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Supplementary Figure 1 from Three-Dimensional Imaging and Quantification of Both Solitary Cells and Metastases in Whole Mouse Liver by Magnetic Resonance Imaging

Supplementary Figure Legend from Three-Dimensional Imaging and Quantification of Both Solitary Cells and Metastases in Whole Mouse Liver by Magnetic Resonance Imaging

Supplementary Video 1 from Three-Dimensional Imaging and Quantification of Both Solitary Cells and Metastases in Whole Mouse Liver by Magnetic Resonance Imaging

Blood vessels and their connections in rat spleen were traced over considerable distances by scanning electron microscopy of microcorrosion casts prepared by injection of minimal amounts of casting material. The periarterial lymphatic sheath and lymphatic nodules are highly developed, containing an abundance of capillaries which terminate in the marginal sinus (MS) and marginal zone (MZ). The MS, which consists of a series of discontinuous flattened vascular spaces interconnected by short capillaries, shows circumferential filling followed by flow radially outward into the MZ. Contrary to the generally accepted view, many venous sinuses begin as open-ended tubes at the MS or MZ, allowing free entry of blood into the venous system, thereby bypassing the reticular meshwork of the red pulp. The majority of arterial capillaries terminate in the reticular meshwork ("open" circulation), but evidence for direct connections between capillaries and venous sinuses ("closed" circulation) was also obtained. Casts of the subcapsular region reveal an elaborate system of venous sinuses in fan-shaped arrays, superimposed on an extensive network of capillaries draining into flattened reticular spaces; such casts provide a three-dimensional map useful in interpreting light microscopic observations of red cell flow in vivo. Sphincter-like constrictions in venous sinuses, at points of connection with larger sinuses, indicate that these are possible sites for control of intrasplenic flow distribution.

Corrosion casts of mouse spleen, examined by scanning electron microscopy, enabled vascular pathways of the arterial, intermediate, and venous circulations to be traced over considerable distances. The arterial tree is surrounded by white pulp immediately upon entering at the hilus, and relatively few arterioles extend into red pulp. A profusion of capillaries is present in both periarterial lymphatic sheaths and lymphatic nodules, arranged as bifurcating systems (rather than anastomosing networks) terminating in the marginal sinus (MS) and marginal zone (MZ). The MS, which is situated between white pulp and MZ, consists of a discontinuous layer of flattened anastomosing spaces which are up to six times as large as those in rat spleen. Extensive filling of the entire MZ took place before appreciable filling of surrounding red pulp occurred. Capillary terminations in red pulp are always continuous with reticular meshwork, i.e., no evidence for a "closed" circulation was found. Casts of the venous origins support the classification "pulp venules" rather than "venous sinuses" and show major morphological differences from the richly anastomosing system of sinuses in rat. In the subcapsular region of mouse spleen large anastomosing veins ramify over the surface, with reticular meshwork occupying extensive areas between adjacent veins. For in vivo microscopy this arrangement offers advantages over that found in rat spleen (accompanying paper), where almost the entire surface is densely covered with venous sinuses.

Survival following diagnosis of liver metastasis remains poor and improved treatment strategies to combat liver metastases are needed. Synthetic triterpenoids, including 1-[2-cyano-3-,12-dioxooleana-1,9(11)-dien-28-oyl]imidazole (CDDO-Imidazolide or CDDO-Im), have been shown to inhibit primary tumor growth and lung metastasis in experimental models. Oral administration of CDDO-Im results in relatively high liver concentrations, suggesting that CDDO-Im may provide an approach to treatment of liver metastases. Here we assessed the effect of CDDO-Im on liver metastasis, using B16F1 (mouse melanoma) and HT-29 (human colon carcinoma) cells. In vitro, nanomolar concentrations of CDDO-Im arrested proliferation or induced cell death in both cell lines. In vivo, cells were injected via a surgically exposed mesenteric vein to target cells to the liver of mice. Mice were then treated with CDDO-Im (800 mg/kg diet) or vehicle control. Livers were removed at endpoint and metastatic burden was quantified by standard histology. In addition, a novel whole liver magnetic resonance imaging (MRI) technique was used to assess the effect of CDDO-Im on growing metastases as well as on non-dividing, solitary cancer cells present in the same livers. CDDO-Im treatment significantly decreased liver metastasis burden in both HT-29 (n = 8 treated, 10 control) and B16F1 (n = 15 treated, 16 control) injected mice (>60%, P < 0.05), but did not reduce the numbers of solitary B16F1 cancer cells (hypo-intensity) in the same livers (P = 0.9). This study demonstrates that CDDO-Im may be useful for the treatment metastatic liver disease as it successfully inhibits growth of actively proliferating liver metastases.

The metastatic cell population, ranging from solitary cells to actively growing metastases, is heterogeneous and unlikely to respond uniformly to treatment. However, quantification of the entire experimental metastatic cell population in whole organs is complicated by requirements of an imaging modality with the large field of view and high spatial resolution necessary to detect both single cells and metastases in the same organ. Thus, it is difficult to assess differential responses of these distinct metastatic populations to therapy. Here, we develop a magnetic resonance imaging (MRI) technique capable of quantifying the full population of metastatic cells in a secondary organ. B16F1 mouse melanoma cells were labeled with micron-sized iron oxide particles (MPIO) and injected into mouse liver via the mesenteric vein. Livers were removed immediately or at day 9 or 11, following doxorubicin or vehicle control treatment, and imaged using a 3T clinical magnetic resonance scanner and custom-built gradient coil. Both metastases (>200 μm) and MPIO-labeled single cells were detected and quantified from MR images as areas of hyperintensity or hypointensity (signal voids), respectively. We found that 1mg/kg doxorubicin treatment inhibited metastasis growth (n = 11 per group; P = 0.02, t test) but did not decrease the solitary metastatic cell population in the same livers (P > 0.05). Thus, the technique presented here is capable of quickly quantifying the majority of the metastatic cell population, including both growing metastases and solitary cells, in whole liver by MRI and can identify differential responses of growing metastases and solitary cells to therapy. [Cancer Res 2009;69(21):8326–31]

Anti-fibrinolytic agents such as aprotinin and epsilon-aminocaproic acid (EACA) are used clinically to decrease peri-operative bleeding. Use of these treatments during cancer-related surgeries has led to investigation of the effect of fibrinolysis inhibition on cancer cell spread. The ability of aprotinin to reduce proteolytic activity of proteases required for metastasis suggests that it could have an anti-metastatic effect in patients undergoing tumor resection. However, many metastatic cells in the vasculature of a secondary tissue are associated with a micro-thrombus. The association of tumor cells with thrombi has been shown to increase their survival; therefore inhibition of plasmin-mediated fibrinolysis might instead increase metastatic cell survival by enhancing the association between thrombi and tumor cells. The goal of this work was to determine the effect of anti-fibrinolytic treatment on experimental metastasis and to establish the role of coagulation factors in this effect. The metastatic ability of B16F10 melanoma cells was evaluated in vivo following cell or animal pre-treatment with aprotinin or EACA. Additionally, a novel in vivo technique was developed, to permit analysis of tumor cell association with thrombi in the lung microvasculature using confocal microscopy. Aprotinin and EACA treatment of mice resulted in a significant increase in lung metastasis. Aprotinin treatment increased the size of thrombi in association with cells arrested in lung capillaries. This study suggests that clinical use of anti-fibrinolytic agents for cancer-related surgeries could result in increased metastatic ability of those cells shed immediately prior to and during surgery, and that this approach thus requires further study.

