ex vivo magnetic resonance (MR) imaging in an experimental rat model of mesangiolysis. MATERIALS AND METHODS: Animal procedures were performed in accordance with protocols approved by Institutional Animal Care and Use Committee. Fourteen rats were divided into two groups: one pathologic (n = 10), with persistent mesangiolysis following simultaneous injection of OX-7 monoclonal antibody and puromycin aminonucleoside in which 10(7) SPIO- and DiI-labeled MSCs were injected, and one control (n = 4). In vivo and ex vivo MR imaging examinations were performed with 4.7- and 9.4-T spectrometers, respectively, and T2*-weighted sequences. In vivo signal intensity variations were measured in the liver and kidney before and 6 days after MSC injection. Intrarenal signal intensity variations were correlated with histopathologic data by means of colocalization of DiI fluorescence, alpha-actin, and Prussian blue stain-positive cells. Histologic differences between the glomerular homing of MSCs in different kidney portions were correlated to the areas of MR signal intensity decrease with nonparametric statistical tests. RESULTS: On in vivo images, signal intensity measurements of pathologic kidneys following MSC injection did not show any signal intensity decrease (P = .7), whereas a 34% +/- 14 (mean +/- standard deviation) signal intensity decrease was observed in the liver (P < .01), where a substantial number of labeled cells were trapped. On ex vivo images, pathologic kidneys showed focal cortical (glomerular) areas of signal intensity loss, which was absent in controls. The areas of low signal intensity correlated well with alpha-actin and Prussian blue stain- and DiI-positive areas (P < .01), which indicates that MSCs specifically home to injured tissue. No MSCs were detected in the kidneys of control animals. CONCLUSION: Intravenously injected MSCs specifically home to focal areas of glomerular damage and can be detected at ex vivo MR imaging.

Animals↗

Local delivery of magnetic resonance (MR) contrast agent in kidney using thermosensitive liposomes and MR imaging-guided local hyperthermia: a feasibility study in vivo.

PURPOSE: To investigate the feasibility of local delivery of a magnetic resonance (MR) contrast agent in vivo using paramagnetic thermosensitive liposomes and infrared (IR) laser-induced local hyperthermia under real-time MR thermometry on rabbit kidney. MATERIALS AND METHODS: Respiratory gated, radio frequency (RF)-spoiled gradient-echo sequences were used for precise MR temperature mapping (SD = 1 degrees C). In vivo heating experiments confirmed local release of MR contrast agent from liposomes. RESULTS: T1 decreased from 800 msec to about 500 msec, as measured after tissue cooling, in those locations where the renal parenchyma was heated above the phase transition temperature of the liposome membrane. CONCLUSION: The release of MR contrast agent has been demonstrated in rabbit kidney in vivo. This may be used as a reporter for simultaneous release of therapeutic agents.

Animals↗

Simultaneous monitoring of temperature and T1: methods and preliminary results of application to drug delivery using thermosensitive liposomes.

A method is presented to obtain temperature and longitudinal relaxivity measurements simultaneously and in near real-time. Quantitative relaxivity values are obtained from the signal magnitude from fast Look-Locker EPI data, whereas phase information from all signal samples on the recovery curve is combined to provide temperature values using the proton resonance frequency method. The utility of this technique is illustrated in an in vitro experiment with thermosensitive liposomes, which are studied as potential micro vehicles for local drug delivery. The method allowed measuring the evolution of relaxivity during RF-heating of liposomes containing a paramagnetic contrast agent, demonstrating increase of liposome permeability near the phase transition temperature. Potential applications are monitoring of local drug delivery using thermosensitive liposomes, and confirmation of reaching the liposomes' threshold temperature during thermal therapy.

Diffusion↗

Spatial and temporal control of expression of therapeutic genes using heat shock protein promoters.

Heat-shock protein promoters, particularly hsp70, have been used for gene therapy strategies because of their efficiency and the possibility of induction by external heat. This review describes some of the characteristics of hsp70 promoters that make them attractive for use in gene therapy. The human hsp70B promoter is especially promising because of its dose response effect with regard to temperature. Spatial and temporal control of transgene expression using hsp70 promoters necessitates non-invasive methods of local heat deposition and accurate local control of temperature. Special emphasis is given to Focused Ultrasound heating guided by Magnetic Resonance temperature mapping.

