Die Autoren danken Drs. Fahad Bafakih und Jim Mandell für die Erfassung und Identifizierung von Patientenproben, Garrett F. Beeghly für die Unterstützung der Immunhistochemie sowie die Biorepository und Tissue Research Facility, das Herz-Kreislauf-Forschungszentrum Histology Core und die Biomolekulare Analyse-Fazilität an der University of Virginia für die Unterstützung mit Probenerfassung, Immunhistochemie und Bildgebung.

Dieses Protokoll identifiziert zelluläre Komponenten in Formalin-fixierten Paraffin-eingebetteten (FFPE) Proben, wie es für klinische Patientenproben typisch ist. Paraffin Einbettung ermöglicht die beste Aufrechterhaltung der Zell-und Gewebe-Morphologie sowie eine bessere Langlebigkeit der Abschnitte. Die Proben für diese Analyse wurden durch die University of Virginia Biorepository und Tissue Research Facility zugegriffen. Patientenproben wurden von einem Neuropathologen ausgewählt, der auf einer endgültigen Diagnose des Glioblastoms (Astrozytom, WHO-Grad IV) basierte, der zwischen 2010 und 2013 an der Universität von Virginia Tumorresektionen abgeschlossen hatte und vor dieser Analyse entdeckt wurde 11 . 1. FFPE-Probenentparaffinierung und Rehydratation HINWEIS: Dieser Teil des Protokolls ist spezifisch für FFPE-Proben. Während Paraffin-eingebettete Proben für diese Analyse aufgrund der Konservierung von zellulären und t nützlicher sein könnenIssue Morphologie, diese Analyse kann auch mit eingefrorenen Abschnitten durchgeführt werden. Bei Verwendung von gefrorenen Abschnitten kann dieser Teil weggelassen werden und gehen direkt zur chromogenen Immunhistochemie über. <ol><li> Führen Sie die folgenden Waschungen für jeweils 5 min aus: Xylol, Xylol, 100% Ethanol, 100% Ethanol, 95% Ethanol, 95% Ethanol, 70% Ethanol, entionisiertes Wasser, entionisiertes Wasser </li></ol> 2. Antigen Retrieval HINWEIS: Dieser Teil des Protokolls ist notwendig, um die bei der Formalin-Fixierung von FFPE-Proben gebildeten Methylenbrücken zu brechen und Antigen-Stellen für Antikörper zu binden. <ol><li> Verdünnen Sie die Tris-basierte Hoch-pH-Antigen-Entmaskungslösung bei der Herstellerempfehlung in destilliertem Wasser. </li><li> Führen Sie eine wärmevermittelte Antigen-Retrieval mit einer Mikrowelle durch. Andere Formen der wärmevermittelten Retrieval (wie Dampfkochtopf, Gemüsedampfer oder kochendes Wasser) würden ebenfalls ausreichen. <ol><li> Die verdünnte Entlüftungslösung in eine nicht versiegelte mikrowellengeeignete gebenSchiff. Legen Sie die Schienen in das Gefäß. Legen Sie Dias in Mikrowelle. </li><li> Kochen für 20 min bei hoher Leistung. Überwachen Sie die Flüssigkeitsspiegel für die Verdunstung und füllen Sie mit destilliertem Wasser nach Bedarf. </li></ol></li><li> Proben in 1 Stunde bei Raumtemperatur abkühlen lassen. </li></ol> 3. Chromogene Immunhistochemie <ol><li> Umrisse Gewebeprobe mit einem hydrophoben Stift, um das Volumen der Reagenzien zu minimieren, die notwendig sind, um die Probe zu bedecken. HINWEIS: Seien Sie sicher, dass die Gewebeproben hydratisiert werden und lassen Sie sie nicht austrocknen, da dies die Verfärbungswirkung beeinträchtigen wird. </li><li> Pipet genug Permeabilisierungslösung (Tris-gepufferte Kochsalzlösung (TBS) + 0,01% Triton-X) zur Deckung der Gewebeprobe (typischerweise etwa 100 - 200 μl). </li><li> Entfernen und verwerfen Sie die Lösung und wiederholen Sie Schritt 3.2. </li><li> Inkubieren von Proben bei Raumtemperatur mit Blockierungslösung (2,5% Pferdeserum + Permeabilisierungslösung). </li><li> Inkubieren Sie Proben über Nacht in 4 ºC mit primären Antikörpern verdünntIn Blockierlösung HINWEIS: Alle hier verwendeten Primärantikörper werden bei 1: 200 verdünnt, aber optimale Verdünnungen können mit seriellen Verdünnungen beginnend mit Herstellerempfehlung bestimmt werden. Detaillierte Informationen zu den in diesem Protokoll verwendeten Antikörpern wurden zuvor veröffentlicht 11 . </li><li> Detektion von primären Antikörpern unter Verwendung eines Meerrettich-Peroxidase-Polymerreagenzes, das dem primären Antikörper-Wirtstier entspricht, nach dem Herstellerprotokoll. </li><li> Pipet genug Permeabilisierungslösung zur Deckung der Gewebeprobe und inkubieren für 5 min. </li><li> Entfernen und entwerfen Lösung und wiederholen Sie Schritt 3.7. </li><li> Inkubieren von Objektträgern in 0,3% H 2 O 2 in 1x TBS für 15 min. </li><li> Entwickeln Sie Proben mit einem Peroxidase-Diaminobenzidin (DAB) -Substrat für 2 - 10 min, bis die gewünschte Fleckenintensität erreicht ist. </li><li> Gegenstichproben zur Identifizierung von Zellkernen, wie z. B. mit Hämatoxylin, nach Herstellerprotokoll. </li><li> Proben mit 100%Ethanol und Xylol. </li><li> Befestigen Sie die Proben dauerhaft mit dem Montagemedium. </li></ol> 4. Zinsanweisungen <ol><li> Bild-Dias unter Hellfeld-Mikroskopie in der Lage, hochauflösende Bilder. HINWEIS: Verwenden Sie bildgebende zellulare Komponenten mit einer Auflösung von mindestens 20x. </li><li> Bewegen Sie die Kamera zu bestimmten Regionen von Interesse in Gewebeproben. </li><li> Bilder als TIFF-Dateien zur Quantifizierung speichern </li></ol> 5. Bildanalyse <ol><li> Öffnen Sie Bilder in ImageJ für die Quantifizierung der prozentualen Abdeckung. </li><li> Verwenden Sie das Threshold Color Plugin, um die lila Farbe von Hämatoxylin-gefärbten Kernen zu entfernen. </li><li> Bild in 8-Bit umwandeln. </li><li> Schwellenwert ohne dunklen Hintergrund hinzufügen. </li><li> Prozessbild unter Verwendung eines der 17 vorgespannten ImageJ-Schwellenfilter ( dh MaxEntropy), so dass nur DAB-gefärbte Teile in der Schwelle enthalten sind. HINWEIS: Wählen Sie den optimierten vorgespannten Schwellenfilter, der minimiertEs Einbeziehung der Hintergrundfärbung. Dies kann von der Qualität der Färbung und Spezifität des Antikörpers abhängen. Verwenden Sie die gleiche Schwelle für alle technischen Replikate innerhalb jeder Patientenprobe. </li><li> Schwellenwert anwenden </li><li> Messen Sie den prozentualen Bereich des Schwellenwertes. </li><li> Durchschnittliche prozentuale Flächendeckung für mehrere Regionen innerhalb jeder Probe. </li></ol>