The majority of breast cancer related deaths occur as a result of metastasis. The failure of effective treatments for metastasis is the underlying cause for this. Much remains unknown about the process of metastasis and how best to prevent or treat metastatic breast cancer. Therefore, a better understanding of the metastatic process is needed in order to determine effective therapeutic interventions to either eradicate, or slow down metastatic outgrowth of breast cancer. Metastasis is an inefficient process, however the ability of only a small number of cells to complete this process may have serious, life-threatening consequences. Little is known about whether expression of the metastasis suppressor breast cancer metastasis suppressor 1 (BRMS1) can suppress metastatic outgrowth in different organs in multiple experimental models of metastasis, or what effect BRMS1 expression has on the various steps in metastatic cascade. In this study we investigated the effect of BRMS1 expression on organ-specific metastasis. In addition, the steps in metastasis that are inhibited by BRMS1-expression were determined. In vivo, BRMS1 expression reduced metastatic burden to liver, bone, brain, and lung in mice by at least 75% (P < 0.05). Detailed quantitative analysis of the metastatic process in lung showed that BRMS1 expression significantly reduced the numbers of solitary single cells that survive after initial arrest within the lung microvasculature, and also inhibited the initiation of growth subsequent to arrest. In vitro, BRMS1 expression decreased cancer cell survival under stress conditions (hypoxia), increased anoikis, and decreased the ability of cancer cells to adhere. These novel findings demonstrate that BRMS1 is a potent suppressor of metastasis in multiple organs, and identify two steps in the metastatic process that are sensitive to inhibition by BRMS1.

Metastasis is the spread of cells from a primary tumor to a distant site, where they arrest and grow to form a secondary tumor. Conventional metastasis models have focused primarily on analysis of end point tumor formation following inoculation with tumor cells. This approach can be used to measure the metastatic potential of cell lines, the morphology of metastases and their vasculature and the overall effectiveness of treatment strategies. However, it cannot, reveal the dynamics of metastatic progression, tumor cell interactions with host tissues or the characteristics of blood flow within the tumor microvasculature. Intravital videomicroscopy has been developed to visualize and quantify the movement of tumor cells and their interactions with host tissues as they travel through metastatic pathways within the body and arrest at secondary sites. Intravital videomicroscopy can also be used to quantify the morphology and functional capacity of tumor microvasculature, as well as the timing and dynamic effects of drugs targeted to disrupt tumor vasculaturization. With the development of new fluorescent probes and reporter genes, intravital videomicroscopy has the potential to provide evidence of the timing and location of metabolic processes within the metastatic cascade that may serve as specific targets for the treatment of breast cancer.

Objective It is proposed to test the practicality of septopalatal protraction in the unilateral cleft palate infant for purposes of straightening the nasal septum and thus relieving nasal airflow obstruction and its detrimental sequelae. Methods Alternate infants affected with complete unilateral palatal clefts had septopalatal protraction for a period of 6 to 8 weeks (protraction group; n = 4). Septal deviation was measured by a standardized technique that used computed tomography scans. The remaining infants had no protraction and served as controls (nonprotraction group; n = 5). Septal deviation was measured in the nonprotraction group from palatoseptal dental molds. Results A total of 9 patients were studied. All patients in the nonprotraction group had worsening of nasal septal deviation over a period of 8 weeks compared with the protraction group, which had complete nasal septal straightening. Differences in septal angle deviation between the protraction group and nonprotraction group at the end of the study were statistically significant (P ≤ 0.01) as measured by the paired Student t test. Conclusions Septopalatal protraction in the newborn appears to provide a means for correcting nasal septal deviation in complete unilateral cleft palate infants. Septopalatal protraction in the newborn is relatively easy and safe. EBM rating B-2

In the current work we demonstrate, for the first time, that single cells can be detected in mouse brain in vivo using magnetic resonance imaging (MRI). Cells were labeled with superparamagnetic iron oxide nanoparticles and injected into the circulation of mice. Individual cells trapped within the microcirculation of the brain could be visualized with high-resolution MRI using optimized MR hardware and the fast imaging employing steady state acquisition (FIESTA) pulse sequence on a 1.5 T clinical MRI scanner. Single cells appear as discrete signal voids on MR images. Direct optical validation was provided by coregistering signal voids on MRI with single cells visualized using high-resolution confocal microscopy. This work demonstrates the sensitivity of MRI for detecting single cells in small animals for a wide range of application from stem cell to cancer cell tracking.

Metastases require a functional blood supply for progressive growth. Thus, therapies that target metastatic vasculature have potential clinical utility. The effects of the vascular-targeting agent (VTA), ZD6126, and the anti-angiogenic agent, ZD6474, on vascular development and function within metastases were compared in an experimental liver metastasis model. Ras-transformed PAP2 fibroblasts were injected into the mesenteric veins of SCID mice to produce a control liver metastasis burden of approximately 40% at 14 days. Mice given a single dose of ZD6126 (200 mg/kg, i.p.) on day 13 were examined 24 h later. Histology revealed a significant reduction in metastatic burden, associated with extensive tumor necrosis, increased tumor cell apoptosis and a reduction in tumor-associated vasculature. In vivo videomicroscopy (IVVM) revealed disrupted, non-functional vascular channels within metastases, with no blood flow. Mice given ZD6474 on days 4 to 10 (50 mg/kg daily, oral gavage) were examined on day 11. Histology revealed a lower metastatic burden, significant reductions in metastasis size and vasculature, and a significant increase in tumor cell apoptosis. IVVM revealed extensive reductions in vascularity and blood flow within metastases. Neither ZD6126 nor ZD6474 treatment affected surrounding normal liver tissue. This study shows that both agents can reduce experimental liver metastasis with no apparent effect on normal vasculature. However, these reductions were attained through distinct effects on the metastatic vasculature. Understanding differences in the modes of action of VTAs and anti-angiogenic agents will be important in optimizing their clinical application and in developing appropriate combination strategies.

