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Advances in Genetics, Volume 69 Serial Editors Theodore Friedmann University of California at San Diego, School of Medicine, USA Jay C. Dunlap Dartmouth Medical School, Hanover, NH, USA Stephen F. Goodwin University of Oxford, Oxford, UK AcademicPressisanimprintofElsevier 525BStreet,Suite1900,SanDiego,CA92101-4495,USA 30CorporateDrive,Suite400,Burlington,MA01803,USA 32JamestownRoad,London,NW17BY,UK Radarweg29,POBox211,1000AEAmsterdam,TheNetherlands Firstedition2010 Copyright(cid:1)2010ElsevierInc.Allrightsreserved. Nopartofthispublicationmaybereproduced,storedinaretrievalsystem ortransmittedinanyformorbyanymeanselectronic,mechanical,photocopying, recordingorotherwisewithoutthepriorwrittenpermissionofthepublisher PermissionsmaybesoughtdirectlyfromElsevier’sScience&TechnologyRights DepartmentinOxford,UK:phone(+44)(0)1865843830;fax(+44)(0)1865853333; email:permissions@elsevier.com.Alternativelyyoucansubmityourrequestonlineby visitingtheElsevierwebsiteathttp://www.elsevier.com/locate/permissions,andselecting ObtainingpermissiontouseElseviermaterial. Notice Noresponsibilityisassumedbythepublisherforanyinjuryand/ordamagetopersonsor propertyasamatterofproductsliability,negligenceorotherwise,orfromanyuseoroperation ofanymethods,products,instructionsorideascontainedinthematerialherein.Becauseof rapidadvancesinthemedicalsciences,inparticular,independentverificationofdiagnosesand drugdosagesshouldbemade. ISBN:978-0-12-375022-8 ISSN:0065-2660 ForinformationonallAcademicPresspublications visitourwebsiteatelsevierdirect.com PrintedandboundinUSA 10 11 12 10 9 8 7 6 5 4 3 2 1 Contributors Numbersinparenthesesindicatethepagesonwhichtheauthors’contributionsbegin. Wadih Arap (31, 97, 115) DavidH.KochCenter,TheUniversityofTexasM.D. Anderson Cancer Center, Houston, Texas, USA, and Department of Experimental Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA, and Department of Genitourinary Medical Oncology, The University of Texas M.D. AndersonCancerCenter,Houston,Texas,USA;DepartmentofCancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston,Texas,USA Zaver M. Bhujwalla (1) JHU ICMIC Program, Russell H. Morgan Department ofRadiologyandRadiologicalScience,TheJohnsHopkinsUniversity School of Medicine, Baltimore, Maryland, USA, and The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins UniversitySchool ofMedicine, Baltimore, Maryland, USA LawrenceF.Bronk(115) DavidH.KochCenter,TheUniversityofTexasM.D. AndersonCancer Center,Houston, Texas, USA Paolo Decuzzi (31, 115) Department of Nanomedicine and Biomedical Engineering, The University of Texas Health Science Center Houston, Houston, Texas, USA, and Center of Bio-/Nanotechnology andEngineeringforMedicine,UniversityofMagnaGraecia,Catanzaro, Italy Wouter H. P. Driessen (31, 115) David H. Koch Center, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA, and Department of Genitourinary Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; Department of Cancer Biology, The University of Texas M.D. AndersonCancer Center,Houston, Texas, USA Julianna K. Edwards (115) David H. Koch Center, The University of Texas M.D.Anderson CancerCenter, Houston, Texas,USA MauroFerrari(31) DepartmentofNanomedicineandBiomedicalEngineering, The University of Texas Health Science Center, Houston, Texas, USA, and Department of Experimental Therapeutic, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; ix x Contributors Department of Biomedical Engineering, Rice University, Houston, Texas,USA Biana Godin (31) Department of Nanomedicine and Biomedical Engineering, TheUniversityofTexasHealthScienceCenter,Houston,Texas,USA AminHajitou(65) DepartmentofGeneTherapy,Section/DivisionofInfectious Diseases, Faculty of Medicine, Imperial College London, Wright- Fleming Institute, St Mary’s Campus, Norfolk Place, London, United Kingdom Sei-YoungLee(31) DepartmentofNanomedicineandBiomedicalEngineering, The University of Texas Health Science Center, Houston, Texas, USA, and Department of Mechanical Engineering, The University of TexasatAustin, Austin,Texas, USA StevenK.Libutti(135) MontefioreMedicalCenter,AlbertEinsteinCollegeof Medicine, Bronx,New York,USA Xiaoli Lu (83) Department of Microbiology and Molecular Genetics, 427 Bridgeside Point II, 450 Technology Drive, University of Pittsburgh SchoolofMedicine, Pittsburgh, Pennsylvania, USA Zhibao Mi (83) Department of Microbiology