A 9.4 T magnetic resonance imaging (MRI) system was used to evaluate the response of a human tumour xenograft model to radiation therapy. The apparent diffusion coefficient (ADC) and the transverse relaxation time (T2) of human glioblastoma multiforme (GBM) tumour xenografts in NIH-iii nude mice were measured before, and at multiple points after, treatment of the tumours with 200 kVp x-rays. The response was characterized as a function of a number of variables of interest in the clinical treatment of cancer with external beam radiation therapy. Mean tumour ADC and T2 responses after single fractions of radiation were investigated, with measurements being made until 14 days after treatment. Single fraction doses ranged from 50 cGy to 800 cGy. Fractionated treatments were used to deliver 800 cGy in two or three fractions with fraction spacings of 24 or 72 hours. The role of hypoxia on ADC and T2 response was investigated by using an externally-applied, suture-based ligature to induce a state of reduced oxygenation in tumours during treatment, after which ADC and T2 were measured using serial MRI. Finally, tumours were dissected in order to provide insight into possible pathophysiological mechanisms explaining the observed responses. Tissue sections were prepared and reviewed by a pathologist. This work adds to the body of literature describing tumour ADC and T2 response to anticancer therapy, and adds to the understanding of ADC and T2 response to radiation therapy in particular. This works supports that of others suggesting the use of ADC and T2 as potential biomarkers for tumour response to treatment. / Medical Physics

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Macrophages associés aux tumeurs (TAMs) sont étroitement liés à l'initiation et la croissance tumorale, l'angiogenèse, l'invasion et les métastases tumorale, la résistance au traitement anti-cancéreux et sont associées à un mauvais pronostic dans de nombreux cancers. La radiothérapie est un des traitements les plus importants antitumoraux et a été montré pour pouvoir moduler les fonctions TAMs. Cependant, les mécanismes moléculaires dans l'activation des macrophages induite par irradiation sont largement inconnues. Dans cette étude, nous avons démontré que les rayonnements ionisants (IR) induit une activation des macrophages de type M1 in vitro et in vivo, qui est associée à une inhibition de la croissance tumorale induite par IR. Nous révélons que la protéine X induit par IR est essentiels dans le déclenchement de l'activation des macrophages. Nous confirmons l'importance de ces résultats en montrant que la sur-expression de la protéine X est liée à une augmentation des macrophages de type M1 chez les patients rectales suivants radiothérapie néo-adjuvante. L'accumulation des macrophages de type M1 est associée à une réponse antitumorale améliorée. Ce travail dévoile des rôles importants de la protéine X dans l'activation des macrophages IR-induite et constitue une base pour le développement de nouvelles stratégies thérapeutiques pour améliorer l’efficacité de la radiothérapie par modulation de l'activation des macrophages. / Tumour-associated macrophages (TAMs) are closely related to tumour initiation and growth, angiogenesis, tumour invasion and metastasis, anti-cancer treatment resistance and are associated with poor prognosis in many cancers. Radiotherapy is among the most important anti-tumour therapies and has been shown to modulate TAMs functions. However, molecular mechanisms underlying irradiation-induced macrophage activation are largely unknown. In this study, we demonstrated that ionizing radiation (IR) induces macrophage M1 activation both in vitro and in vivo, which is associated with IR-induced tumour growth inhibition. We reveal that IR-induced X protein is critical in triggering macrophage activation. We confirm the significance of these findings by showing that up-regulation of X protein is related with increased M1 macrophages infiltration in rectal patients following neo-adjuvant radiotherapy. Accumulation of M1 macrophages is associated with an improved anti-tumour response. This work unveils important roles of X protein in IR-induced macrophages activation and provides basis for the development of new therapeutic strategies to enhance radiotherapy efficacy through modulating macrophage activation.

Radiomics analyses commonly apply imaging features of different complexity for the prediction of the endpoint of interest. However, the prognostic value of each feature class is generally unclear. Furthermore, many radiomics models lack independent external validation that is decisive for their clinical application. Therefore, in this manuscript we present two complementary studies. In our modelling study, we developed and validated different radiomics signatures for outcome prediction after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) based on computed tomography (CT) and T2-weighted (T2w) magnetic resonance (MR) imaging datasets of 4 independent institutions (training: 122, validation 68 patients). We compared different feature classes extracted from the gross tumour volume for the prognosis of tumour response and freedom from distant metastases (FFDM): morphological and first order (MFO) features, second order texture (SOT) features, and Laplacian of Gaussian (LoG) transformed intensity features. Analyses were performed for CT and MRI separately and combined. Model performance was assessed by the area under the curve (AUC) and the concordance index (CI) for tumour response and FFDM, respectively. Overall, intensity features of LoG transformed CT and MR imaging combined with clinical T stage (cT) showed the best performance for tumour response prediction, while SOT features showed good performance for FFDM in independent validation (AUC = 0.70, CI = 0.69). In our external validation study, we aimed to validate previously published radiomics signatures on our multicentre cohort. We identified relevant publications on comparable patient datasets through a literature search and applied the reported radiomics models to our dataset. Only one of the identified studies could be validated, indicating an overall lack of reproducibility and the need of further standardization of radiomics before clinical application.