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T. H. Helbich Department of Biomedical Imaging and Image-guided Therapy

Division of Molecular and Gender Imaging

Medical University of Vienna

Tumor Imaging: From Morphology to Molecules

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

CancerImages:MORPHOLOGY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

Goal for 2030

molecularimagingcellular,molecularlevel

conventionalradiologymacroscopic-anatomicallevel

1x109

-  Detect CA earlier -  Reduce overdiagnosis -  Treat earlier & better

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

Metastasis [18F]FDG PET DWIBS Bone Scan CT/MRI

Angiogenesis CE-MRI qBOLD VAM Proliferation

[18F]FLT PET, MRSI, DWI

Cell Death PET MRS Hyperpolarized MRI

Altered Metabolism

[18F]FDG PET MRSI Hyperpolarized MRI [18F] MISO PET CEST

Hanahan D. et al. Cell 2011;144:646-74.

HALLMARKS&NON-invasiveIMAGING

•  One tumor sample has 100 mutations on every human gene •  10 underlining CA principles (15.000 citations)

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DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

MultiparametricMRIincancers

DCE-MRI morphology &

neoangiogenesis

1H-MRSI metabolism

DWI microstructural

changes Red

uctiono

fbiopsie

s50%

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

MRI of Tumor Oxygenation

•  9.4 Tesla •  Measures oxygen metabolism •  in BLOOD & TISSUE •  Oxygen inhalation •  Correlation with HIF-1α

(hypoxia induced factor 1α)

Poster#A74

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

•  Endogenous CEST:

•  Gac-CEST (Glycosaminoglycan) •  Amide-CEST (ATP) •  Amine-CEST •  aaa-CEST (aliphatic) •  Hydroxyl-CEST •  Glu-CEST •  Gluco-CEST

Emerging techniques: Chemical Exchange Saturation Transfer (CEST)

80mM

40mM

20mM

10mM

0mM

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

Emerging techniques for Metabolism: Hyperpolarized(HP)MRSI

•  HP MRSI allows rapid, radiation-free, non-invasive investigation of tumor metabolism using hyperpolarized exogenous probes e.g 13C

•  Hyperpolarization results in an extensive increase in signal intensity, e.g 13C >50,000 fold at 3T

Smallflame Wildlandfire

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DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

Emerging techniques: Hyperpolarized(HP)MRSI

•  HP 13C probes injected into living systems

•  HP 13C pyruvate incorporated into cell and metabolized

•  Conversion of pyruvate to lactate measured with chemical shift imaging

Mignionetal.,2013Xuetal.,2013Xuetal.,2014Butteta.,2015

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

Nanoparticle Imaging

•  Vehicles used: •  Cell tracking •  Multimodal contrast agents (MRI / PET / Optic) •  Treatment (loading with DRUG)

HRSM:2016-2020:5,7MIll

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

MOLECULARMPHYBRIDMRI •  Improves:

– Detection

– Characterization

– Staging

– Therapy monitoring

– Overdiagnosis

Tailored therapy

DWI NANO

CESTMRIPatients will acknowledge our efforts implementing personalized medicine

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

DEPARTMENT OF BIOMEDICAL IMAGING AND IMAGE-GUIDED THERAPY

HRSM-Fund:NANOBILD

Consortium:

PI: Helbich & Hacker

CoPI:

E. Reimhult BOKU

M. Ogris UW

5.7 Mill €

AIM: NANOBILD Development of multimodal

Contrast agents