and Molecular Genetics, 427 Bridgeside Point II, 450 Technology Drive, University of Pittsburgh SchoolofMedicine, Pittsburgh, Pennsylvania, USA RenataPasqualini(31,97,115) DavidH.KochCenter,TheUniversityofTexas M.D.AndersonCancerCenter,Houston,Texas,USA,andDepartment of Experimental Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA, and Department of Genitourinary Medical Oncology, The University of Texas M.D. AndersonCancerCenter,Houston,Texas,USA;DepartmentofCancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston,Texas,USA ArvindP.Pathak (1) JHUICMIC Program,Russell H.Morgan Departmentof Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University SchoolofMedicine, Baltimore, Maryland, USA Marie-FrancePenet(1) JHUICMICProgram,RussellH.MorganDepartment ofRadiologyandRadiologicalScience,TheJohnsHopkinsUniversity SchoolofMedicine, Baltimore, Maryland, USA Bettina Proneth (31, 115) David H. Koch Center, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA, and Department of Genitourinary Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; Department of Cancer Biology, The University of Texas M.D. AndersonCancer Center, Houston,Texas, USA Contributors xi Paul D. Robbins (83) Department of Microbiology and Molecular Genetics, 427 Bridgeside Point II, 450 Technology Drive, University of PittsburghSchool ofMedicine, Pittsburgh, Pennsylvania, USA RolandoRumbaut(31) Children’sNutritionResearchCenter,BaylorCollegeof Medicine, Houston,Texas, USA Masanori Sato (97) David H. Koch Center, The University of Texas M.D. AndersonCancer Center,Houston, Texas, USA Glauco R. Souza (115) David H. Koch Center, The University of Texas M.D. AndersonCancer Center,Houston, Texas, USA Prashanth Sreeramoju (135) Montefiore Medical Center, Albert Einstein CollegeofMedicine, Bronx,NewYork,USA Srimeenakshi Srinivasan (31) Department of Nanomedicine and Biomedical Engineering, The University of Texas Health Science Center, Houston,Texas, USA Virginia J. Yao (97) David H. Koch Center, The University of Texas M.D. AndersonCancer Center,Houston, Texas, USA Maliha Zahid (83) Department of Microbiology and Molecular Genetics, 427 Bridgeside Point II, 450 Technology Drive, University of PittsburghSchool ofMedicine, Pittsburgh, Pennsylvania, USA 1 MR Molecular Imaging of Tumor Vasculature and Vascular Targets Arvind P. Pathak,*,† Marie-France Penet,* and Zaver M. Bhujwalla*,† *JHU ICMIC Program, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore,Maryland,USA †The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins UniversitySchoolofMedicine,Baltimore,Maryland,USA I. Introduction II. Structural,Functional,andMolecularCharacteristics ofTumorVasculature III. BasisofContrastinMRImages A. Endogenouscontrast B. Exogenouscontrast C. Lowmolecularweightcontrastagents D. Highmolecularweightcontrastagents IV. ImagingReceptorExpression V. ImagingVascularTargeting VI. MultimodalMolecular-FunctionalImagingof TumorVasculature VII. Conclusion Acknowledgments References AdvancesinGenetics,Vol.69 0065-2660/10$35.00 Copyright2010,ElsevierInc.Allrightsreserved. DOI:10.1016/S0065-2660(10)69010-4 2 Pathak et al. ABSTRACT Tumor angiogenesis and the ability of cancer cells to induce neovasculature continue to be a fascinating area of research. As the delivery network that provides substrates and nutrients, aswell as chemotherapeutic agents tocancer cells, but allows cancer cells to disseminate, the tumor vasculature is richly primed with targets and mechanisms that can be exploited for cancer cure or control. The spatial and temporal heterogeneity of tumor vasculature, and the heterogeneity of response to targeting, make noninvasive imaging essential for understanding the mechanisms of tumor angiogenesis, tracking vascular target- ing,anddetectingtheefficacyofantiangiogenictherapies.Withitsnoninvasive characteristics, exquisite spatial resolution and range of applications, magnetic resonanceimaging(MRI)techniqueshaveprovidedawealthoffunctionaland molecular information on tumor vasculature in applications spanning from “benchtobedside”.Theintegrationofmolecularbiologyandchemistrytodesign novelimagingprobesensuresthecontinuedevolutionofthemolecularcapabil- itiesofMRI.Inthisreview,wehavefocusedondevelopmentsinthecharacteri- zationoftumorvasculaturewithfunctionalandmolecularMRI. (cid:1)2010,ElsevierInc. I. INTRODUCTION The two major mechanisms resulting in the formation of blood