Patterns of framework invasion in patients with laryngeal cancer: correlation of in vitro magnetic resonance imaging and pathological findings.

Total laryngectomy for laryngeal squamous cell carcinoma means a drastic change in the way of living for a patient. New surgical techniques such as laser surgery attempt to save the voice. To be oncologically correct, an accurate assessment of the tumor extent is necessary. Imaging is especially important in determining tumor extent in the regions where conventional and endoscopic ENT examinations are less accurate. Correlations of CT, in vivo MRI and pathological findings after surgery have demonstrated that MRI is more sensitive than CT, but that it overestimates the degree of cartilage invasion. Cartilage invasion is believed to be a contraindication to radiation therapy and voice-sparing surgery. In a prospective study, Gd-enhanced in vitro MRI of 10 total laryngectomy specimens was correlated with subsequent pathological examination. Good correlation of the anatomical relationships of the tumor between the in vitro images and gross pathology were found. Important is the absence of false negatives in our study, indicating that cartilage invasion can be ruled out when a normal signal intensity on in vitro MRI of the cartilage is seen. This has important oncological implications for partial voice-sparing laryngeal surgery.

A comparison between different imaging strategies for diffusion measurements with the centric phase-encoded turboFLASH sequence.

The study compared the results of three centrally reordered phase-encoded turboFLASH sequences for diffusion-weighted imaging (DWI). The sequences were conventional turboFLASH, turboFLASH with subtraction of T1-related effects, and turboFLASH with correction for T1-related effects during the imaging period only. The relative merits were studied with respect to image quality and accuracy by computer simulation and by experimental validation on phantoms and on in vivo rat brain. A T1-related underestimation of the diffusion coefficient ranging from -30% (T1 approximately 200 ms) to -5% (T1 approximately 1 s) was found to exist for the conventional sequence. Image artifacts, caused by longitudinal relaxation during the imaging period, are reflected in calculated diffusion maps. When the correction sequence is used, the artifacts and the systematic errors are reduced but longitudinal relaxation during the delay between preparation and imaging periods remains large enough to induce significant errors (-15% for T1 approximately 200 ms to -3% for T1 approximately 1 s). The subtraction sequence eliminates the influence of T1 effects on the calibrations, but leads to identical artifacts for all diffusion-weighted images.

Complementary use of T2-weighted and postcontrast T1- and T2*-weighted imaging to distinguish sites of reversible and irreversible brain damage in focal ischemic lesions in the rat brain.

The evolution of a photochemically induced cortical infarct was monitored using T2-, postcontrast (GdDOTA) T1-, and postcontrast (DyDTPA-BMA) T2*-weighted NMR imaging techniques. Data acquired with these different NMR imaging types were compared, both qualitatively and quantitatively. The T2*-weighted NMR images after spordiamide injection (DyDTPA-BMA) were perfusion-weighted images that allowed the differentiation between several infarct-related areas in terms of different degrees of perfusion deficiency. No quantitative information on cerebral blood flow (CBF) was obtained. A clear distinction was made between areas with a complete lack of CBF located in the core of the lesion and temporary CBF insufficiencies in the rim surrounding this core. Concomitant observations on T2-weighted and postcontrast T1-weighted images revealed the same temporary rim characterized by an increased water content, and an intact blood-brain barrier (BBB), as well as by reduced perfusion. This rim appeared within the first hours after infarct induction, reached a maximum 24 h later, and lasted between 3-5 days, when its size gradually decreased until complete disappearance. These observations suggest the existence of an area at risk. Only on postcontrast T1-weighted images, the core of the lesion remained visible during the whole experimental period (10 days) and reflected in all likelihood the irreversibly damaged ischemic central core. The combined application of different NMR imaging techniques when studying focal cerebral infarctions in the rat brain allowed us to distinguish, in terms of NMR characteristics, zones of reversible from irreversible brain damage and to estimate the severity of the damage. This might offer an appropriate experimental setup for the screening of cerebroprotective compounds.

Complementary use of T2- and postcontrast T1-weighted NMR images for the sequential monitoring of focal ischemic lesions in the rat brain.