<ol>
	<li>Claes, A., Idema, A. J., Wesseling, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffuse+glioma+growth:+a+guerilla+war.">Diffuse glioma growth: a guerilla war.</a> Acta Neuropathol. 114 (5), 443-458 (2007).</li><li>Holland, E. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glioblastoma+multiforme:+the+terminator.">Glioblastoma multiforme: the terminator.</a> Proc. Natl. Acad. Sci. U. S. A. 97 (12), 6242-6244 (2000).</li><li>Wild-Bode, C., Weller, M., Rimner, A., Dichgans, J., Wick, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sublethal+Irradiation+Promotes+Migration+and+Invasiveness+of+Glioma+Cells.">Sublethal Irradiation Promotes Migration and Invasiveness of Glioma Cells.</a> Cancer Res. 61 (6), (2001).</li><li>Tuettenberg, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recurrence+pattern+in+glioblastoma+multiforme+patients+treated+with+anti-angiogenic+chemotherapy.">Recurrence pattern in glioblastoma multiforme patients treated with anti-angiogenic chemotherapy.</a> J. Cancer Res. Clin. Oncol. 135 (9), 1239-1244 (2009).</li><li>Munson, J. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-invasive+adjuvant+therapy+with+imipramine+blue+enhances+chemotherapeutic+efficacy+against+glioma.">Anti-invasive adjuvant therapy with imipramine blue enhances chemotherapeutic efficacy against glioma.</a> Sci. Transl. Med. 4 (127), 127ra36 (2012).</li><li>Correia, A. L., Bissell, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+tumor+microenvironment+is+a+dominant+force+in+multidrug+resistance.">The tumor microenvironment is a dominant force in multidrug resistance.</a> Drug Resist. Updat. 15 (1-2), 39-49 (2012).</li><li>Rubin, J. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Only+in+congenial+soil:+the+microenvironment+in+brain+tumorigenesis.">Only in congenial soil: the microenvironment in brain tumorigenesis.</a> Brain Pathol. 19 (1), 144-149 (2009).</li><li>Bettinger, I., Thanos, S., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microglia+promote+glioma+migration.">Microglia promote glioma migration.</a> Acta Neuropathol. 103 (4), 351-355 (2002).</li><li>Le, D. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exploitation+of+astrocytes+by+glioma+cells+to+facilitate+invasiveness:+a+mechanism+involving+matrix+metalloproteinase-2+and+the+urokinase-type+plasminogen+activator-plasmin+cascade.">Exploitation of astrocytes by glioma cells to facilitate invasiveness: a mechanism involving matrix metalloproteinase-2 and the urokinase-type plasminogen activator-plasmin cascade.</a> J. Neurosci. 23 (10), 4034-4043 (2003).</li><li>Ye, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumor-associated+microglia/macrophages+enhance+the+invasion+of+glioma+stem-like+cells+via+TGF-&#946;1+signaling+pathway.">Tumor-associated microglia/macrophages enhance the invasion of glioma stem-like cells via TGF-&#946;1 signaling pathway.</a> J. Immunol. 189, 444-453 (2012).</li><li>Yuan, J. X., Bafakih, F. F., Mandell, J. W., Horton, B. J., Munson, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+Analysis+of+the+Cellular+Microenvironment+of+Glioblastoma+to+Develop+Predictive+Statistical+Models+of+Overall+Survival.">Quantitative Analysis of the Cellular Microenvironment of Glioblastoma to Develop Predictive Statistical Models of Overall Survival.</a> J. Neuropathol. Exp. Neurol. , (2016).</li><li>Yuan, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+Image+Analysis+of+Cellular+Heterogeneity+in+Breast+Tumors+Complements+Genomic+Profiling.">Quantitative Image Analysis of Cellular Heterogeneity in Breast Tumors Complements Genomic Profiling.</a> Sci. Transl. Med. 4 (157), (2012).</li><li>Yi, E. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Distribution+of+Obstructive+Intimal+Lesions+and+Their+Cellular+Phenotypes+in+Chronic+Pulmonary+Hypertension.">Distribution of Obstructive Intimal Lesions and Their Cellular Phenotypes in Chronic Pulmonary Hypertension.</a> Am. J. Respir. Crit. Care Med. 162 (4), 1577-1586 (2000).</li><li>Turcan, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IDH1+mutation+is+sufficient+to+establish+the+glioma+hypermethylator+phenotype.">IDH1 mutation is sufficient to establish the glioma hypermethylator phenotype.</a> Nature. 483 (7390), 479-483 (2012).</li><li>Songtao, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IDH+mutations+predict+longer+survival+and+response+to+temozolomide+in+secondary+glioblastoma.">IDH mutations predict longer survival and response to temozolomide in secondary glioblastoma.</a> Cancer Sci. 103 (2), 269-273 (2012).</li><li>Shinojima, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prognostic+Value+of+Epidermal+Growth+Factor+Receptor+in+Patients+with+Glioblastoma+Multiforme.">Prognostic Value of Epidermal Growth Factor Receptor in Patients with Glioblastoma Multiforme.</a> Cancer Res. 63, 6962-6970 (2003).</li><li>Karpel-Massler, G., Schmidt, U., Unterberg, A., Halatsch, M. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Therapeutic+inhibition+of+the+epidermal+growth+factor+receptor+in+high-grade+gliomas:+where+do+we+stand?.">Therapeutic inhibition of the epidermal growth factor receptor in high-grade gliomas: where do we stand?.</a> Mol. Cancer Res. 7 (7), 1000-1012 (2009).</li><li>Badie, B., Schartner, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+microglia+in+glioma+biology.">Role of microglia in glioma biology.</a> Microsc. Res. Tech. 54 (2), 106-113 (2001).</li><li>Watters, J. J., Schartner, J. M., Badie, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microglia+function+in+brain+tumors.">Microglia function in brain tumors.</a> J. Neurosci. Res. 81 (3), 447-455 (2005).</li><li>Alves, T. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glioblastoma+cells:+A+heterogeneous+and+fatal+tumor+interacting+with+the+parenchyma.">Glioblastoma cells: A heterogeneous and fatal tumor interacting with the parenchyma.</a> Life Sci. 89 (15), 532-539 (2011).</li><li>Hambardzumyan, D., Gutmann, D. H., Kettenmann, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+microglia+and+macrophages+in+glioma+maintenance+and+progression.">The role of microglia and macrophages in glioma maintenance and progression.</a> Nat. Neurosci. 19 (1), 20-27 (2015).</li><li>Zhai, H., Heppner, F. L., Tsirka, S. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microglia/macrophages+promote+glioma+progression.">Microglia/macrophages promote glioma progression.</a> Glia. 59 (3), 472-485 (2011).</li><li>Placone, A. L., Qui&#241;ones-Hinojosa, A., Searson, P. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+astrocytes+in+the+progression+of+brain+cancer:+complicating+the+picture+of+the+tumor+microenvironment.">The role of astrocytes in the progression of brain cancer: complicating the picture of the tumor microenvironment.</a> Tumor Biol. 37 (1), 61-69 (2016).</li><li>Rath, B. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Astrocytes+Enhance+the+Invasion+Potential+of+Glioblastoma+Stem-Like+Cells.">Astrocytes Enhance the Invasion Potential of Glioblastoma Stem-Like Cells.</a> PLoS One. 8 (1), e54752 (2013).</li></ol>