vessels are vasculogenesis and angiogenesis. Vasculogenesis describes the establishment of the vasculature during embryogenesis and development. Angiogenesis, a term coinedbyDr.JohnHunterin1794todescribetheformationofnewbloodvessels from extant vasculature (Hunter, 1794), is a process that occurs in both the embryo and the adult (Carmeliet, 2005). In 1865, Rudolf Virchow made the observationthattumorshavedistinctcapillarynetworks(Virchow,1863),which wasfollowedbythefirstsystematicstudiesofthetumorvasculaturebyGoldman in1907(Goldman,1907)andbyLewisin1927whodeterminedthatthetumor environment has a profound effect on the architecture of angiogenic vessels (Lewis, 1927). (See Ribatti’s (2009) comprehensive treatise on the history of tumorangiogenesisresearch.)Acenturylater,theobservationthatadultangio- genesiswasahallmarkofpathologiesrangingfromcancertodiabeticretinopa- thy(JainandCarmeliet,2001)ledFolkman(1971)topositinhisseminalpaper thatsolidtumorgrowthwas“angiogenesis-dependent”.Init,healsointroduced the concept of “antiangiogenic” therapy or the idea that solid tumor growth couldbearrestedbypreventingtherecruitmentandformationofdenovoblood vessels. In the decades since, a comprehensive understanding of the molecular 1.MolecularMRIofTumorVasculature 3 mechanismsregulatingtumorangiogenesishasemerged,resultingintheidenti- fication of a slew of angiogenesis inhibitors, many of which are currently in clinicaltrials(Folkman,2007). Inacarefulstudyofcarcinomaofthebronchus,ThomlinsonandGray observedthattheonsetofnecrosisoccurredatapproximately160(cid:1)mfromthe nearestvessel,adistancecalculatedtobethediffusionlimitofoxygen.Basedon thesedata,theypredictedthepresenceofhypoxiaintumorsthatwouldleadto radioresistance(ThomlinsonandGray,1955).Almostfourdecadeslater,withthe discovery of the hypoxia inducible factor-1 (HIF-1), and its role as a transcrip- tionalregulatorofanever-increasinglistofgenes(Semenza,2010),tumorhypoxia resultingfromthechaotictumorvasculaturehasbeenimplicatedinmetabolism, angiogenesis,invasion,metastasis,anddrugresistance(Bertoutetal.,2008). SinceClarketal.(1931)createdsomeoftheearliestimagesofneovas- cularizationintransparentrabbitearchambersinthe1930s,advancesinphysics (e.g., new imaging methods), chemistry (e.g., the synthesis of novel imaging probes),andbiology(e.g.,developmentofinnovativegenereportersystemsand theidentificationofnoveltargets)haveusheredinanewerainthecharacteri- zationofangiogenesisandantiangiogenictherapyusingimaging(McDonaldand Choyke, 2003; Pathak et al., 2008a). Even a century ago, the importance of “individualizingcancertreatment”and“penetratingintothedarknessofphysio- logical conditions existing in tumor growths” was recognized in the prescient remarksmadebyE.Goldmanin1907(Goldman,1907). Theimportanceoftumorvasculatureinseveralphenotypiccharacteristics ofcancer,aswellasindrugdeliveryandmetastasis,hasbecomeveryevident,and angiogenicorvasculartargetingismeetingwithsomesuccessasapotentialtreat- mentforcancer(Folkman,2007;NeriandBicknell,2005).Thesedevelopments havenotonlynecessitatedthegenomicandfunctionalcharacterizationofindivid- ualtumorstoidentifyspecificmoleculartargets,butalsotheabilitytononinvasively detectthespatialandtemporalresponsetothesenewtargetedtherapies.Noninva- sive imaging techniques, the availability of “smart probes” as well as molecular strategiessuchastheuseofsmallinterferingRNAtodownregulatespecifictargets areplayinganincreasinglyimportantroleinthiseraoftargetedmolecularmedicine. ThepurposeofthisreviewistodescriberecentadvancesinMRIasappliedtotumor vasculaturecharacterizationandtargeting. II. STRUCTURAL, FUNCTIONAL, AND MOLECULAR CHARACTERISTICS OF TUMOR VASCULATURE Studiesoftumorvascularmorphologyhaveidentifiedavarietyofstructuraland functional differences between tumor and normal vasculature (see Konerding et al., 2000 for a comprehensive review). Tumor-induced blood vessels are 4 Pathak et al. typicallysinusoidal,exhibitdiscontinuousbasementmembranes,andlacktight endothelial cell junctions making them highly permeable to macromolecules. Other characteristics of the tumor vasculature include (i) spatial heterogeneity and loss of branching hierarchy, (ii) arteriovenous shunts, (iii) acutely and transiently collapsing vessels, (iv) poor differentiation and a lack of smooth musclecelllining,and(v)aninabilitytomatchtheelevatedmetabolicdemand ofcancercells,resultinginareasofhypoxiaandnecrosis. Pioneering