Breast cancer is noted for long periods of tumor dormancy and metastases can occur many years after treatment. Adjuvant chemotherapy is used to prevent metastatic recurrence but is not always successful. As a model for studying mechanisms of dormancy, we have used two murine mammary carcinoma cell lines: D2.0R/R cells, which are poorly metastatic but form metastases in some mice after long latency times, and D2A1/R cells, which form more numerous metastases much earlier. Previously we identified a surprisingly large population of dormant but viable solitary cells, which persisted in an undivided state for up to 11 weeks after injection of D2.0R/R cells. Dormant cells were also detected for D2A1/R cells, in a background of growing metastases. Here we used this model to test the hypothesis that dormant tumor cells would not be killed by cytotoxic chemotherapy that targets actively dividing cells, and that the late development of metastases from D2.0R/R cells would not be inhibited by chemotherapy that effectively inhibited D2A1/R metastases. We injected mice with D2A1/R or D2.0R/R cells via a mesenteric vein to target liver. We developed a doxorubicin (DXR) treatment protocol that effectively reduced the metastatic tumor burden from D2A1/R cells at 3 weeks. However, this treatment did not reduce the numbers of solitary dormant cells in mice injected with either D2A1/R or D2.0R/R cells. Furthermore, DXR did not reduce the metastatic tumor burden after an 11-week latency period in mice injected with D2.0R/R cells. Thus, apparently effective chemotherapy may spare non-dividing cancer cells, and these cells may give rise to metastases at a later date. This study has important clinical implications for patients being treated with cytotoxic chemotherapy.

Metastasis is responsible for most cancer deaths. A better under standing of the process provides opportunities to develop new treatments to prevent metastasis. This article summarizes findings from experimental in vivo videomicroscopy and quantitative studies on metastatic inefficiency, which indicate that early steps in hematogenous metastasis may be quite efficient, but that regulation of cancer cell growth in secondary sites determines metastatic outcome. The authors have identified three key stages of this growth regulation: survival of a subset of single cells, proliferation of a subset of these cells to form preangiogenic micrometastases, and persistence of growth of a subset of these to form vascularized metastases. Formation of clinically relevant metastases is determined by the proportion of cells that proceeds successfully through each stage, and surviving single cells and preangiogenic micrometastases both represent possible sources of tumor dormancy.

In cancer metastasis, only a small percentage of cells released from a primary tumor successfully form distant lesions, but it is uncertain at which steps in the process cells are lost. Our goal was to determine what proportions of B16F1 melanoma cells injected intraportally to target mouse liver 1) survive and extravasate, 2) form micrometastases (4 to 16 cells) by day 3, 3) develop into macroscopic tumors by day 13, and 4) remain as solitary dormant cells. Using in vivo videomicroscopy, a novel cell accounting assay, and immunohistochemical markers for proliferation (Ki-67) and apoptosis (TUNEL), we found that 1) 80% of injected cells survived in the liver microcirculation and extravasated by day 3, 2) only a small subset of extravasated cells began to grow, with 1 in 40 forming micrometastases by day 3, 3) only a small subset of micrometastases continued to grow, with 1 in 100 progressing to form macroscopic tumors by day 13 (in fact, most micrometastases disappeared), and 4) 36% of injected cells remained by day 13 as solitary cancer cells, most of which were dormant (proliferation, 2%; apoptosis, 3%; in contrast to cells within macroscopic tumors: proliferation, 91%; apoptosis/necrosis, 6%). Thus, in this model, metastatic inefficiency is principally determined by two distinct aspects of cell growth after extravasation: failure of solitary cells to initiate growth and failure of early micrometastases to continue growth into macroscopic tumors.

Carboxyamidotriazole (CAI), an inhibitor of calcium-mediated signal transduction, is a promising new cytostatic anti-cancer drug which has entered Phase II clinical trials, and for which multiple modes of action have been proposed. We tested the hypothesis that CAI can inhibit tumor angiogenesis in vivo. The ability of orally administered CAI to inhibit experimental metastases of B16F1 melanoma cells in mouse liver was assessed. A computer-assisted stereological technique was then used to analyze images from histological sections of CAI-treated vs. control livers; the vascular volume percentage (percentage of tumor volume consisting of functional microvessels) was determined to assess the effect of CAI on tumor angiogenesis. CAI treatment significantly reduced the size (8 × reduction in volume; P = 0.02) but not the number of metastases. In association with this reduction in tumor size, CAI significantly decreased the vascular volume percentage within metastases by at least a factor of two (P = 0.001). A reduction in both number of microvessels/mm2 and microvessel size (cross-sectional area) was found to contribute to this decrease. CAI treatment did not affect the vascular volume percentage of normal liver tissue surrounding metastases (P = 0.8). This study documents for the first time that CAI can inhibit tumor angiogenesis within metastases in vivo.

The exocrine pancreas has a lobular structure and an intricate capillary network supplies the lobules. Casts of these capillaries are either straight and of constant width, provided with many shallow crests, or undulating and of varying diameter, provided with bulges and deeper constrictions. The mean capillary cast diameter is 6.32 microns (SD 0.53) and 3.91 microns (SD 0.84) at constriction sites. The first type corresponds to non-fenestrated capillaries, makes 24% of capillaries and is more frequently provided with pericytes (2.7 +/- 0.9 pericytes per capillary profile). The second type corresponds to fenestrated capillaries, comprises 76% of the capillaries and is less frequently provided with pericytes (1.5 +/- 0.6 pericytes per capillary profile). The endothelial cells of capillaries regularly form intermediate junctions and microvilli and contain microtubuli and cytoplasmic filaments. Intravital observations show that capillaries are capable of contracting and narrowing the capillary lumen. This contractility is accomplished by endothelial cells both at and apart from their nuclear regions while pericytes never contracted spontaneously during our in vivo observations. The capillary diameters estimated by intravital measurements, 3.53 microns (SD 1.05), are similar to cast measurements but differ at constricted segments from cast measurements. Flow reduction shows more variability in smaller capillaries and the flow is more reduced in capillaries of 5 microns diameter to about 40% of open capillaries vs. 68% in capillaries with 7.5 microns diameter. Veins are either provided with smooth muscle sphincters or with valves. These results indicate that corrosion casting accurately shows the geometry of capillaries. However, where the capillaries are drastically constricted, they might not be filled and therefore may be underestimated during measurements. Since none of the intravital luminal constrictions are small enough to reduce flow (smaller than 1 micron luminal diameter) and because many constrictions are effective to reduce flow, we conclude that capillaries of the exocrine pancreas are always capable of maintaining continuous blood flow yet can influence blood perfusion. The presence of venous valves in association with venous sphincters constitutes a new situation concerning blood drainage regulation in the exocrine pancreas.

