Review Article

Preclinical Imaging Biomarkers for Postischaemic Neurovascular Remodelling

Table 2

Literature search results and extracted data.

ReferenceMethod and application (models)Imaging parametersContrast agent or molecular probeSafety considerations for clinical translationApplications

Bosomtwi et al. [14]MRI to observe poststroke vascular changes (rats)FOV: 32 mmFeridexNoninvasiveTissues can be monitored long term through stages of angiogenesis enabling evaluation of vascular remodelling

Bosomtwi et al. [15]MRI in combination with LSCM to visualise postischaemic changes in vasculature (rats)FOV: 32 mmMIONsNoninvasive; high doses of intravascular agent are requiredLSCM can be used to validate MRI data; poststroke vascular remodelling can be three-dimensionally quantified

Brunner et al. [16]fUS to measure postischaemic cerebral blood volume (rats)Resolution: 100 μm, FOV: 12.8 × 9 mm2, duration: approx. 3 minNoneNo contrast agent injections are requiredStroke longitudinally studied across all stages; can image whilst in motion, as the probe is implanted on the head

Cai et al. [17]PET to observe VEGFR expression in poststroke angiogenesis (rats)64Cu-DOTA-VEGF121Some cellular VEGFRs may be visualised, resulting in the potential to observe poststroke reorganisation and plasticity

Deddens et al. [18]MRI to detect vascular remodelling after cerebral ischaemia (mice)FOV: 1 × 1.2 × 2 cm3PECAM-1-targetted FeOx microparticlesPECAM-1 can be used to assess poststroke vascular remodelling

Ding et al. [19]MRI to visualise poststroke cerebral angiogenesis (rats)FOV: 32 × 32 × 16 mm3Gd-DTPANoninvasiveDetect angiogenesis and determine the temporal profile of angiogenic processes

Errico et al. [20]Ultrafast US localisation microscopy to visualise neurovasculature and quantify haemodynamic characteristics (rats)Resolution: 12.5 × 2.5 × 1 μm3Inert perfluorocarbon-filled microbubblesMicrobubbles are clinically approved contrast agentsEven slight haemodynamic changes in neurovasculature can be monitored; the resolution can be enhanced by localising microbubbles directly from radiofrequency data; motion correction algorithms needed

Figueiredo et al. [21]CTATo observe cerebral vascular anatomy and blood flow (mice)Resolution: 163μm3, duration: 20–40 sIomeprolInjection of contrast agent is requiredCan detect changes in the diameter of vasculature
MRAResolution: 31 × 31 × 93 μm3, FOV: 12 × 16 mm2, duration: 58 minNoneNo ionising radiation
Digital subtraction angiographyResolution: 14 × 14 μm2, duration: 3 sIomeprolLow injection volume and dose of radiation, although much more invasive than CTA and MRACan detect changes in intracerebral blood flow

Gramer et al. [22]PET, LSI, and RGB reflectometry to measure CBF, blood oxygenation, and glucose metabolism (rats)Resolution (PET): 1.3 mm (FWHM), FOV: 12 × 7 mm2[18F]FDGThin-skull preparation is requiredCan be used to quantify metabolic activity of neurovasculature in real time making it suitable for studying pathological conditions. Partial volume is an issue

Horton et al. [23]Triphoton fluorescence microscopy to visualise hippocampal vasculature (mice)Resolution: 4.4 μm (axial, FWHM)Dextran-coupled Texas Red dyeOvercomes the limitations of two-photon microscopy, such as signal-to-background ratio of excitation in scattering tissues and lack of fluorescent labels that can be used

Howles et al. [24]Contrast-enhanced MRA to visualise neurovasculature (mice)Resolution: 52 × 52 × 100 μm3, FOV: 20 × 20 × 8 mm3, duration: approx. 12 minSC-Gd liposomal nanoparticlesSC-Gd allows for high contrast-to-noise ratio; useful to visualise very small vascular structures