Unsere hier vorgeschlagene Methode ist ein quantitativer Ansatz zur Analyse von histologischen Proben, die mit der traditionellen chromogenen Immunhistochemie gefärbt wurden. Die aktuelle Methodik für diese Art von Analyse umfasst ähnliche Färbeprotokolle, gefolgt von der Einstufung durch unabhängige Pathologen. Diese Methode ist zuverlässig, aber für eine Reihe von Anwendungen ist ein präziseres Verständnis der zellulären Make-up erforderlich, wie ein besseres Verständnis der Heterogenität im Zusammenhang m...

Glioblastom (GBM), der häufigste und bösartige Hirntumor, zeichnet sich durch eine stark diffuse Invasion aus der primären Tumormasse in das umgebende gesunde Gehirnparenchym 1 , 2 aus . Diese diffuse Invasion macht den Tumor besonders schwierig, vollständig zu resezieren, und die eindringenden Krebszellen, die nach der Therapie bleiben, ist der häufigste Grund für unvermeidliches Rezidiv 2 , 3 , 4 . Bisher fanden wir die diffuse Gliom Zellinvasion Hemmung therapeutisch vorteilhaft 5, wird jedoch wenig über die komplexen Mechanismen bekannt ist GBM Invasion beitragen. Die Tumor-Mikroumgebung oder das Gewebe, das den Krebs umgibt, wurde in die Progression von Tumoren in mehreren Krebsarten 6 , 7 verwickelt. Die Glioblastom-Tumor-Mikroumgebung, in pArtikulär, ist relativ unter- charakterisiert und ist eindeutig komplex und komponiert mehrere Gliazellen wie Astrozyten, Mikroglia und Oligodendrozyten sowie extrazelluläre Matrix, lösliche Faktoren und biophysikalische Faktoren. Experimentell wurde gezeigt, dass Astrozyten und Mikroglia die Gliomprogression und Invasion 8 , 9 , 10 erhöhen, aber die Zusammensetzung aller Gliazellen in der nativen menschlichen Gehirnmikroumgebung ist unbekannt. Wir haben zuvor gezeigt, dass mikroumweltliche Komponenten das Überleben des Patienten durch quantitative Analyse der zellulären Komponenten der Glioblastom-Mikroumgebung vorhersagen und unsere Analysen in ein proportionales Gefahrenmodell 11 einbinden können. Hier beschreiben wir die quantitative Analyse Methode zur Identifizierung der Populationen von Gliazellen innerhalb der Tumor-Masse und angrenzenden Regionen der Tumor-Resektionen von Glioblastom-PatientenS. Wir verwendeten die chromogene Immunhistochemie, um die Gliazellpopulationen und ImageJ zu identifizieren, um die prozentuale Abdeckung der Färbung für jede Gliapopulation zu analysieren. Die Beurteilung der prozentualen Abdeckung schafft eine einfache Messung zur Bestimmung der morphologischen Unterschiede der Zellen, insbesondere derjenigen, die durch Wechselwirkungen mit Krebszellen betroffen sind. Frühere Studien zur Quantifizierung der histopathologischen Färbung verwenden Standardfärbung wie Hämatoxylin und Eosin 12 oder Masson&#39;s Trichrom 13 , die nicht die Spezifität der Antikörper-basierten Immunhistochemie-Färbung nutzen. Unsere Methode wurde entwickelt, um die Gliapopulationen innerhalb der Glioblastom-Patienten-Tumor-Resektionen direkt zu quantifizieren, die wir zur Aufklärung der komplexen Glioblastom-Mikroumgebung anstreben.

<table border="0" cellpadding="0" cellspacing="0" width="573">
	<tbody>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Xylene</td>
			<td style="width:71px;">Fisher Chemical</td>
			<td style="width:119px;">X3P</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Ethanol</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">High pH antigen unmasking solution</td>
			<td style="width:71px;">Vector Labs</td>
			<td>H-3301</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">TBS</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Triton-X</td>
			<td style="width:71px;">Amresco</td>
			<td style="width:119px;">9002-93-1</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Horse serum</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Anti-ALDH1L1&#160;</td>