Escape of cancer cells from the circulation (extravasation) is thought to be a major rate-limiting step in metastasis, with few cells being able to extravasate. Furthermore, highly metastatic cells are believed to extravasate more readily than poorly metastatic cells. We assessed in vivo the extravasation ability of highly metastatic ras-transformed NIH 3T3 cells (PAP2) versus control nontumorigenic nontransformed NIH 3T3 cells and primary mouse embryo fibroblasts. Fluorescently labeled cells were injected intravenously into chicken embryo chorioallantoic membrane and analyzed by intravital videomicroscopy. The chorioallantoic membrane is an appropriate model for studying extravasation, since, at the embryonic stage used, the microvasculature exhibits a continuous basement membrane and adult permeability properties. The kinetics of extravasation were assessed by determining whether individual cells (n = 1481) were intravascular, extravascular, or in the process of extravasation, at 3, 6, and 24 h after injection. Contrary to expectations, our results showed that all three cell types extravasated with the same kinetics. By 24 h after injection > 89% of observed cells had completed extravasation from the capillary plexus. After extravasation, individual fibroblasts of all cell types demonstrated preferential migration within the mesenchymal layer toward arterioles, not to venules or lymphatics. Thus in this model and for these cells, extravasation is independent of metastatic ability. This suggests that the ability to extravasate in vivo is not necessarily predictive of subsequent metastasis formation, and that postextravasation events may be key determinants in metastasis.

Flow quantification with high-frequency power Doppler ultrasound can be performed using the wall-filter selection curve (WFSC) method [M. Elfarnawany et al., Ultrasound Med. Biol. 38, 1429-1439 (2012)]. The WFSC method plots color pixel density (CPD) as a function of wall filter cut-off velocity as a means of objectively selecting an operating point cut-off velocity. In this study, an in vivo video microscopy (IVVM) system was used to measure the size of small (140-400 μm diameter) mouse testicular vessels immediately after the vessels were imaged with 30 MHz power Doppler. The mouse remained on the same platform throughout ultrasound and IVVM imaging. Measurements in four image planes from three mice demonstrated that, similar to previously reported flow-phantom data, in vivo WFSCs exhibit distinct, sloped "characteristic intervals" at cut-off velocities where the CPD approaches the gold-standard IVVM estimate of vascular volume fraction. A wide range of operating point cut-off velocities (4.5 to 12 mm/s) was obtained, which indicates that use of a predetermined cut-off can produce substantial errors in cross-sectional studies that employ power Doppler to quantify vascularity. The WFSC method is a promising strategy for adapting the cut-off velocity to intersubject and longitudinal variations in blood flow during microvascular imaging experiments.

Hematogenous and lymph node metastasis of melanoma cells is a major cause of death in the United States and Canada. Melanoma cells have a propensity for spreading to lymph nodes via the lymphatics. However, little is known about regional growth patterns of draining lymph node metastases arising from dermal melanomas. In a mouse model, by 10–14 days following intradermal injection, melanoma cells were replicating as discrete, evenly spaced lymph node metastases. When the injection site was excised at 4 days post intradermal injection, neither primary dermal tumors nor lymph node metastases were observed, indicating that metastasizing cells did not come directly from the initial injection and that the primary dermal tumor was required for lymph node metastases. While 23.1% of melanoma cells were proliferating in the lymph node, only 0.9% of these cells were undergoing apoptosis. We never observed metastasizing cancer cells replicating in blood or lymphatic vessels. When melanoma cells undergo hematogenous metastasis after portal vein injection, they are initially arrested in the liver by size constraints. However, they extravasate as an active process involving pseudopodial projections; during this process the vasculature remains intact. The metastasizing cells can then migrate to preferred sites for replication. In the lung, after intravenous injection, melanoma cells become arrested by size constraint at sites directly proportional to the available lung volume. By 10 days post injection, cancer cell replication preferentially occurs at the lung surface with 80% coverage. The vast majority of single, extravasated melanoma cells in the lung and liver are dormant. However, metastatic efficiency and dormancy of melanoma cells can vary widely with the melanoma cell line injected and/or the organ involved. The percentage of inoculated cells that remain as single, dormant cells at 2 weeks post inoculation is tenfold higher for B16F1 cells in liver compared with B16F10 cells in the lung. In contrast, metastatic efficiency of B16 F10 cells in lung is >500-fold higher than for B16F1 cells in liver.

Metastases are responsible for the majority of failures in cancer treatment. Clarifying steps in metastasis and their molecular mechanisms will be important for the development of anti-metastasis therapeutic strategies. Considerable progress has been made in identifying molecules involved in metastasis. However, because of the nature of assays that have been available, conclusions about steps in metastasis and their molecular bases have been drawn primarily from inference. In order to complete the picture of how metastases form, a technique is needed to directly watch the process in vivo as it occurs over time. We have developed an intravital videomicroscopy (IVVM) procedure to make such observations possible. Results from IVVM are providing us with new conceptual understanding of the metastatic process, as well as the nature and timing of the contributions of molecules implicated in metastasis (e.g. adhesion molecules and proteinases). Our findings suggest that early steps in metastasis, including hemodynamic destruction and extravasation, may contribute less to metastatic inefficiency than previously believed. Instead, our results suggest that the control of post-extravasation growth of individual cancer cells is a significant contributor to metastatic inefficiency. Thus, this stage may be an appropriate target for design of novel strategies to prevent metastases.

During our recent studies of the capillaries in exocrine pancreas of mouse, numerous local constrictions which reduced the luminal diameter were observed both by scanning electron microscopy of corrosion casts and by in vivo microscopy. In the present study we have identified the features responsible for the constrictions and compared the diameters of vessels and constrictions measured using the two methods. A simple theoretical model was used to predict the effects of such constrictions on blood flow in the acinar capillaries of the pancreas. Intravital observations revealed that bulging endothelial cells were primarily responsible for the constrictions. For samples of 100 measurements, good agreement was found between the mean capillary diameters from casts (6.3 microns +/- 0.50 SD) and in vivo (6.2 microns +/- 0.53 SD), but the mean diameter measurement at constrictions was greater (P < 0.01) in casts (3.9 microns +/- 0.84 SD) than in vivo (3.5 microns +/- 1.05 SD). Topical application of norepinephrine caused endothelial nuclear regions to bulge into the capillary lumen, decreasing the mean diameter at these locations to 3.3 microns +/- 0.9 (SD, n = 21). Based on the 100 in vivo measurements, the theoretical model predicted that, on average, the constrictions would reduce flows to 51% of those in fully open vessels. It is unlikely, however, that the constrictions observed in acinar capillaries of the pancreas of mouse would result in significant blockage of the vessels by red blood cells.

