Abstract
Abstract Pediatric Ependymoma (EPN) is an aggressive brain tumor for which the benefits of chemo-radiation (CR) therapy have yet to be established. Our team has previously reported behavior patterns of EPN, including high tumor cellularity, cytological anaplasia, high mitotic index, tumor necrosis, and the presence of inflammatory cells such as M2-type macrophages. Recently, we have established advanced MRI protocols and computational algorithms for cell- and vessel-size imaging. The goal of this study is to develop advanced MRI analysis for CR response biomarkers (including tumor size, cell- and vessel-size correlates, and texture analysis) in mice with patient-derived xenografts (PDX) of pediatric EPN. Female severely immune deficient (SCID) mice were used for intracranial orthotopical inoculation of disaggregated tumors from pediatric EPN patients. All multi-parametric MRI sequences (fast spin echo, FLAIR, diffusion weighted, quantitative T2- and r2*-maps) were acquired on a Bruker 9.4 Tesla MRI scanner prior to CR, followed by 2 days and 2 weeks after CR treatment. All radiation treatment was performed using an animal image-guided precision XRAD irradiator (2Gyx5days), using MRI and CT guided EPN localization with added 30 mg/kg 5-fluoracil. All MRI analysis was performed using Bruker ParaVision software and MATLAB based modeling. The sensitivity of T2w-MRI scans was 0.2 mm for the smallest tumor detected; the median tumor volume at baseline was 2.5 mm3. Untreated mice showed rapid progression of tumor growth from small to intermediate to large EPN. The increased tumor sizes in untreated EPN were characterized by low ADC, highly elevated blood vessel density and large tumor cell size. A significant decrease in vessel size density and an increase in inflammatory cells were seen as soon as 2 days after CR therapy. The late response (2 weeks post CR) is characterized by increased ADC values and decreased cell size, resulting in significantly decreased tumor volumes.
Published Version
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