			<td style="width:71px;">abcam&#160;</td>
			<td style="width:119px;">ab56777</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Anti-Iba1&#160;</td>
			<td style="width:71px;">abcam&#160;</td>
			<td style="width:119px;">ab5076</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Anti-Oligodendrocyte Specific Protein1&#160;</td>
			<td style="width:71px;">abcam&#160;</td>
			<td style="width:119px;">ab53041</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">ImmPRESS anti-goat</td>
			<td style="width:71px;">Vector Labs</td>
			<td style="width:119px;">MP-7405</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">ImmPRESS Universal (anti-mouse/rabbit)</td>
			<td style="width:71px;">Vector Labs</td>
			<td style="width:119px;">MP-7500</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Hydrogen peroxide</td>
			<td style="width:71px;">Sigma Aldrich</td>
			<td style="width:119px;">216763</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">ImmPACT DAB substrate</td>
			<td style="width:71px;">Vector Labs</td>
			<td style="width:119px;">SK-4105</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Hematoxylin counterstain</td>
			<td style="width:71px;">ThermoScientific</td>
			<td style="width:119px;">72404</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Histochoice Mounting Media</td>
			<td style="width:71px;">Amresco</td>
			<td style="width:119px;">H157-475</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Aperio Scanscope</td>
			<td style="width:71px;">Leica Biosystems</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Image Scanscope</td>
			<td style="width:71px;">Leica Biosystems</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="84">
			<td height="84" style="height:84px;width:216px;">Super HT PAP Pen</td>
			<td style="width:71px;">Research Products International</td>
			<td style="width:119px;">195506</td>
			<td></td>
		</tr>
	</tbody>
</table>

quantitative immunohistochemistry of the cellular microenvironment in patient glioblastoma resections

Mit dem wachsenden Interesse an der Tumor-Mikroumgebung haben wir uns bemüht, eine Methode zur spezifischen Bestimmung der Mikroumgebungskomponenten innerhalb von Patientenproben von Glioblastom, dem tödlichsten und am meisten invasiven Hirntumor, zu entwickeln. Es sind nicht nur quantitative Methoden, die für die genaue Beschreibung von erkrankten Geweben von Vorteil sind, sondern auch potenziell zu einer genaueren Prognose, Diagnose und Entwicklung von gewebetechnischen Systemen und Ersetzungen beitragen. Im Glioblastom wurden Gliazellen, wie Mikroglia und Astrozyten, unabhängig mit einer schlechten Prognose auf der Grundlage der Pathologieabstufung korreliert. Der Zustand dieser Zellen und anderer Gliazellenkomponenten ist jedoch nicht quantitativ gut beschrieben worden. Dies kann aufgrund der großen Prozesse, die diese Gliazellen markieren, schwierig sein. Darüber hinaus konzentrieren sich die meisten histologischen Analysen auf die gesamte Gewebeprobe oder nur innerhalb der Masse des Tumors, im Gegensatz zu der Abgrenzung von Quantifizierungen, die auf Regionen basierenHin das sehr heterogene Gewebe. Hier beschreiben wir eine Methode zur Identifizierung und quantitativen Analyse der Populationen von Gliazellen innerhalb der Tumormasse und angrenzenden Regionen der Tumorresektionen von Glioblastompatienten. Wir verwendeten die chromogene Immunhistochemie, um die Gliazellpopulationen bei Patienten-Tumor-Resektionen und ImageJ zu identifizieren, um die prozentuale Abdeckung der Färbung für jede Glia-Population zu analysieren. Mit diesen Techniken sind wir in der Lage, die Gliazellen in allen Regionen der Gliom-Tumor-Mikroumgebung besser zu beschreiben.