Cell Line, Tumor↗

In vivo MR imaging of intravascularly injected magnetically labeled mesenchymal stem cells in rat kidney and liver.

PURPOSE: To evaluate in vivo magnetic resonance (MR) imaging with a conventional 1.5-T system for depiction and tracking of intravascularly injected superparamagnetic iron oxide (SPIO)-labeled mesenchymal stem cells (MSCs). MATERIALS AND METHODS: This study was conducted in accordance with French law governing animal research and met guidelines for animal care and use. Rat MSCs were labeled with SPIO and transfection agent. Relaxation rates at 1.5 T, cell viability, proliferation, differentiation capacity, and labeling stability were assessed in vitro as a function of SPIO concentration. MSCs were injected into renal arteries of healthy rats (labeled cells in four, unlabeled cells in two) and portal veins of rats treated with carbon tetrachloride to induce centrolobular liver necrosis (labeled cells and unlabeled cells in two each). Follow-up serial T2*-weighted gradient-echo MR imaging and R2* mapping were performed. MR imaging findings were compared histologically. RESULTS: SPIO labeling caused a strong R2* effect that increased linearly with iron dose; R2* increase for cells labeled for 48 hours with 50 microg of iron per milliliter was 50 sec(-1) per million cells per milliliter. R2* was proportional to iron load of cells. SPIO labeling did not affect cell viability (P > .27). Labeled cells were able to differentiate into adipocytes and osteocytes. Proliferation was substantially limited for MSCs labeled with 100 microg Fe/mL or greater. Label half-life was longer than 11 days. In normal kidneys, labeled MSCs caused signal intensity loss in renal cortex. After labeled MSC injection, diseased liver had diffuse granular appearance. Cells were detected for up to 7 days in kidney and 12 days in liver. Signal intensity loss and fading over time were confirmed with serial R2* mapping. At histologic analysis, signal intensity loss correlated with iron-loaded cells, primarily in renal glomeruli and hepatic sinusoids; immunohistochemical analysis results confirmed these cells were MSCs. CONCLUSION: MR imaging can aid in monitoring of intravascularly administered SPIO-labeled MSCs in vivo in kidney and liver.

Adipocytes↗

Stability of real-time MR temperature mapping in healthy and diseased human liver.

PURPOSE: To determine the stability and quality of MR temperature mapping using the proton resonance frequency (PRF) method in the liver of hepatic tumor patients. MATERIALS AND METHODS: The standard deviation (SD) of a series of temperature maps was determined in 30 patients (21 patients with cirrhotic livers with carcinoma, and nine patients with noncirrhotic livers with metastasis or angioma) and in five volunteers at normal body temperature under free breathing. A respiratory-gated segmented echo-planar imaging (EPI) sequence (three slices in one expiration phase) was performed with sensitivity encoding (SENSE) acceleration on a 1.5 T scanner. Motion-corrupted images were identified by calculation of the cross-correlation coefficient, and discarded. RESULTS: A T2* range of 10-33 msec was found, with especially low values in advanced cirrhotic livers. The mean temperature SD in patients was 2.3 degrees C (range = 1.5-5.0 degrees C). The stability in healthy livers was slightly better than that in cirrhotic livers, and it was higher in the right liver than in the left liver. The gating failed in 4% of the images when the respiratory cycle was irregular, leading to motion artifacts and errors in the temperature maps. CONCLUSION: The achieved temperature stability and image quality makes real-time quantitative monitoring of thermal ablation of liver tumors feasible on a clinical scanner.

Artifacts↗

Automatic spatial and temporal temperature control for MR-guided focused ultrasound using fast 3D MR thermometry and multispiral trajectory of the focal point.