Flow quantification with high-frequency (>20 MHz) power Doppler ultrasound can be performed objectively using the wall-filter selection curve (WFSC) method to select the cutoff velocity that yields a best-estimate color pixel density (CPD). An in vivo video microscopy system (IVVM) is combined with high-frequency power Doppler ultrasound to provide a method for validation of CPD measurements based on WFSCs in mouse testicular vessels. The ultrasound and IVVM systems are instrumented so that the mouse remains on the same imaging platform when switching between the two modalities. In vivo video microscopy provides gold-standard measurements of vascular diameter to validate power Doppler CPD estimates. Measurements in four image planes from three mice exhibit wide variation in the optimal cutoff velocity and indicate that a predetermined cutoff velocity setting can introduce significant errors in studies intended to quantify vascularity. Consistent with previously published flow-phantom data, in vivo WFSCs exhibited three characteristic regions and detectable plateaus. Selection of a cutoff velocity at the right end of the plateau yielded a CPD close to the gold-standard vascular volume fraction estimated using IVVM. An investigator can implement the WFSC method to help adapt cutoff velocity to current blood flow conditions and thereby improve the accuracy of power Doppler for quantitative microvascular imaging.

We examined the extravasation and subsequent migration and growth of murine mammary tumor cell lines (D2A1 and D2.OR) which differ in their metastatic ability in lung and liver, invasiveness in vitro and expression of the cysteine proteinase cathepsin L. In light of the differences in invasiveness and cathepsin L expression, we hypothesized that during hematogenous metastasis the two cell lines would differ primarily in their ability to extravasate. We used in vivo videomicroscopy of mouse liver and chick embryo chorioallantoic membrane to examine the process and timing of extravasation and subsequent steps in metastasis for these cell lines. In contrast to our expectations, no differences were found between the cell lines in either the timing or mechanism of extravasation, at least 95% of cells having extravasated by 3 days after injection. However, after extravasation, the more metastatic and invasive D2A1 cells showed a greater ability to migrate to sites which favor tumor growth and to replicate to form micrometastases. These studies point to post-extravasation events (migration and growth) as being critical in metastasis formation.

MicroRNAs are small non-coding RNAs that regulate post-transcriptional gene expression. In the short time since the discovery of microRNAs, the literature has burgeoned with studies focused on the biosynthesis of microRNAs, target prediction and binding, and mechanisms of translational repression by microRNAs. Given the prominent role of microRNAs in all areas of cell biology, it is not surprising that microRNAs are also linked to human diseases, including those of the nervous system. One of the least-studied areas of microRNA research is how their expression is regulated outside of development and cancer. Thus, we examined a role for regulation of microRNAs by neurotransmitter receptor activation in mouse brain. We focused on the group I metabotropic glutamate receptors by using intracerebroventricular injection of the selective agonist, (S)-3,5-dihydroxyphenylglycine (DHPG) in mouse brain. We then examined the expression of microRNAs in the cerebral cortex by Ambion and Invitrogen microarrays, and the expression of mature microRNA sequences by SABiosciences qPCR arrays, at 4, 8 and 24 hours after DHPG injection. These studies revealed that the largest number of significantly regulated microRNAs was detected 8 hours after DHPG injection in the microarrays and qPCR arrays. We then used RNA blots to quantify microRNA expression, and in situ hybridization to examine cellular distribution of the microRNAs regulated by DHPG. Bioinformatic analysis of the microRNAs regulated 8 hours after DHPG in all three arrays revealed KEGG pathways that are known to correlate with group I mGluR effects, as well as recently described and novel pathways. These studies are the first to show that DHGP regulates the expression of microRNAs in mouse cerebral cortex, and support the hypothesis that group I mGluRs may regulate microRNA expression in mouse brain.

Capillaries in the mouse exocrine pancreas were studied by scanning electron microscopy of microvascular corrosion casts, transmission electron microscopy of tissue sections, and high resolution intravital video-microscopy. Two types of capillaries were discerned by corrosion casting. The first type was rather straight, had a constant diameter of 5-6 microns, and its surface showed multiple circumferential furrows. The frequency of such constrictions was less in the second type, which was more undulated and had a diameter of 7-9 microns. In the second type, these constrictions defined bulged areas of the capillary cast. Corresponding tissue sections also showed two types of capillaries, fenestrated and non-fenestrated capillaries. Microtubules were abundant in all capillary endothelial cells, whereas bundles of microfilaments were scarce. Microtubules were arranged along the long axis of endothelial cells as well as parallel to endothelial cell border regions. Endothelial cells were joined by intermediate junctions along cell borders running both circumferentially and longitudinally. Flow reversal in capillaries and spontaneous endothelial contractions were documented in vivo. Endothelial cells bulged into the lumen, either at their nuclear region or distant from it. Spontaneous contraction of pericytes was not observed. These results suggest that contraction of capillaries is carried out by endothelial cells, representing an autonomous flow regulatory device. Capillary contraction in exocrine pancreas may be influenced by blood-borne agents, probably by those released in Langerhans islets.

Biomechanical interactions of cancer cells with the microvasculature were studied using high resolution intravital videomicroscopy. We compared initial arrest of murine B16F10 melanoma and D2A1 mammary carcinoma cells fluorescently labelled with calcein-AM, in low pressure (liver) vs high pressure (cremaster muscle) microvascular beds. Cells were arrested due to size restriction at the inflow side of the microcirculation, penetrating further and becoming more deformed in muscle than liver [median length to width ratios of 3.3 vs 1.3 for D2A1 cells, and 2.5 vs 1.2 for B16F10, at 1 min post-injection (p.i.)]. During the next 2 h many cells became stretched, giving maximum length to width ratios of 68 vs 22.1 (D2A1) and 28 vs 5.6 (B16F10) in muscle vs liver. Ethidium bromide exclusion demonstrated that over 97% of the cells maintained membrane integrity for > 2 h p.i. (In contrast, when an acridine orange labelling procedure was used, membrane disruption of B16F10 cells occurred within 15 min p.i.) Our experiments do not indicate the ultimate fate of the cancer cells, but if cell lysis occurs it must be on a time scale of hours rather than minutes. We report a process of 'clasmatosis' in cancer cells arrested in the microcirculation: large membrane-enclosed fragments (> 3 microns in diameter) became 'pinched off' from arrested cells, in both liver and muscle, often within minutes or even seconds of arrest. The significance of this process is not yet understood. In this study intravital videomicroscopy has thus provided a valuable clarification of the interactions of cancer cells with vessel walls during metastasis.

