1 MRI Biomarkers for Cancer Assessment October 14, 2011 Jens Jensen Center for Biomedical Imaging and Department of Radiology

2 A Little History R Damadian, Science, 1971

3 P Lauterbur, Nature, 1973

4 R Damadian, Patent, 1974 Tim Trio, Siemens, 2004 Glioblastoma

5 An intrinsic biological property that is quantifiable with MRI and that is useful for diagnosing or characterizing disease. What’s an MRI Biomarker?

6 Cerebral Blood Volume Knopp et al, Radiology 1999

7 Dynamic Contrast Enhanced MRI (“perfusion MRI”) Cerebral Blood Volume Cerebral Blood Flow Mean Transit Time Plasma/Interstitium Transfer Rate (K trans ) Microvessel density and size signal time course data + pharmacokinetic/NMR model

Scatterplot of lesion ROI-averaged ΔKtrans (≡ Ktrans [shutter-speed approach] − Ktrans [standard approach]). Huang W et al. Radiology doi: /radiol ©2011 by Radiological Society of North America

9 Diffusion MRI AB CD Rosenkrantz et al, submitted to Radiology diffusion coefficient diffusional kurtosis Prostate cancer malignant vs. benign, 48 subjects

10 Other MRI Cancer Biomarkers Sodium imaging Hyperpolarized C-13 Magnetic resonance spectroscopy Interstitial fluid pressure Molecular imaging contrast agents

11 The Good and the Bad Versatile High spatial resolution Soft tissue contrast Widely available Non-invasive

12 The Good and the Bad Complicated post-processing Low precision quantification Hard to standardize Expensive Low sensitivity

13 Yankeelov et al., Magnetic Resonance in Medicine, 2003