The noninvasive nature of NMR imaging enables serial studies on a single animal. In 12 male Wistar rats, the dynamic progression of a photochemically induced (Rose Bengal) infarct was studied starting immediately after induction and up to 10 days. The results demonstrated that both T2- and postcontrast T1-weighted NMR images are required to discern the time dependent dynamics of the ischemic process. The ischemic lesion was already visible on T2-weighted images within 30 min after the induction. Twenty-four hours after the insult, both area and intensity reached maximum values. Hereafter and up to day 10, both parameters decreased. Postcontrast T1- weighted images revealed a blood-brain barrier (BBB) rupture immediately after the induction which persisted until 10 days after the insult. The application of contrast agents such as Gd-DOTA or Gd-HP-DO3A also allowed the detection of 10-day-old lesions which were not always discernable on T2-weighted images. The penetration of both contrast agents in the affected area proceeded slower the first 5 days after the insult while at day 10, maximum contrast enhancement was reached almost immediately after administration of the contrast agent. At 24 hr after the insult, the discrepancy between the lesion area as determined on T2-weighted images and on postcontrast T1-weighted images was maximal. At this stage, the lesion was characterized by central core with a leaky BBB surrounded by a reversible zone which appeared enhanced on T2-weighted images.

Noninvasive in vivo 13C-NMR spectroscopy in the rat to study the pharmacokinetics of 13C-labeled xenobiotics.

Noninvasive NMR methodology has been developed to enable monitoring of 13C-labeled xenobiotics in the rat in vivo. 2,2-Dichloro-1-(2-chlorophenyl)-1-(4-chlorophenyl)-[3-13C]-propane can be detected in the liver of intact rats by in vivo 13C surface coil NMR spectroscopy after ip administration of the compound. The experiments were performed at 1.9 and 9.4 Tesla. The intrahepatic changes of the signal intensity of the labeled compound were followed as a function of time. In the days following administration, the concentration decreased and dropped to values below the detection limit after 12 days. The study demonstrates the feasibility of studies on pharmacokinetics of 13C-labeled compounds in the rat using noninvasive, in vivo surface coil NMR spectroscopy in animals. The sensitivity allows the detection of a single dose of the drug of 200 mg/kg, but can be improved.

Proton relaxation enhancement by means of serum albumin and poly-L-lysine labeled with DTPA-Gd3+: relaxivities as a function of molecular weight and conjugation efficiency.

A series of poly-L-lysine chains, with molecular weight ranging from 3300 up to 102,000 Da, were labeled with DTPA-Gd3+. No significant differences in longitudinal and transversal relaxivity, could be demonstrated as a function of the chain length. The R1 and R2 relaxivities were respectively 2.5 and 5 times superior to those of plain DTPA-Gd3+ (at 2.4 T). Bovine serum albumin was also labeled in a way that a wide (DTPA-Gd3+)/BSA range (3-39) was obtained. The longitudinal relaxivity, of these paramagnetically labeled albumins, increased with increasing (DTPA-Gd3+)/BSA ratios. This effect was most pronounced at very low (DTPA-Gd3+)/BSA ratios.

Noninvasive in vivo 13C-NMR spectroscopy of a 13C-labeled xenobiotic in the rat.

This study demonstrates that the xenobiotic product, 1-(o-chlorophenyl)-1-(p-chlorophenyl)-2,2-dichloro-3-13C-propane can be monitored in the liver of an intact animal by in vivo 13C surface coil NMR spectroscopy after intraperitoneal administration. The carbon-13 label could be detected after a single dose of only 200 mg/kg of the product. The intrahepatic changes of the signal intensity of the labeled product were monitored as a function of time. No signals corresponding to metabolites could be detected.

High resolution NMR imaging: Gd-DTPA labeled enzyme as a probe for permeability studies in polyacrylamide gels.

The penetration of horse liver alcohol dehydrogenase (HLAD) molecules into polyacrylamide gel beads, which are used to immobilize the enzyme, was studied. HLAD was labeled with gadolinium diethylene-triamine-pentaacetic acid (Gd-DTPA), using the N-hydroxy-succinimide active ester of DTPA as a chelating agent. The HLAD-(Gd-DTPA)27 has a 3.7-fold larger longitudinal (R1) and a 14-fold larger transversal relaxivity (R2) (at 2.4 T) than the plain Gd-DTPA. A series of dry polyacrylamide gel beads, with total monomer concentration ranging from 5% to 30% were synthesized and swollen in a buffered solution of HLAD-(Gd-DTPA)27. The gel beads were examined with high resolution NMR imaging. The T1- and T2-weighted images revealed that the permeability for the labeled HLAD decreased with increasing total monomer concentration of the gel beads. These imaging results correlate fairly well with the enzymatic reactivities measured for the same range of gel beads but swollen in a solution of non labeled HLAD and NAD+ (nicotinamide adenine dinucleotide). It is concluded that Gd-labeling can be used to monitor the distribution of weakly concentrated, water soluble products in a solid matrix.