Für diese Analyse wurden zwei Interessenbereiche innerhalb unserer Tumorresektionen - die primäre Tumormasse und die angrenzenden Regionen, die in erster Linie aus gesundem Gewebe mit diffus eindringenden Krebszellen zusammengesetzt waren ( Abbildung 1A , 1B ) - durch die Zusammenarbeit von Neuropathologen an Hämatoxylin- und Eosin-gefärbten Patienten identifiziert Proben. Innerhalb jeder Patientenprobe wurde eine positive Färbung für ...

Watch this Scientific Journal Video about Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections at JoVE.com

Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections

Quantitative Immunhistochemie der zellulären Mikroumgebung bei Patienten-Glioblastom-Resektionen

Dieses Protokoll wurde entwickelt, um Tumor-Mikroumgebungs-Komponenten in Glioblastom-Patienten-Resektionen mit chromogener Immunhistochemie und ImageJ quantitativ zu identifizieren.

With the growing interest in the tumor microenvironment, we set out to develop a method to specifically determine the microenvironment components within ...

quantitative-immunohistochemistry-cellular-microenvironment-patient

Research

JoVE Journal

Medicine

9.6K Aufrufe.  University of Virginia.  Dieses Protokoll wurde entwickelt, um Tumor-Mikroumgebungs-Komponenten in Glioblastom-Patienten-Resektionen mit chromogener Immunhistochemie und ImageJ quantitativ zu identifizieren. 

Serie: Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections

Quantitative Visualization and Detection of Skin Cancer Using Dynamic Thermal Imaging

In 2010 approximately 68,720 melanomas will be diagnosed in the US alone, with around 8,650 resulting in death 1. To date, the only effective treatment for melanoma remains surgical excision, therefore, the key to extended survival is early detection 2,3. Considering the large numbers of patients diagnosed every year and the limitations in accessing specialized care quickly, the development of objective in vivo diagnostic instruments to aid the diagnosis is essential. New techniques to detect skin cancer, especially non-invasive diagnostic tools, are being explored in numerous laboratories. Along with the surgical methods, techniques such as digital photography, dermoscopy, multispectral imaging systems (MelaFind), laser-based systems (confocal scanning laser microscopy, laser doppler perfusion imaging, optical coherence tomography), ultrasound, magnetic resonance imaging, are being tested. Each technique offers unique advantages and disadvantages, many of which pose a compromise between effectiveness and accuracy versus ease of use and cost considerations. Details about these techniques and comparisons are available in the literature 4.
Infrared (IR) imaging was shown to be a useful method to diagnose the signs of certain diseases by measuring the local skin temperature. There is a large body of evidence showing that disease or deviation from normal functioning are accompanied by changes of the temperature of the body, which again affect the temperature of the skin 5,6. Accurate data about the temperature of the human body and skin can provide a wealth of information on the processes responsible for heat generation and thermoregulation, in particular the deviation from normal conditions, often caused by disease. However, IR imaging has not been widely recognized in medicine due to the premature use of the technology 7,8 several decades ago, when temperature measurement accuracy and the spatial resolution were inadequate and sophisticated image processing tools were unavailable. This situation changed dramatically in the late 1990s-2000s. Advances in IR instrumentation, implementation of digital image processing algorithms and dynamic IR imaging, which enables scientists to analyze not only the spatial, but also the temporal thermal behavior of the skin 9, allowed breakthroughs in the field.
In our research, we explore the feasibility of IR imaging, combined with theoretical and experimental studies, as a cost effective, non-invasive, in vivo optical measurement technique for tumor detection, with emphasis on the screening and early detection of melanoma 10-13. In this study, we show data obtained in a patient study in which patients that possess a pigmented lesion with a clinical indication for biopsy are selected for imaging. We compared the difference in thermal responses between healthy and malignant tissue and compared our data with biopsy results. We concluded that the increased metabolic activity of the melanoma lesion can be detected by dynamic infrared imaging.

We demonstrated that malignant pigmented lesions with increased metabolic activity generate quantifiable amounts of heat and the measurement of the transient thermal response of the skin to a cooling excitation allows quantitative identification of melanoma and other skin cancers (vs. non-proliferative nevi) at an early stage of the disease.

Quantitative Visualisierung und Erkennung von Hautkrebs mit Dynamic Thermal Imaging

In 2010 approximately 68,720 melanomas will be diagnosed in the US alone, with around 8,650 resulting in death 1. To date, the only effective treatment ...

