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A Model to Simulate Clinically Relevant Hypoxia in Humans
Published on: December 22, 2016
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A DWI-based hypoxia model shows robustness in an external prostatectomy cohort.
M Fernandez Salamanca1, T Hompland2, M Deręgowska-Cylke3
1Department of Radiology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
Frontiers in Oncology
|August 7, 2024
Summary
The Consumption and Supply based Hypoxia (CSH) model using diffusion-weighted imaging (DWI) accurately reflects prostate cancer hypoxia. This MRI tool, the hypoxia fraction (HFDWI), correlates with higher tumor grade and stage.
Area of Science:
- Oncology
- Radiology
- Biomarkers
Background:
- Prostate cancer hypoxia is a known negative prognostic indicator.
- The Consumption and Supply based Hypoxia (CSH) model, utilizing diffusion-weighted imaging (DWI), shows promise for assessing tumor hypoxia via MRI.
- Validating the CSH model's hypoxia fraction (HFDWI) against pathological features is crucial for its clinical utility.
Purpose of the Study:
- To validate the association between the CSH model's hypoxia fraction derived from DWI (HFDWI) and pathological Grade Group (pGG) and pathological T-staging (pTstage).
- To assess the robustness of the HFDWI metric in an external prostatectomy cohort.
- To compare HFDWI performance between an original (Oslo) and an external (Netherlands Cancer Institute - NKI) cohort.
Main Methods:
- Apparent diffusion coefficient (ADC) and fractional blood volume (fBV) maps were generated from DWI data of 291 prostatectomy patients.
- The CSH model was applied to calculate the hypoxia fraction (HFDWI) for each lesion, with median scaling for inter-center consistency.
- Statistical analyses, including T-tests, Mann-Whitney tests, and Pearson correlation, were used to compare HFDWI values and assess correlations with pGG and pTstage.
Main Results:
- The HFDWI demonstrated comparable absolute values and metric performance in the external NKI cohort versus the original Oslo cohort.
- Higher HFDWI values were significantly associated with higher pathological Grade Group (pGG ≥ 3) and higher pathological T-stage (pTstage = 3) in both cohorts.
- A significant positive correlation was found between HFDWI and prostate cancer pGG groups (ρ = 0.41, p<0.001).
Conclusions:
- The CSH model, using DWI to calculate HFDWI, is robust and reliable when validated in an external cohort.
- The HFDWI metric serves as a plausible indicator of true tumor hypoxia in prostate cancer.
- This validated MRI-based hypoxia assessment tool warrants further investigation for clinical application in prostate cancer management.