Of the different modalities to induce local hyperthermia, focused ultrasound is the only noninvasive technology available at the moment. In addition to the 3D localization of the target region, it has been shown that MRI can provide real-time thermometry and allows online, automatic control of temperature evolution of the focal point. Treatment of a large tissue volume (as compared to the focal spot size, i.e., the ultrasound wavelength) can be achieved rapidly by moving the focal point along an inside-out spiral trajectory. It has been shown previously that under linear conditions of energy deposition versus temperature, the spatial profile of the temperature within a large area can be controlled. In this study, a proportional, integral, and derivative (PID) spatial-and-temporal controller is described for the control of the temperature evolution within the target region under more variable conditions. The aim was to reach a predefined temperature profile after a few successive trajectories. Heat conduction in tissue is exploited to obtain a uniform temperature increase in a volume using discrete sonications without any waiting time. Input data sets consisted of 3D temperature maps provided online by a MR scanner. For each new trajectory, the controller recalculates the number of sonications per surface unit (spatial density of points describing the trajectory) and the applied power. Its performance was tested ex vivo and in vivo. Diameters of the target region ranged from 9 mm to 19 mm. Targeted temperature increase ranged from +8 degrees C to +18 degrees C. Spatiotemporal temperature control showed good stability and fast convergence, for both circular and elliptic ROIs.

Algorithms↗

Feasibility of MR-guided focused ultrasound with real-time temperature mapping and continuous sonication for ablation of VX2 carcinoma in rabbit thigh.

The efficiency of MRI-guided focused ultrasound (FUS) hyperthermia with continuous sonication was investigated for the treatment of VX2 carcinoma implanted in rabbit thigh muscle. Six rabbits were treated with a single session of FUS when the tumor diameter exceeded 2 cm (10-21 days after implant). The FUS treatment method was based on a spiral trajectory of the focal point that allows continuous sonication under automatic, real-time MR guidance. The total heating time was approximately 1000 sec. Efficacy of treatment was evaluated twice a week based on clinical (weight) and MRI data. Treated animals were sacrificed 5 weeks after the heating procedure and histological analysis was performed. Tumor regression was observed in each treated animal. Complete ablation of tumor, with confirmation by histological analysis, was obtained in five of six treated cases. Tumor regrowth occurred in one animal. Thermal injury was limited to the targeted region in three cases, but ablation also reached some healthy muscle around the tumor in the other three cases. A good correlation was found between postmortem histological analysis and premortem MRI data. Efficacy of MR-controlled hyperthermia using FUS heating with spiral trajectories was demonstrated for successful local control of intramuscular VX2 tumor.

Animals↗

Real-time MR temperature mapping of rabbit liver in vivo during thermal ablation.

It has been shown that quantitative MRI thermometry using the proton resonance frequency (PRF) method can be used to noninvasively monitor the evolution of tissue temperature, and to guide minimally-invasive tumor ablation based on local hyperthermia. Although hepatic tumors are among the main targets for thermal ablation, PRF-based temperature MRI of the liver is difficult to perform because of motion artifacts, fat content, and low T(*) (2). In this study the stability of real-time thermometry was tested on a clinical 1.5 T scanner for rabbit liver in vivo. The fast segmented EPI principle was used together with respiratory gating to limit respiratory motion artifacts. Lipid signal suppression was achieved with a binomial excitation pulse. Saturation slabs were applied to suppress artifacts due to flowing blood. The respiratory-gated MR thermometry in the rabbit liver in vivo showed a standard deviation (SD) of 1-3 degrees C with a temporal resolution of 3 s per slice and 1.4 mm x 1.9 mm spatial resolution in plane (slice thickness = 5 mm). The method was used to guide thermal ablation experiments with a clinical infrared laser. The estimated size of the necrotic area, based on the thermal dose calculated from MR temperature maps, corresponded well with the actual lesion size determined by histology and conventional MR images obtained 5 days posttreatment. These results show that quantitative MR temperature mapping can be obtained in the liver in vivo, and can be used for real-time control of thermal ablation and for lesion size prediction.

Animals↗

A PRESTO-SENSE sequence with alternating partial-Fourier encoding for rapid susceptibility-weighted 3D MRI time series.