The chick embryo is a useful model for studying hematogenous metastasis. Cancer cells injected into veins of the chorioallantoic membrane (CAM) circulate briefly through all tissues but form metastases predominantly in the CAM. This respiratory organ is particularly suitable for intravital microscope because of its accessibility without the need for surgery and the density and planar configuration of its vessels (which we confirmed by microcorrosion casting). Using an inverted microscope with oblique transillumination for high-resolution images and epifluorescence to identify labeled B16F1 melanoma cells, we studied successive stages of metastasis formation in the CAM in vivo. By 2 min postinjection (pi) all cancer cells had become arrested within the microvasculature. This initial arrest appeared to be due to size restriction, based on measurements of cell and vessel diameters. At 15-60 min pi, trapped cells were seen in tapering arterioles (27%), orifices from arterioles to the capillary plexus (61%), or in the plexus itself (12%). Some cells had extravasated into the underlying mesenchyme by 3 hr (pi), and at 24 hr all cancer cells had completed this process. The mean rate of migration out of capillary lumens was approximately 1 micron/hr. Micrometastases grew in a planar configuration just beneath the capillary plexus, with a cell doubling time of approximately 24 hr. Our technique is also applicable to other tumor types and host animals and provides a powerful tool to complement studies on the molecular basis of metastasis.

BACKGROUND There are few techniques that permit direct observation of tumor metastasis. The ability to observe steps in this process as they occur in experimental animals would complement studies on molecular mechanisms. PURPOSE We have developed a novel procedure using high-resolution intravital videomicroscopy to permit direct observation of cells as they arrest in the microcirculation, extravasate, and form micrometastases. We used this procedure to study early steps in experimental metastasis in immune-deficient chick embryos, permitting us to develop this technique in a relatively accessible respiratory organ and in the absence of host immune responses. Our goals were to develop techniques applicable to this host and to other hosts and to clarify the process of hematogenous tumor spread in this host. METHODS We injected fluorescently labeled B16F1 melanoma cells into the circulation of 11- to 13-day chick embryos, and using intravital videomicroscopy, we observed the cells in the chorioallantoic membrane over time. RESULTS The majority of injected cells were trapped initially in orifices to the chorioallantoic membrane capillary plexus or in tapering ends of arterioles leading to the plexus. During the first 2 hours, cells were found only in vessel lumina. After 8 hours, 83% of cells had extravasated, and the rest were in the process of extravasation. Cell shape changes and pseudopodial extensions were seen during extravasation and tumor development. Tumor cell division was seen only after extravasation. Tumors tended to develop near microvessels and were often wrapped around them. CONCLUSIONS Intravital videomicroscopy can provide new information about steps in metastasis. This procedure is applicable to other hosts and can be used in future studies to test hypotheses about molecular mechanisms of tumor spread.

The spleen plays a central role in the pathogenesis of chronic idiopathic thrombocytopenic purpura (ITP); it produces massive quantities of antiplatelet antibodies, leading to accelerated phagocytosis of platelets. Lymphoid hyperplasia typically occurs in the spleen, characterized by large numbers of lymphatic nodules with active germinal centers. Whether changes in splenic microcirculatory pathways also occur is not known. We have studied this question by scanning electron microscopy of corrosion casts, comparing spleens removed from patients with ITP with normal spleens obtained from organ transplant donors. The casts demonstrate two major changes in microcirculatory pathways in ITP. Firstly, a striking proliferation of arterioles and capillaries is found in the white pulp and marginal zone (MZ), seen as extensive vascularization in 92.3% of lymphatic nodules (n = 191) versus 0.6% (n = 224) in normal spleens. Secondly, the marginal sinus, a series of flattened, anastomosing vascular spaces between the white pulp and MZ, is absent in 89.4% of lymphatic nodules versus 4.9% in normal spleens. The cause of these microcirculatory changes, which may not be exclusive to ITP, is presently unknown. Absence of the marginal sinus may affect distribution of blood flow through the MZ such that platelets spend increased amounts of time in the proximity of macrophages. In the presence of antiplatelet antibodies found in ITP spleens, this delayed transit would lead to greatly increased platelet destruction.

The spleen concentrates blood to twice arterial hematocrit, but how it does so is poorly understood. We hypothesize that hemoconcentration results from percolation of blood through the reticular meshwork (RM) between capillary endings and venous channels. The RM has a large flow cross section, producing low shear rates, and an enormous surface area for red blood cell (RBC) adhesion. If these conditions cause slowing of RBCs with respect to plasma, increased hematocrits will occur (inverse Fahraeus effect). Movements of individual RBCs through the RM were studied from intravital microscopic videorecordings of Ringer-perfused mouse spleens. Analysis of three 70-microns paths showed characteristic "stop and go" motion, RBCs spending 0.015 to 9.71 see in any 7-microns segment, despite steady (+/- 15%) perfusate velocity. At some locations RBCs adhered to reticular cells/fibers by point attachment and at others they became caught over fibers. In general, RBCs were detained in the RM by surface interactions rather than by narrow channel. Perfusate ("plasma") velocity was estimated to be at least that of the fastest RBCs in each segment. Ratios of overall mean RBC and plasma velocities for three paths were 0.19, 0.20, and 0.37. Applying these velocity ratios to a feed hematocrit of 40% leads to predicted splenic hematocrits up to 78%. We conclude that this slowing of RBCs within the reticular meshwork provides the primary mechanism for generating the high intrasplenic hematocrit.

Experimental studies on angiogenesis are clarifying many aspects of this important process and are leading to new approaches to use this information clinically. Histology of fixed tissues is a commonly used "gold standard" for assessing development of tumor vasculature during disease progression or changes in vasculature in response to genetic manipulation or therapy. However, histology provides only a static snapshot-in-time of vascular status, and can provide only limited information about vessel function or dynamics. Here we describe microscopy techniques and image processing approaches for using intravital video microscopy (IVVM) for the study of normal and tumor vascular morphology and function. IVVM provides powerful, high-resolution approaches for observing the vasculature in multiple organs or experimental animals. In addition to providing informative images, IVVM combined with video postprocessing and image analysis approaches can be used to extract valuable quantitative information from video images. This information includes morphological parameters such as vascular diameter, density, branching, and three-dimensional vascular geometry, as well as functional and physiological information such as the identification of vessels that are perfused with red blood cells (RBCs) or plasma, rate of RBC flow, and oxygen status of RBCs. An added strength of IVVM is the ability to provide longitudinal information, looking at changes in vascular morphology and function over time in individual animals. In this chapter, we describe methods and analytical approaches for using IVVM to study vascular morphology and dynamics.