work by Jain, Vaupel, and others has demonstrated that structural anomalies of the tumor vasculature result in altered hemodynamics, bloodrheology,andtumorbloodflow(Jain,1988;Vaupeletal.,1989).Figure1.1 summarizesthebidirectionalrelationshipsbetweentheanomalousaspectsofthe tumorvasculatureandtheresultingpathophysiologicalandmolecularperturba- tionsinthetumormicroenvironment. In addition to angiogenesis-dependent pathways, nonangiogenic path- waysfortumorgrowthhavealsobeenobserved.Ofthese,vascularcooptionand vasculogenic mimicry are the most well known. In a landmark study, Holash Abnormal tumor vessel architecture Abnormal hemodynamics Abnormal rheology Abnormal interstitial space Abnormal oxygenation, pH, nutrient supply, drainage, and metabolism Gene expression Clonal heterogeneity (e.g. VEGF, HIF-1 etc.) Metastatic and Cell cycle effects invasive potential Sensitivity to radiotherapy Anticancer drug delivery Figure 1.1. Schematic to illustrate how abnormal tumor vessel architecture results in altered hemodynamics (blood flow), blood rheology, and elevated interstitial fluid pressure. Thesealterationsinturnprofoundlyaffectsthetumormicroenvironment(i.e.,oxyge- nation, pH, etc.), which in turn modulates multiple phenomena ranging from gene expressiontosensitivitytoradiotherapy.AdaptedfromMollsandVaupel(2000). 1.MolecularMRIofTumorVasculature 5 et al., (1999) demonstrated that in contrast to the prevailing view that most tumorsbeginasavascularmasses,asubsetoftumorsinitiallygrewby“coopting” existing host blood vessels. This coopted host vasculature did not immediately undergoangiogenesisbutinitiallyregressed,leadingtoanavasculartumorwith massivetumorcellloss.Eventually,theremainingtumorwasrescued byrobust angiogenesisatthetumorrim.Maniotisetal.(1999)describedanothermodeof vascularchannelformationwhichwasdubbed“vasculogenicmimicry”tohigh- light the fact that parts of the microcirculation of aggressive uveal melanomas consist of channels lined by a layer of extracellular matrix and the tumor cells themselves.Changetal.(2000)havedescribedtheformationof“mosaicvessels” inacoloncarcinomamodel,whereinbothtumorandendothelialcellscontrib- utedtovasculartubeformation. Theheterogeneity of tumorvasculature canpose a formidable clinical challenge. The structural and functional deficiencies of the tumor vasculature profoundly impact drug delivery, radiosensitivity, proliferation rate, invasion, metastases, andthemetabolic micromilieu (pO2, pH,energy status;Konerding etal.,2000)ofthetumor.However,asdiscussedsubsequently,thisheterogeneity of the tumor vasculature also presents an opportunity for the identification of noveldrugtargetsthatcanbeexploitedtodeveloptumorvasculature-selective therapeuticstrategies(NeriandBicknell,2005). As summarized in several excellent reviews (Baluk et al., 2005; McDonald and Choyke, 2003; Munn, 2003), the physiology and organization of the tumor vasculature at the spatial scale of the endothelial cell is also abnormal. Such abnormalities include gaps in interendothelial tight junctions resultinginlossofbarrierfunction,looseornoassociationwithpericytes,anda compromised or incomplete basement membrane (Kalluri, 2003). This micro- scopicpictureisfurthercomplicatedbythephenomenaofvasculogenicmimicry and mosaic vessels described earlier. However, at this scale, the diversity of surface proteins selectively expressed by angiogenic tumor vessels has been exploitedastargetsfornovelcontrastagentsusingarangeofimagingmodalities (McDonaldandChoyke,2003).Someoftheseepitopesonangiogenicendothe- lial cells andbasement membrane components have alsobeen tested fortumor vessel selective drug-targeting strategies as summarized in Table 1.1 (Molema, 2005). The review by Langenkamp and Molema (2009) lists endothelial cell- specificgenesusedtoidentifytissuemicrovasculature,whilealandmarkpaperby Croix et al. (2000) demonstrates the diversity of the genes expressed in human tumorendothelium.Bothimagingreceptorexpressionandvasculartargetingare discussedindetailinensuingsections. Conventionalimage contrastinradiologic images providesdifferences in the level of brightness or intensity of parts of the image corresponding to anatomically or physiologically different locations. While traditionally such contrast has aided in the differentiation of normal from pathologic tissue, such

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