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Vessel Architectural Imaging Identifies Cancer Patient Responders to Anti-angiogenic Therapy

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2013

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Emblem, K. E., K. Mouridsen, A. Bjornerud, C. T. Farrar, D. Jennings, R. J. H. Borra, P. Y. Wen, et al. 2013. “Vessel Architectural Imaging Identifies Cancer Patient Responders to Anti-angiogenic Therapy.” Nature medicine 19 (9): 1178-1183. doi:10.1038/nm.3289. http://dx.doi.org/10.1038/nm.3289.

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Abstract

Measurement of vessel caliber by Magnetic Resonance Imaging (MRI) is a valuable technique for in vivo monitoring of hemodynamic status and vascular development, especially in the brain. Here, we introduce a new paradigm in MRI coined as Vessel Architectural Imaging (VAI) that exploits an intriguing and overlooked temporal shift in the MR signal forming the basis for vessel caliber estimation and show how this phenomenon can reveal new information on vessel type and function not assessed by any other non-invasive imaging technique. We also show how this biomarker can provide novel biological insights into the treatment of cancer patients. As an example, we demonstrate using VAI that anti-angiogenic therapy can improve microcirculation and oxygen saturation levels and reduce vessel calibers in patients with recurrent glioblastomas, and more crucially, that patients with these responses have prolonged survival. Thus, VAI has the potential to identify patients who would benefit from therapies.

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Vessel caliber, perfusion MRI, cerebral hemodynamics, glioblastoma, anti-VEGF

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