A 3D sequence for dynamic susceptibility imaging is proposed which combines echo-shifting principles (such as PRESTO), sensitivity encoding (SENSE), and partial-Fourier acquisition. The method uses a moderate SENSE factor of 2 and takes advantage of an alternating partial k-space acquisition in the "slow" phase encode direction allowing an iterative reconstruction using high-resolution phase estimates. Offering an isotropic spatial resolution of 4 x 4 x 4 mm(3), the novel sequence covers the whole brain including parts of the cerebellum in 0.5 sec. Its temporal signal stability is comparable to that of a full-Fourier, full-FOV EPI sequence having the same dynamic scan time but much less brain coverage. Initial functional MRI experiments showed consistent activation in the motor cortex with an average signal change slightly less than that of EPI.

Algorithms↗

Influence of fMRI data sampling on the temporal characterization of the hemodynamic response.

Experimental and modeling studies were used to estimate the effect of different sampling rates (repetition times, TR) and different sampling positions on the estimates of the temporal properties of the hemodynamic response function (HRF) derived from fMRI studies. Data were acquired at a TR of 250 ms and then subjected to various degrees of undersampling. Using a gaussian fitting function it is demonstrated that the accuracy of HRF peak time determination decreases with lower sampling rate (higher TR). The decrease in accuracy amounts to about 50 ms per second of TR increase. In addition, temporal shifts of the HRF peak time are found when reducing the influence of the more variable descending part of HRF curve by using a temporal cut-off after HRF peak time. The shift scales with TR, amounts up to 100 ms for a TR of 1500 ms and a cut-off of 3-4 s and depends on the sampling position. The use of the full HRF function does not lead to a shift but increases the influence of potential confounding factors as large veins and poststimulus undershoot. Since both accuracy and potential shifts of HRF peak determination scale with TR, it is important that temporal fMRI studies are carried out with high sampling rates.

Arousal↗

Imaging the changes in renal T1 induced by the inhalation of pure oxygen: a feasibility study.

The effect of the inhalation of pure oxygen on the kidney was evaluated by measuring monoexponential T1 and T2* relaxation times in nine volunteers using a multiple-shot turbo spin echo and multiple echo gradient echo sequences, respectively. The T1 of the renal cortex decreased significantly when breathing pure oxygen as compared to normoxia (from 882 +/- 59 to 829 +/- 70 msec, P < 0.05), while that of the renal medulla was unchanged. No significant changes were seen in the T2* of either compartment. Dynamic imaging using an inversion recovery sequence with an optimized inversion time typically produced signal changes of 20% in the renal cortex. Studies to assess if oxygen-induced changes in flow contributed to this effect showed that the flow contribution was not significant. Although longer inversion times (880 ms) produced optimal contrast, acceptable contrast was also obtained at shorter inversion times (450 msec) in the renal cortex, spleen, and lung, with the latter being of opposite polarity to the other two tissues, implying a shorter parenchymal T1 than previously reported in the literature. The results are consistent with oxygen acting as an intravascular contrast agent which induces a shortening of T1 in the arterial blood volume.

Feasibility Studies↗

Automatic control of hyperthermic therapy based on real-time Fourier analysis of MR temperature maps.

Local hyperthermia is increasingly being used for therapeutic purposes, such as tumor ablation. Heat conduction and energy absorption in vivo during the hyperthermic procedure are largely unknown, thus making feedback temperature control highly desirable. Here, a general method for temperature control based on Fourier transformation (FT) of the bio-heat equation is presented, taking into account heat diffusion (D) and energy absorption (alpha) together with temperature distribution derived from rapid, continuous MR temperature mapping. The main advantages of the new method are: 1) the spatial distribution of heat deposition and conduction over the full region of interest (ROI) is taken into account, and 2) the high speed resulting from the use of fast FT (FFT) of temperature maps allows rapid feedback coupling. Initial tests based on MRI-guided focused ultrasound (FUS) demonstrated that high-quality temperature regulation can be obtained even for erroneous values of D and alpha, so long as their relative error remained in the same range. Performance of the automated control procedure was validated ex vivo and in vivo on rabbit thigh using moderate FUS heating. During the procedure, the standard deviation (SD) of the temperature remained in the range of temperature noise obtained by MRI, indicative of the performance of the regulation algorithm.

Algorithms↗