Forschung

Medizin

Identification and Isolation of Slow-Dividing Cells in Human Glioblastoma Using Carboxy Fluorescein Succinimidyl Ester (CFSE)

Tumor heterogeneity represents a fundamental feature supporting tumor robustness and presents a central obstacle to the development of therapeutic strategies1. To overcome the issue of tumor heterogeneity, it is essential to develop assays and tools enabling phenotypic, (epi)genetic and functional identification and characterization of tumor subpopulations that drive specific disease pathologies and represent clinically relevant targets. It is now well established that tumors exhibit distinct sub-fractions of cells with different frequencies of cell division, and that the functional criteria of being slow cycling is positively associated with tumor formation ability in several cancers including those of the brain, breast, skin and pancreas as well as leukemia2-8. The fluorescent dye carboxyfluorescein succinimidyl ester (CFSE) has been used for tracking the division frequency of cells in vitro and in vivo in blood-borne tumors and solid tumors such as glioblastoma2,7,8. The cell-permeant non-fluorescent pro-drug of CFSE is converted by intracellular esterases into a fluorescent compound, which is retained within cells by covalently binding to proteins through reaction of its succinimidyl moiety with intracellular amine groups to form stable amide bonds9. The fluorescent dye is equally distributed between daughter cells upon divisions, leading to the halving of the fluorescence intensity with every cell division. This enables tracking of cell cycle frequency up to eight to ten rounds of division10. CFSE retention capacity was used with brain tumor cells to identify and isolate a slow cycling subpopulation (top 5% dye-retaining cells) demonstrated to be enriched in cancer stem cell activity2. 
This protocol describes the technique of staining cells with CFSE and the isolation of individual populations within a culture of human glioblastoma (GBM)-derived cells possessing differing division rates using flow cytometry2. The technique has served to identify and isolate a brain tumor slow-cycling population of cells by virtue of their ability to retain the CFSE labeling.

Identification and Isolation of Slow-Dividing Cells in Human Glioblastoma Using Carboxy Fluorescein Succinimidyl Ester CFSE

This video protocol demonstrates the application of the fluorescent dye carboxyfluorescein succinimidyl ester (CFSE) for the identification and separation of different sub-populations of cells in human glioblastoma based on frequency of cell division.

Identifizierung und Isolierung von Slow-teilenden Zellen im menschlichen Glioblastoma Mit Carboxyfluorescein Succinimidyl Ester (CFSE)

Tumor heterogeneity represents a fundamental feature supporting tumor robustness and presents a central obstacle to the development of therapeutic ...

Live Imaging of Drug Responses in the Tumor Microenvironment in Mouse Models of Breast Cancer

The tumor microenvironment plays a pivotal role in tumor initiation, progression, metastasis, and the response to anti-cancer therapies. Three-dimensional co-culture systems are frequently used to explicate tumor-stroma interactions, including their role in drug responses. However, many of the interactions that occur in vivo in the intact microenvironment cannot be completely replicated in these in vitro settings. Thus, direct visualization of these processes in real-time has become an important tool in understanding tumor responses to therapies and identifying the interactions between cancer cells and the stroma that can influence these responses. Here we provide a method for using spinning disk confocal microscopy of live, anesthetized mice to directly observe drug distribution, cancer cell responses and changes in tumor-stroma interactions following administration of systemic therapy in breast cancer models. We describe procedures for labeling different tumor components, treatment of animals for observing therapeutic responses, and the surgical procedure for exposing tumor tissues for imaging up to 40 hours. The results obtained from this protocol are time-lapse movies, in which such processes as drug infiltration, cancer cell death and stromal cell migration can be evaluated using image analysis software.

We describe a method for imaging response to anti-cancer treatment in vivo and at single cell resolution.

Live-Imaging of Drug Responses in der Tumor-Mikroumgebung in Mausmodellen von Brustkrebs

The tumor microenvironment plays a pivotal role in tumor initiation, progression, metastasis, and the response to anti-cancer therapies. Three-dimensional ...

Cell-based Assay Protocol for the Prognostic Prediction of Idiopathic Scoliosis Using Cellular Dielectric Spectroscopy

This protocol details the experimental and analytical procedure for a cell-based assay developed in our laboratory as a functional test to predict the prognosis of idiopathic scoliosis in asymptomatic and affected children. The assay consists of the evaluation of the functional status of Gi and Gs proteins in peripheral blood mononuclear cells (PBMCs) by cellular dielectric spectroscopy (CDS), using an automated CDS-based instrument, and the classification of children into three functional groups (FG1, FG2, FG3) with respect to the profile of imbalance between the degree of response to Gi and Gs proteins stimulation. The classification is further confirmed by the differential effect of osteopontin (OPN) on response to Gi stimulation among groups and the severe progression of disease is referenced by FG2. Approximately, a volume of 10 ml of blood is required to extract PBMCs by Ficoll-gradient and cells are then stored in liquid nitrogen. The adequate number of PBMCs to perform the assay is obtained after two days of cell culture. Essentially, cells are first incubated with phytohemmaglutinin (PHA). After 24 hr incubation, medium is replaced by a PHA-free culture medium for an additional 24 hr prior to cell seeding and OPN treatment. Cells are then spectroscopically screened for their responses to somatostatin and isoproterenol, which respectively activate Gi and Gs proteins through their cognate receptors. Both somatostatin and isoproterenol are simultaneously injected with an integrated fluidics system and the cells&#39; responses are monitored for 15 min. The assay can be performed with fresh or frozen PBMCs and the procedure is completed within 4 days.

A structured protocol is presented for a cell-based assay as a functional test to predict the prognosis of idiopathic scoliosis using cellular dielectric spectroscopy (CDS). The assay can be performed with fresh or frozen peripheral blood mononuclear cells (PBMCs) and the procedure is completed within 4 days.

Zellbasierte Assay-Protokoll für die prognostische Prognose der idiopathischen Skoliose Mit Cellular dielektrischer Spektroskopie

This protocol details the experimental and analytical procedure for a cell-based assay developed in our laboratory as a functional test to predict the ...

Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma

A novel device that employs TTF therapy has recently been developed and is currently in use for the treatment of recurrent glioblastoma (rGBM). It was FDA approved in April 2011 for the treatment of patients 22 years or older with rGBM. The device delivers alternating electric fields and is programmed to ensure maximal tumor cell kill1.
Glioblastoma is the most common type of glioma and has an estimated incidence of approximately 10,000 new cases per year in the United States alone2. This tumor is particularly resistant to treatment and is uniformly fatal especially in the recurrent setting3-5. Prior to the approval of the TTF System, the only FDA approved treatment for rGBM was bevacizumab6. Bevacizumab is a humanized monoclonal antibody targeted against the vascular endothelial growth factor (VEGF) protein that drives tumor angiogenesis7. By blocking the VEGF pathway, bevacizumab can result in a significant radiographic response (pseudoresponse), improve progression free survival and reduce corticosteroid requirements in rGBM patients8,9. Bevacizumab however failed to prolong overall survival in a recent phase III trial26. A pivotal phase III trial (EF-11) demonstrated comparable overall survival between physicians&#8217; choice chemotherapy and TTF Therapy but better quality of life were observed in the TTF arm10.
There is currently an unmet need to develop novel approaches designed to prolong overall survival and/or improve quality of life in this unfortunate patient population. One appealing approach would be to combine the two currently approved treatment modalities namely bevacizumab and TTF Therapy. These two treatments are currently approved as monotherapy11,12, but their combination has never been evaluated in a clinical trial. We have developed an approach for combining those two treatment modalities and treated 2 rGBM patients. Here we describe a detailed methodology outlining this novel treatment protocol and present representative data from one of the treated patients.

A novel methodology that is employed for the treatment of recurrent glioblastomas is described. This treatment approach employs the application of alternating electric tumor treating fields (TTFields), known as TTF Therapy in combination with bevacizumab, a targeted agent that is currently FDA approved as monotherapy.

Tumor Behandlung Feldtherapie in Kombination mit Bevacizumab für die Behandlung von rezidivierendem Glioblastom

A novel device that employs TTF therapy has recently been developed and is currently in use for the treatment of recurrent glioblastoma (rGBM). It was FDA ...

A "Patient-Like" Orthotopic Syngeneic Mouse Model of Hepatocellular Carcinoma Metastasis

The majority of cancer-related deaths are caused by the metastasis of the cancer rather than the primary tumor itself. Yet, the underlying mechanisms of cancer metastasis are still unclear. Animal models are essential for elucidating the mechanisms and for evaluating novel strategies for the treatment of metastatic cancers. Here, an in-depth description of a &#8220;patient-like&#8221; orthotopic syngeneic mouse model for exploring the mechanisms of metastasis of solid organ tumors is provided. The survival surgical implantation of BNL 1ME A.7R.1 mouse hepatocellular carcinoma cells directly into the liver (the organ of origin) of the inbred wild-type immune competent laboratory mouse strain, BALB/c is described. The success and reproducibility of this methodology recommends it for widespread use in elucidating the biological mechanisms of solid organ cancer metastasis.

The metastatic spread of cancer is the major cause of cancer-related deaths. We provide an in-depth description of our survival surgery methodology for establishing a &#8220;patient-like&#8221; orthotopic syngeneic mouse model system for studying the mechanisms of metastasis in solid organ tumors.

Ein &quot;Patient-Like&quot; Orthotope Syngene Maus-Modell der Leberzellkarzinom Metastasen

The majority of cancer-related deaths are caused by the metastasis of the cancer rather than the primary tumor itself. Yet, the underlying mechanisms of ...

A Human Glioblastoma Organotypic Slice Culture Model for Study of Tumor Cell Migration and Patient-specific Effects of Anti-Invasive Drugs

Glioblastoma (GBM) continues to carry an extremely poor clinical prognosis despite surgical, chemotherapeutic, and radiation therapy. Progressive tumor invasion into surrounding brain parenchyma represents an enduring therapeutic challenge. To develop anti-migration therapies for GBM, model systems that provide a physiologically relevant background for controlled experimentation are essential. Here, we present a protocol for generating slice cultures from human GBM tissue obtained during surgical resection. These cultures allow for ex vivo experimentation without passaging through animal xenografts or single cell cultures. Further, we describe the use of time-lapse laser scanning confocal microscopy in conjunction with cell tracking to quantitatively study the migratory behavior of tumor cells and associated response to therapeutics. Slices are reproducibly generated within 90 min of surgical tissue acquisition. Retrovirally-mediated fluorescent cell labeling, confocal imaging, and tumor cell migration analyses are subsequently completed within two weeks of culture. We have successfully used these slice cultures to uncover genetic factors associated with increased migratory behavior in human GBM. Further, we have validated the model&#39;s ability to detect patient-specific variation in response to anti-migration therapies. Moving forward, human GBM slice cultures are an attractive platform for rapid ex vivo assessment of tumor sensitivity to therapeutic agents, in order to advance personalized neuro-oncologic therapy.

Current ex vivo models of glioblastoma (GBM) are not optimized for physiologically relevant study of human tumor invasion. Here, we present a protocol for generation and maintenance of organotypic slice cultures from fresh human GBM tissue. A description of time-lapse microscopy and quantitative cell migration analysis techniques is provided.

Ein menschliches Glioblastom Organotypisches Scheibenkulturmodell zur Untersuchung der Tumorzellmigration und patientenspezifischen Wirkungen von antiinvasiven Arzneimitteln

Glioblastoma (GBM) continues to carry an extremely poor clinical prognosis despite surgical, chemotherapeutic, and radiation therapy. Progressive tumor ...