Hu et al. [25]Optical-resolution PAM to study micro-haemodynamic activities (rodents)Resolution: 5 × 15 μm2NoninvasiveCan help quantify changes in metabolic parameters

Huang et al. [26]MRI to assess vascular reactivity and functionality during postischaemic proangiogenic vascular remodelling (rats)FOV: 2.56 × 2.56 cm2Anaesthesia protocols must be optimised to minimise physiological disturbance

Jimenez-Xarrie et al. [27]MRI to assess postischaemic cerebrovascular damageFOV: 32 × 32 mm, duration: 9 min 17 sNoneIsoflurane anaesthesia can affect stroke outcomes and evaluation of vascular changesLong-term vascular consequences of ischaemia with coincident hypertension can be studied

Kolodziej et al. [28]SPECT to study CBF (mice)Resolution: 0.7 mm (FWHM), FOV: 20.9 mm (axial), duration: approx. 2 h99mTc-HMPAO99mTc-HMPAO is lipophilic and is quickly cleared from the plasmaUses pinhole imaging for higher resolution

Lake et al. [29]MRI to assess poststroke brain morphology and vascular function (rats)Resolution: 0.1 × 0.1 mm2, duration: <12 minPropofol anaesthesia induces 20–60% regional vasoconstriction, which may influence vascular studiesFunctional MRI can be used to measure resting blood flow and cerebrovascular reactivity; structural MRI may have limited sensitivity to detect subtle changes in tissue morphology

Lecoq et al. [30]Two-photon phosphorescence lifetime microscopy to measure the partial pressure of oxygen and blood flow (mice)Resolution: <1 μm (lateral)Phosphorescent nanoprobe PtP-C343Minimally invasive; the probe is neither toxic nor phototoxicOxygen gradients in microvascular networks can be distinguished; this is particularly useful for postischaemia imaging

Letourneur et al. [31]Two-photon laser scanning microscopy to longitudinally image vascular development (mice)Duration: 50–150 sFluorescein-conjugated dextran and Texas Red-dextranRequires thinning of the skull; head must be immobilisedCan longitudinally image the same areas over many days; can measure flow dynamics over time in relation to changes in vessel diameter

Li et al. [32]LSI to study neurovasculature (rats)Resolution: 6.7 × 6.7 μm2NoneRequires thinning of the skullDifferent circulatory dynamics can be observed at different spatial locations

Liao et al. [33]Functional PAM to study functional changes in total haemoglobin concentration, cerebral blood volume, and haemoglobin O2 saturation in cerebral blood vessels (rats)Resolution: 36 × 65 μm2NoneCan be complemented with other imaging modalities for label-free visualisation of neurovasculature

Lin et al. [34]3D ΔR2-based microscopy of MRA to visualise poststroke changes in neurovasculature (rats)Resolution: 54 × 54 × 72 μm3, FOV: 2.8 × 2.8 × 1.4 cm3, duration: 76 minMIONsGreater magnetic fields may be needed to visualise smaller vesselsCan simultaneously visualise microvascular morphology and reveal physiological properties of microvascular cerebral blood volume

Luckl et al. [35]LSI and imaging of intrinsic signals to study CBF dynamics during ischaemia (rats)Resolution: 140 μm every 2 s, FOV: 5 × 5 mm2Erythrosin B dyeRequires thinning of the skull for better observationVascular changes in metabolism can be quantified

Miao et al. [36]LSI to study angiogenesis (rats)FOV: 4.7 × 4.7 mm2NoneRequires thinning of the skullCBF under various pathological states can be analysed, and smaller vessels can be enhanced; results can be affected by motion artefacts

Nagaraja et al. [37]MRI to visualise poststroke changes in the BBB (rats)FOV: 32 mmGd-DTPA and Gd-DTPA linked to bovine serum albumin and Evans blue dyeNoninvasiveDifferent measurements are obtained with different contrast agents; quantifying BBB permeability can help in understanding the progression of ischaemic injury