Breast cancer metastasis suppressor 1 (BRMS1) inhibits the ability of multiple human and murine cancer cell lines to metastasize to lymph nodes, bones and lungs. Comparison of mRNA expression in metastatic MDA-MB-435 human carcinoma cells (435) and metastasis-suppressed BRMS1 transfectants (435/BRMS1) showed a marked (90%) reduction of osteopontin (OPN) mRNA and protein expression in BRMS1-overexpressing cells. OPN expression is associated with disease progression in patients, with higher levels of OPN produced by cancer cells associated with poorer patient survival. Furthermore, OPN has been suggested to promote survival of cancer cells in response to stress, although the mechanisms by which this may occur remain poorly understood. This study tested the hypothesis that re-expression of OPN in metastasis-suppressed 435/BRMS1 cells would reverse metastasis suppression and confer protection from stress-induced apoptosis. A stable pooled population of OPN overexpressing 435/BRMS1 cells was created (435/BRMS1/OPN). OPN re-expression did not affect in vitro cell growth rates; however, increased anchorage independent growth/survival and protection from hypoxia-induced apoptosis was observed (p0.05). In vivo, OPN re-expression in BRMS1 transfected cells did not affect in vivo primary tumor growth but did increase the incidence of spontaneous metastasis to lymph nodes and lungs in mice. These novel findings suggest that OPN downregulation by BRMS1 may be responsible, at least in part, for BRMS1-mediated metastasis suppression by sensitizing cancer cells to stress induced apoptosis. These studies clarify one mechanism by which BRMS1 can suppress metastasis.

Experimental studies on angiogenesis are clarifying many aspects of this important process and are leading to new approaches to use this information clinically. Histology of fixed tissues is a commonly used “gold standard” for assessing development of tumor vasculature during disease progression or changes in vasculature in response to genetic manipulation or therapy. However, histology provides only a static snapshot‐in‐time of vascular status, and can provide only limited information about vessel function or dynamics. Here we describe microscopy techniques and image processing approaches for using intravital video microscopy (IVVM) for the study of normal and tumor vascular morphology and function. IVVM provides powerful, high‐resolution approaches for observing the vasculature in multiple organs or experimental animals. In addition to providing informative images, IVVM combined with video postprocessing and image analysis approaches can be used to extract valuable quantitative information from video images. This information includes morphological parameters such as vascular diameter, density, branching, and three‐dimensional vascular geometry, as well as functional and physiological information such as the identification of vessels that are perfused with red blood cells (RBCs) or plasma, rate of RBC flow, and oxygen status of RBCs. An added strength of IVVM is the ability to provide longitudinal information, looking at changes in vascular morphology and function over time in individual animals. In this chapter, we describe methods and analytical approaches for using IVVM to study vascular morphology and dynamics.

It is generally assumed that when a muscle is shortened or extended the total length of capillaries does not change, implying that capillaries are nondistensible, longitudinally. On the basis of stereological estimates of capillary anisotropy versus sarcomere length, we propose that as long as capillaries are in a tortuous configuration muscle extension will merely decrease the tortuosity, leaving vessel length unaltered. Once capillaries have been pulled into a straight configuration, further extension of the muscle will cause the vessels to stretch. By means of intravital videomicroscopy we have demonstrated that stretching of individual capillaries does indeed occur over a sarcomere length range of 2.1 to 2.9 μm in rat extensor digitorum longus muscle. In vivo measurements of the lengths of six capillaries together with the sarcomere lengths of adjacent fibers were made in muscles positioned at various degrees of extension. Normalized data indicated that four capillaries stretched to the same degree as the muscle, one stretched more and another less. This may reflect differences in distensibility or tortuosity of capillaries in series with one another. The elastic stretching of capillaries during muscle activity may have important consequences in terms of shifts in permeability and increases in capillary surface area.

Lymphatic vessels provide one of the main anatomical routes by which invasive tumor cells can disseminate from the primary tumor. Certain types of cancer, breast cancer in particular, have a propensity to disseminate via the lymphatics.Yet despite the prevalence of lymphatic metastasis, experimental work elucidating the underlying biology, until recently, has been relatively limited. In the past several years, experimental metastasis research has experienced a surge in the number of studies examining the molecular determinants of lymphatic metastasis, as well as in vivo imaging of its progression in animal models.The following review aims to highlight recent preclinical experimental work that contributes to our basic understanding of lymphatic metastasis in breast cancer, and to describe a recently developed human cell model for lymphatic metastasis. Before continuing, however, a brief overview of clinical and pathological studies that detail the natural history of lymphatic metastasis in breast cancer will set the disease model, which experimental models must mimic.

Metastasis (the spread of cancer from a primary tumor to secondary organs) is responsible for most cancer deaths. The ability to follow the fate of a population of tumor cells over time in an experimental animal would provide a powerful new way to monitor the metastatic process. Here we describe a magnetic resonance imaging (MRI) technique that permits the tracking of breast cancer cells in a mouse model of brain metastasis at the single-cell level. Cancer cells that were injected into the left ventricle of the mouse heart and then delivered to the brain were detectable on MR images. This allowed the visualization of the initial delivery and distribution of cells, as well as the growth of tumors from a subset of these cells within the whole intact brain volume. The ability to follow the metastatic process from the single-cell stage through metastatic growth, and to quantify and monitor the presence of solitary undivided cells will facilitate progress in understanding the mechanisms of brain metastasis and tumor dormancy, and the development of therapeutics to treat this disease.

The identification and quantification of tumour volume measurement variability is imperative for proper study design of longitudinal non-invasive imaging of pre-clinical mouse models of cancer. Measurement variability will dictate the minimum detectable volume change, which in turn influences the scheduling of imaging sessions and the interpretation of observed changes in tumour volume. In this paper, variability is quantified for tumour volume measurements from 3D high-frequency ultrasound images of murine liver metastases. Experimental B16F1 liver metastases were analysed in different size ranges including less than 1 mm3, 1-4 mm3, 4-8 mm3 and 8-70 mm3. The intra- and inter-observer repeatability was high over a large range of tumour volumes, but the coefficients of variation (COV) varied over the volume ranges. The minimum and maximum intra-observer COV were 4% and 14% for the 1-4 mm3 and1 mm3 tumours, respectively. For tumour volumes measured by segmenting parallel planes, the maximum inter-slice distance that maintained acceptable measurement variability increased from 100 to 600 microm as tumour volume increased. Comparison of free breathing versus ventilated animals demonstrated that respiratory motion did not significantly change the measured volume. These results enable design of more efficient imaging studies by using the measured variability to estimate the time required to observe a significant change in tumour volume.

The objective of this study was to determine the time-course of computed tomography (CT) contrast enhancement of an iodinated blood-pool contrast agent.Five C57BL/6 mice were anesthetized, imaged at baseline, and given an iodinated blood-pool contrast agent. Micro-CT scans were acquired at 0, 0.25, 0.5, 1, 2, 4, 8, and 24 hours after injection. The mean CT number was determined in a region of interest in 7 organs.The CT contrast enhancement was plotted as a function of time for each organ. We identified an imaging window immediately after injection suitable for visualizing the vascular system and a second imaging window at 24 hours for visualizing liver and spleen.A single injection of the blood-pool contrast agent can be used for dual-phase investigations of the vasculature (t = 0 hours) and liver (t = 24 hours), which can be applied to studies of liver tumors or disease.