Generation of Microtumors Using 3D Human Biogel Culture System and Patient-derived Glioblastoma Cells for Kinomic Profiling and Drug Response Testing

The use of patient-derived xenografts for modeling cancers has provided important insight into cancer biology and drug responsiveness. However, they are time consuming, expensive, and labor intensive. To overcome these obstacles, many research groups have turned to spheroid cultures of cancer cells. While useful, tumor spheroids or aggregates do not replicate cell-matrix interactions as found in vivo. As such, three-dimensional (3D) culture approaches utilizing an extracellular matrix scaffold provide a more realistic model system for investigation. Starting from subcutaneous or intracranial xenografts, tumor tissue is dissociated into a single cell suspension akin to cancer stem cell neurospheres. These cells are then embedded into a human-derived extracellular matrix, 3D human biogel, to generate a large number of microtumors. Interestingly, microtumors can be cultured for about a month with high viability and can be used for drug response testing using standard cytotoxicity assays such as 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and live cell imaging using Calcein-AM. Moreover, they can be analyzed via immunohistochemistry or harvested for molecular profiling, such as array-based high-throughput kinomic profiling, which is detailed here as well. 3D microtumors, thus, represent a versatile high-throughput model system that can more closely replicate in vivo tumor biology than traditional approaches.

Patient-derived xenografts of glioblastoma multiforme can be miniaturized into living microtumors using 3D human biogel culture system. This in vivo-like 3D tumor assay is suitable for drug response testing and molecular profiling, including kinomic analysis.

Die Erzeugung von Microtumors Mit 3D Human Biogel Kultursystem und Patienten stammGlioblastomZellen für Kinomic Profilieren and Drug Response-Testing

The use of patient-derived xenografts for modeling cancers has provided important insight into cancer biology and drug responsiveness. However, they are ...

Extended Time-lapse Intravital Imaging of Real-time Multicellular Dynamics in the Tumor Microenvironment

In the tumor microenvironment, host stromal cells interact with tumor cells to promote tumor progression, angiogenesis, tumor cell dissemination and metastasis. Multicellular interactions in the tumor microenvironment can lead to transient events including directional tumor cell motility and vascular permeability. Quantification of tumor vascular permeability has frequently used end-point experiments to measure extravasation of vascular dyes. However, due to the transient nature of multicellular interactions and vascular permeability, the kinetics of these dynamic events cannot be discerned. By labeling cells and vasculature with injectable dyes or fluorescent proteins, high-resolution time-lapse intravital microscopy has allowed the direct, real-time visualization of transient events in the tumor microenvironment. Here we describe a method for using multiphoton microscopy to perform extended intravital imaging in live mice to directly visualize multicellular dynamics in the tumor microenvironment. This method details cellular labeling strategies, the surgical preparation of a mammary skin flap, the administration of injectable dyes or proteins by tail vein catheter and the acquisition of time-lapse images. The time-lapse sequences obtained from this method facilitate the visualization and quantitation of the kinetics of cellular events of motility and vascular permeability in the tumor microenvironment.

This protocol describes the use of multiphoton microscopy to perform extended time-lapse imaging of multicellular interactions in real time, in vivo at single cell resolution.

Erweiterte Zeitraffer-Intravital Imaging von Echtzeit-Vielzellige Dynamics im Tumormikromilieu

In the tumor microenvironment, host stromal cells interact with tumor cells to promote tumor progression, angiogenesis, tumor cell dissemination and ...

Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain

Imaging techniques that reflect dynamic bone turnover may aid in characterizing a wide range of bone pathologies. Bone is a dynamic tissue undergoing continuous remodeling with the competing activity of osteoblasts, which produce the new bone matrix, and osteoclasts, whose function is to eliminate mineralized bone. [18F]-NaF is a positron emission tomography (PET) radiotracer that enables visualization of bone metabolism. [18F]-NaF is chemically absorbed into hydroxyapatite in the bone matrix by osteoblasts and can thus noninvasively detect osteoblastic activity, which is occult to conventional imaging techniques. Kinetic modeling of dynamic [18F]-NaF-PET data provides detailed quantitative measures of bone metabolism. Conventional semi-quantitative PET data, which utilizes standardized uptake values (SUVs) as a measure of radiotracer activity, is referred to as a static technique due to its snapshot of tracer uptake in time.&#160; Kinetic modeling, however, utilizes dynamic image data where tracer levels are continuously acquired providing tracer uptake temporal resolution. From the kinetic modeling of dynamic data, quantitative values like blood flow and metabolic rate (i.e., potentially informative metrics of tracer dynamics) can be extracted, all with respect to the measured activity in the image data. When combined with dual modality PET-MRI, region-specific kinetic data can be correlated with anatomically registered high-resolution structural and pathologic information afforded by MRI. The goal of this methodological manuscript is to outline detailed techniques for performing and analyzing dynamic [18F]-NaF-PET-MRI data. The lumbar facet joint is a common site of degenerative arthritis disease and a common cause for axial low back pain.&#160; Recent studies suggest [18F]-NaF-PET may serve as a useful biomarker of painful facetogenic disease.&#160; The human lumbar facet joint will, therefore, be used as a prototypical region of interest for dynamic [18F]-NaF-PET-MRI analysis in this manuscript.

Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain

Imaging techniques that reflect dynamic bone turnover may aid in characterizing a wide range of bone pathologies. We present detailed methodologies for performing and analyzing dynamic [18F]-NaF-PET-MRI data in a patient with facetogenic low back pain using the lumbar facet joints as a prototypical region of interest.

Quantitative [18F]-Naf-PET-MRI-Analyse zur Bewertung des dynamischen Knochenumsatzes bei Patienten mit facetogenen Rückenschmerzen

Imaging techniques that reflect dynamic bone turnover may aid in characterizing a wide range of bone pathologies. Bone is a dynamic tissue undergoing ...