文章目录

肿瘤治疗反应成像的新方法

New approaches for imaging tumour responses to treatment

原文发布日期：2008-02-01

DOI: 10.1038/nrc2289

类型: Review Article

开放获取: 否

要点：

要点翻译：

英文摘要：

摘要翻译：

原文链接：

文章：

肿瘤治疗反应成像的新方法

New approaches for imaging tumour responses to treatment

原文发布日期：2008-02-01

DOI: 10.1038/nrc2289

类型: Review Article

开放获取: 否

要点：

Detection of the early responses of tumours to treatment could be used to guide subsequent therapy, allowing rapid selection of the most appropriate therapy, with attendant welfare benefits for the patient and cost benefits for the health-care system.
Tumour responses to treatment are conventionally assessed by imaging measurements of tumour size. However, tumour shrinkage can take weeks or even months to become apparent or, with some therapies, might not occur at all, despite a positive response to treatment.
Imaging measurements of tumour biochemistry or cell biology can give an earlier indication of whether a tumour is responding to treatment than measurements of tumour size. For example, measurements of the reduction in tumour uptake of a radiolabelled glucose analogue, 2-[¹⁸F]fluoro-2-deoxy-D-glucose, are already used clinically to detect tumour responses to treatment, often before there is any change in tumour size.
The radionuclide imaging techniques, positron-emission tomography and single photon-emission computed tomography, can be used to monitor receptor expression using appropriately labelled receptor ligands. As these techniques are so sensitive (they can detect concentrations in the 10⁻¹²–10⁻¹⁰ M range), the agents can be administered at sub-pharmacological doses.
Labelling of cell metabolites (for example, amino acids, acetate, the glucose analogue fluorodeoxyglucose) with positron-emitting isotopes (¹¹C and ¹⁸F) allows imaging of tumour metabolism in the clinic.
Magnetic resonance imaging of the protons in tissue water gives relatively high-resolution images of tissue morphology. By using receptor ligands that have been labelled with paramagnetic tags that affect the spin relaxation times, magnetic resonance imaging measurements of tissue water can be used to image receptor expression indirectly.
Magnetic resonance spectroscopy (MRS) can be used to detect tumour metabolites in vivo. Phosphorus-31 MRS can be used to monitor the levels of ATP, inorganic phosphate and intracellular pH and ¹H MRS the levels of various abundant metabolites, including lactate, neutral lipids and phospholipid metabolites, such as phosphocholine.
Nuclear spin hyperpolarization can be used to dramatically enhance the sensitivity
(> 10,000×) of the magnetic resonance experiment. Hyperpolarization of injected molecules allows spectroscopic imaging of their distribution in the body and subsequent metabolism.
The availability of these clinical imaging modalities in configurations that can be used with animal models of disease in the laboratory should promote the translation of new imaging techniques from the laboratory into the clinic.

要点翻译：

检测肿瘤对治疗的早期反应可用于指导后续治疗，从而快速选择最合适的治疗方案，这不仅能为患者带来福祉效益，也能为医疗系统节省成本。
传统上通过影像学测量肿瘤大小来评估肿瘤对治疗的反应。然而，肿瘤缩小可能需要数周甚至数月才能显现，或者在某些治疗中，尽管对治疗有积极反应，但可能根本不会发生缩小。
与测量肿瘤大小相比，对肿瘤生化或细胞生物学进行影像学测量可以更早地显示肿瘤是否对治疗产生反应。例如，通过测量肿瘤对放射性标记葡萄糖类似物2-[18F]氟-2-脱氧-D-葡萄糖的摄取减少，已在临床上用于检测肿瘤对治疗的反应，这通常发生在肿瘤大小出现任何变化之前。
放射性核素成像技术，如正电子发射断层扫描和单光子发射计算机断层扫描，可以使用适当标记的受体配体来监测受体表达。由于这些技术非常敏感（可以检测到10^−12至10^−10 M范围内的浓度），因此可以在亚药理剂量下使用这些标记物。
用正电子发射同位素（11C和18F）标记细胞代谢物（例如氨基酸、乙酸、葡萄糖类似物氟脱氧葡萄糖）可以在临床中成像肿瘤代谢。
对组织水中的质子进行磁共振成像可以提供相对高分辨率的组织形态图像。通过使用带有顺磁性标记的受体配体影响自旋弛豫时间，可以通过磁共振成像测量组织水间接成像受体表达。
磁共振波谱可用于检测体内肿瘤代谢物。磷-31磁共振波谱可用于监测ATP、无机磷酸盐和细胞内pH水平，而1H磁共振波谱可用于监测各种丰富代谢物的水平，包括乳酸、中性脂质和磷脂代谢物（如磷酸胆碱）。
核自旋超极化可用于显著提高磁共振实验的灵敏度（超过10,000倍）。注射分子的超极化允许通过波谱成像显示其在体内的分布和后续代谢。
这些临床成像模式在实验室中可与动物疾病模型结合使用，应能促进新成像技术从实验室向临床的转化。

英文摘要：

Tumour responses to treatment are still largely assessed from imaging measurements of reductions in tumour size. However, this can take several weeks to become manifest and in some cases may not occur at all, despite a positive response to treatment. There has been considerable interest, therefore, in non-invasive techniques for imaging tissue function that can give early evidence of response. These can be used in clinical trials of new drugs to give an early indication of drug efficacy, and subsequently in the clinic to select the most effective therapy at an early stage of treatment.

摘要翻译：

肿瘤对治疗的反应目前仍主要通过影像学测量肿瘤体积缩小来评估。然而，这种变化可能需要数周才能显现，在某些情况下甚至完全不会出现，尽管治疗实际上已产生积极效果。因此，人们一直致力于开发能够成像组织功能的非侵入性技术，以便更早地检测到治疗反应。这些技术可用于新药临床试验，及早提示药物疗效，随后在临床中用于在治疗早期选择最有效的治疗方案。