There is a clinical need for noninvasive
biomarkers of tumor hypoxia for prognostic and predictive studies,
radiotherapy planning, and
therapy monitoring.
Oxygen-enhanced MRI (OE-MRI) is an emerging imaging technique for quantifying the spatial distribution and extent of
tumor oxygen delivery in vivo. In OE-MRI, the longitudinal relaxation rate of
protons (ΔR1) changes in proportion to the concentration of molecular
oxygen dissolved in plasma or interstitial tissue fluid. Therefore, well-oxygenated tissues show positive ΔR1. We hypothesized that the fraction of
tumor tissue refractory to
oxygen challenge (lack of positive ΔR1, termed "Oxy-R fraction") would be a robust
biomarker of
hypoxia in models with varying vascular and hypoxic features. Here, we demonstrate that OE-MRI signals are accurate, precise, and sensitive to changes in
tumor pO2 in highly vascular 786-0
renal cancer xenografts. Furthermore, we show that Oxy-R fraction can quantify the hypoxic fraction in multiple models with differing hypoxic and vascular phenotypes, when used in combination with measurements of
tumor perfusion. Finally, Oxy-R fraction can detect dynamic changes in
hypoxia induced by the vasomodulator agent
hydralazine. In contrast, more conventional
biomarkers of
hypoxia (derived from blood oxygenation-level dependent MRI and dynamic contrast-enhanced MRI) did not relate to tumor hypoxia consistently. Our results show that the Oxy-R fraction accurately quantifies tumor hypoxia noninvasively and is immediately translatable to the clinic.