Vessel architectural imaging identifies cancer patient responders to anti-angiogenic therapy

Nat Med. 2013 Sep;19(9):1178-83. doi: 10.1038/nm.3289. Epub 2013 Aug 18.

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 termed vessel architectural imaging (VAI) that exploits an overlooked temporal shift in the magnetic resonance 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 noninvasive imaging technique. We also show how this biomarker can provide new biological insights into the treatment of patients with cancer. As an example, we demonstrate using VAI that anti-angiogenic therapy can improve microcirculation and oxygen saturation 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.

Trial registration: ClinicalTrials.gov NCT00035656.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Biomarkers
  • Blood Vessels / physiology*
  • Brain / blood supply*
  • Glioblastoma / blood supply*
  • Glioblastoma / drug therapy
  • Humans
  • Magnetic Resonance Angiography*
  • Microcirculation / drug effects
  • Quinazolines / therapeutic use
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Biomarkers
  • Quinazolines
  • Receptors, Vascular Endothelial Growth Factor
  • cediranib

Associated data

  • ClinicalTrials.gov/NCT00035656