Multiparametric MRI for characterization of the tumour microenvironment
Cet article décrit l'évolution du rôle de l'IRM multiparamétrique dans la caractérisation non invasive du microenvironnement tumoral, présente ses applications pour la détection des cancers, la stadification et l'évaluation de la réponse thérapeutique puis examine les considérations liées à l'utilisation future de ce type d'IRM, notamment pour les diagnostics personnalisés
Our understanding of tumour biology has evolved over the past decades and cancer is now viewed as a complex ecosystem with interactions between various cellular and non-cellular components within the tumour microenvironment (TME) at multiple scales. However, morphological imaging remains the mainstay of tumour staging and assessment of response to therapy, and the characterization of the TME with non-invasive imaging has not yet entered routine clinical practice. By combining multiple MRI sequences, each providing different but complementary information about the TME, multiparametric MRI (mpMRI) enables non-invasive assessment of molecular and cellular features within the TME, including their spatial and temporal heterogeneity. With an increasing number of advanced MRI techniques bridging the gap between preclinical and clinical applications, mpMRI could ultimately guide the selection of treatment approaches, precisely tailored to each individual patient, tumour and therapeutic modality. In this Review, we describe the evolving role of mpMRI in the non-invasive characterization of the TME, outline its applications for cancer detection, staging and assessment of response to therapy, and discuss considerations and challenges for its use in future medical applications, including personalized integrated diagnostics.
Nature Reviews Clinical Oncology , résumé, 2024