A cross-sectional study to test equivalence of low- versus intermediate-flip angle dynamic susceptibility contrast MRI measures of relative cerebral blood volume in patients with high-grade gliomas at 1.5 Tesla field strength

Introduction1.5 Tesla (1.5T) remain a significant field strength for brain imaging worldwide. Recent computer simulations and clinical studies at 3T MRI have suggested that dynamic susceptibility contrast (DSC) MRI using a 30° flip angle (“low-FA”) with model-based leakage correction and no gadolinium-based contrast agent (GBCA) preload provides equivalent relative cerebral blood volume (rCBV) measurements to the reference-standard acquisition using a single-dose GBCA preload with a 60° flip angle (“intermediate-FA”) and model-based leakage correction. However, it remains unclear whether this holds true at 1.5T. The purpose of this study was to test this at 1.5T in human high-grade glioma (HGG) patients.MethodsThis was a single-institution cross-sectional study of patients who had undergone 1.5T MRI for HGG. DSC-MRI consisted of gradient-echo echo-planar imaging (GRE-EPI) with a low-FA without preload (30°/P-); this then subsequently served as a preload for the standard intermediate-FA acquisition (60°/P+). Both normalized (nrCBV) and standardized relative cerebral blood volumes (srCBV) were calculated using model-based leakage correction (C+) with IBNeuro™ software. Whole-enhancing lesion mean and median nrCBV and srCBV from the low- and intermediate-FA methods were compared using the Pearson’s, Spearman’s and intraclass correlation coefficients (ICC).ResultsTwenty-three HGG patients composing a total of 31 scans were analyzed. The Pearson and Spearman correlations and ICCs between the 30°/P-/C+ and 60°/P+/C+ acquisitions demonstrated high correlations for both mean and median nrCBV and srCBV.ConclusionOur study provides preliminary evidence that for HGG patients at 1.5T MRI, a low FA, no preload DSC-MRI acquisition can be an appealing alternative to the reference standard higher FA acquisition that utilizes a preload

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Direct age determination of a subtropical freshwater crayfish (redclaw, cherax quadricarinatus) using ossicular growth marks

Recent studies have reported that crustacean age determination is possible. We applied a direct ageing method (i.e. transverse cross sectioning of gastric ossicles) to a subtropical freshwater crayfish (Cherax quadricarinatus) sourced from an aquaculture population. Growth mark periodicity and the potential for chronological depositions were investigated by staining C.quadricarinatus with calcein and examining their ossicles a year later. Pterocardiac ossicles were superior to other ageing structures (i.e. other ossicles and eyestalks) and produced repeatable between-reader counts (87% were corroborated and 13% varied by ±1). C.quadricarinatus size-at-age data (for an aquaculture population) was described by a von Bertalanffy growth equation (L∞ = 32 mm occipital carapace length; K = 0.64; t0 = –0.18; R2 = 0.81). Ossicular growth marks did not correspond to moult history. The calcein stain was retained over an annual cycle comprising multiple moults, demonstrating that pterocardiac ossicles retain chronological information. The maximum age (3+) corroborated other indirectly-obtained longevity estimates for C. quadricarinatus. Multiple lines of evidence indicate that the growth marks in C. quadricarinatus ossicles are probably deposited annually during winter. The ability to extract age information from subtropical decapods provides substantial opportunities for advancing fisheries and conservation research globally, but further research is needed to provide a definitive validation and elucidate the mechanism governing the accrual of ossicular growth marks

<i>Cherax quadricarinatus</i> occipital carapace length for 0–3+ putative age classes fitted with a von Bertalanffy growth curve.

<p>Putative ages were estimated based on the number of primary growth marks within the endocuticle. The von Bertalanffy growth parameters for the aquaculture population sampled were: <i>L</i>_<i>∞</i> = 32 mm OCL; <i>K</i> = 0.64; <i>t</i>₀ = –0.18; R² = 0.81; <i>n</i> = 15). Square = juvenile, circle = male, triangle = female.</p

Pterocardiac ossicles used to assign <i>Cherax quadricarinatus</i> putative ages.

<p>The exocuticular (a) and endocuticular (b) layers are divided by the cuticular boundary (indicated by the black arrow). Growth marks only occur within the endocuticle. A: Juvenile aged at 0+ (6 months), without a growth mark beyond the cuticular boundary. B: Adult crayfish aged at 3+ (3.5 years), showing declining spacing between endocuticular growth marks (indicated by black dots). Note the presence of additional material (> 50% of the previous cycle) beyond the outermost growth mark.</p

Confocal microscopy image showing a <i>Cherax quadricarinatus</i> ossicle from a 3+ crayfish that was stained with calcein and reared for one year.

<p>A: The cuticular boundary (a) and calcein stain incorporated just before and adjacent to the third growth mark (indicated by white dots). B: Inset showing the relative width of the growth cycle incorporating the calcein mark (w₁) and the subsequent annual cycle (w₂).</p

Relationship between the number of urocardiac ridges and occipital carapace length for <i>Cherax quadricarinatus</i>.

<p>The number of urocardiac ridges increases with increasing crayfish size (<i>n</i> = 34).</p