Liver metastasis is a clinically significant contributor to the mortality associated with melanoma, colon, and breast cancer. Preclinical mouse models are essential to the study of liver metastasis, yet their utility has been limited by the inability to study this dynamic process in a noninvasive and longitudinal manner. This study shows that three-dimensional high-frequency ultrasound can be used to noninvasively track the growth of liver metastases and evaluate potential chemotherapeutics in experimental liver metastasis models. Liver metastases produced by mesenteric vein injection of B16F1 (murine melanoma), PAP2 (murine H-ras–transformed fibroblast), HT-29 (human colon carcinoma), and MDA-MB-435/HAL (human breast carcinoma) cells were identified and tracked longitudinally. Tumor size and location were verified by histologic evaluation. Tumor volumes were calculated from the three-dimensional volumetric data, with individual liver metastases showing exponential growth. The importance of volumetric imaging to reduce uncertainty in tumor volume measurement was shown by comparing three-dimensional segmented volumes with volumes estimated from diameter measurements and the assumption of an ellipsoid shape. The utility of high-frequency ultrasound imaging in the evaluation of therapeutic interventions was established with a doxorubicin treatment trial. These results show that three-dimensional high-frequency ultrasound imaging may be particularly well suited for the quantitative assessment of metastatic progression and the evaluation of chemotherapeutics in preclinical liver metastasis models.

The intraobserver variability in volume measurements of small (less than 2 mm/sup 3/) tumors using three-dimensional high-frequency ultrasound has been assessed in two murine liver metastasis models. The maximum coefficient of variation was 10.7% for five B16F1 murine melanoma liver metastases and 18.2% for seven HT-29 human colon carcinoma liver metastases. The intraobserver variability was small compared to the tumor growth measured at two-day intervals in the rapidly progressing B16F1 model. However, the maximum measurement variability was comparable to the four-day growth rate in the slowly progressing HT-29 model.

A functional microcirculation is vital to the survival of mammalian tissues. In vivo video microscopy is often used in animal models to assess microvascular function, providing real-time observation of blood flow in normal and diseased tissues. To extend the capabilities of in vivo video microscopy, we have developed a contrast-enhanced system with postprocessing video analysis tools that permit quantitative assessment of microvascular geometry and function in vital organs and tissues. FITC-labeled dextran (250 kDa) was injected intravenously into anesthetized mice to provide intravascular fluorescence contrast with darker red blood cell (RBC) motion. Digitized video images of microcirculation in a variety of internal organs (e.g., lung, liver, ovary, and kidney) were processed using computer-based motion correction to remove background respiratory and cardiac movement. Stabilized videos were analyzed to generate a series of functional images revealing microhemodynamic parameters, such as plasma perfusion, RBC perfusion, and RBC supply rate. Fluorescence contrast revealed characteristic microvascular arrangements within different organs, and images generated from video sequences of liver metastases showed a marked reduction in the proportion of tumor vessels that were functional. Analysis of processed video sequences showed large reductions in vessel volume, length, and branch-point density, with a near doubling in vessel segment length. This study demonstrates that postprocessing of fluorescence contrast video sequences of the microcirculation can provide quantitative images useful for studies in a wide range of model systems.

Death from cancer is usually due to metastasis. Fortunately, most cells that escape from a primary tumor fail to form metastases. Identifying reasons for this failure will help development of anti-metastatic therapies. Intravital videomicroscopy (IVVM) can be used to observe cancer cells injected into live animals. Co-injected microspheres can be used to assess cell survival. These techniques have been used to show that circulating tumor cells generally arrest in the microcirculation and may extravasate with high efficiency. While many tumor cells may survive in a secondary site, only a small subset form micrometastases and only a subset of these micrometastases persist to form vascularized macrometastases. Furthermore, solitary tumor cells may remain dormant for long periods of time in secondary sites. These findings suggest that metastatic growth and angiogenesis are prime targets for anti-metastatic therapy.

Metastasis via the lymphatic system is considered a major factor in mortality from breast cancer. At present there are no models for direct measurement of tumor cell spread by lymphatics. This is needed for understanding basic biology of lymphatic involvement developing treatments and assessing their effectiveness. Purpose: To develop and assess IVVM for imaging the morphology and fluid dynamics of lymphatic vessels in mouse models during tumor development. Scope: Assessment of the concept that in vivo video microscopy (IVVM) can be used for studying experimental cancer spread via the lymphatic system. Methods: Primary tumors were formed by intradermal injection of cancer cells (ventral midline between inguinal lymph nodes). IVVM was used to examine lymphatics on one side (skinflap under anesthesia, 1-25 days post injection); conventional histology used to examine other side. Results: Tumor formation was accompanied by a well developed lymphatic network adjacent to the tumor and enlarged lymphatic vessels with valves in tissues between the tumor and lymph nodes as seen by histology and lVVM. By IVVM, lymphatic endothelium and cells carried by lymph flow could be clearly seen. Conclusion: IVVM is a powerful tool for studying cancer cells as they interact with the lymphatic system.

Tumors can recur years after treatment, and breast cancer is especially noted for long periods of dormancy. The status of the cancer during this period is poorly understood. As a model to study mechanisms of dormancy, we used murine D2.0R mammary carcinoma cells, which are poorly metastatic but form occasional metastases in liver and other organs after long latency. Highly metastatic D2A1 cells provided a positive, metastatic control. Our goals were to learn how the cell lines differ in survival kinetics in a secondary site and to seek evidence for the source of D2.0R dormancy. In spontaneous metastasis assays from mammary fat pad injections, we found evidence for dormancy because of a persistence of large numbers of solitary cells in the liver. To quantify the fate of cells after arrival in liver, experimental metastasis assays were used. To permit identification of cells that had not divided, cells were labeled before injection with fluorescent nanospheres, which were diluted to undetectable levels by cell division. Cancer cells were injected i.v. to target them to the liver and coinjected with reference microspheres to monitor cell survival. Dormancy was defined as retention of nanosphere fluorescence in vivo, as well as negative staining for the proliferation marker Ki67. A large proportion of D2.0R cells persisted as solitary dormant cells. No metastases formed, but viable cells could be recovered from the liver 11 weeks after injection. Large numbers of solitary, dormant, Ki67-negative D2A1 cells were also detected against a background of progressively growing metastases. Thus, this study identified a possible contributor to tumor dormancy: solitary, dormant cells that persist in tissue. If such cells are present in patients, they could contribute to tumor recurrence and would not be susceptible to current therapeutic strategies targeting proliferating cells.