Sakadžić et al. [38]Two-photon phosphorescence lifetime microscopy to measure partial pressure of oxygen in cortical microvasculature under hypoxic conditions (rats, mice)Phosphorescent nanoprobe PtP-C343Minimally invasive with low doses of the probe required; no detected leakage of the probe into interstitial spacesThe partial pressure of oxygen can be simultaneously assessed at various positions and depths, making it more feasible to functionally study transient changes in oxygen levels

Schambach et al. [39]Volume-CTA to visualise cerebral vessels (mice)Duration: 40 sIodinated contrast agentLarge dose of contrast agent is requiredChanges in vessel diameter can be monitored

Schroeter et al. [40]PETTo observe postischaemic vascular changes (rats)Duration: up to 60 min[18F]FDG and [11C]PK11195NoninvasiveCharacterise neuroinflammation and metabolic disruptions repeatedly over time.
MRIFOV: 3.0 cmNoninvasiveCan help localise areas of infarction

Seo et al. [41]Contrast-enhanced μCT to visualise poststroke changes in cerebral vasculature (rats)Duration: approx. 2 minIopromideHigh doses of iodinated contrast agent are neededImages are subject to blurring due to physiological motion

Stein et al. [42]PAM to study blood oxygenation dynamics of hypoxic cerebral vasculature (mice)Resolution: 70 × 54 μm2None; monitors “endogenous” haemodynamicsNoninvasiveSingle blood vessels can be noninvasively assessed in real time

Struys et al. [43]PETTo characterise acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion (mice)Resolution: 1.35 mm (transaxial, FWHM), duration: 10 min[15O]H2O and [18F]FDGCan be used to monitor short-term/long-term perfusion and vascular remodelling in ischaemic stroke models
MRIResolution: 98 × 98 μm2, FOV: 2.5 × 2.5 cm2

Tsukada et al. [44]PET to study postischaemic changes (monkeys)Duration: 91 min[18F]flurpiridaz and [18F]BCPP-EFSurgical procedures are invasive and require anaesthesiaStudy metabolic properties and distinguish inflammatory processes

Yanev et al. [45]Steady-state contrast-enhanced MRI to assess the changes in cerebral blood volume and microvascular density after transient stroke (rats)FOV: 30 × 30 mm2, duration: approx. 135 minUltrasmall iron oxide particlesChanges in cerebral blood volume and microvascular density can be observed at least 3 months after stroke; only perfused (and therefore functional) vessels can be detected

Yoon et al. [46]Multiphoton luminescence to visualise morphological changes in cortical vasculature over time (mice)PEG-GNPsPEG-GNPs are highly biocompatibleLong circulation time of PEG-GNPs enables vascular imaging for several hours, making them suitable to observe remodelling

Yu et al. [47]Spectral Doppler OCT to quantitatively assess dynamic blood flow before and after stroke (mice)Duration: approx. 20 minRose bengalMimics ischaemic conditions by reducing CBF in microvasculature; the pulsatility of CBF is quantified; changes in heart rate due to anaesthesia wearing off and being readministered must be considered

Zhang et al. [48]SR-PCI to visualise neural microvasculature (rats)Resolution: <10 μm, FOV: approx. 3 mmNoneHigh doses of ionising radiationVascular architecture and volume can be visualised and quantified; FOV is limited

External sources were not consulted to fill in missing details at this stage in the research. Abbreviations: FOV, field of view; MRI, magnetic resonance imaging; LSCM, laser scanning confocal microscopy; MION, monocrystalline iron oxide nanoparticle; fUS, functional ultrasound; PET, positron emission tomography; VEGFR, vascular endothelial growth factor receptor; PECAM, platelet endothelial cell adhesion molecule; Gd-DTPA, gadolinium-diethylenetriaminepentaacetate; US, ultrasound; CTA, computed tomography-angiography; MRA, magnetic resonance angiography; LSI, laser speckle imaging; RGB, red-green-blue; CBF, cerebral blood flow; FWHM, full width at half maximum; [18F]FDG, [18F]fluorodeoxyglucose; SC-Gd, surface-conjugated gadolinium; PAM, photoacoustic microscopy; SPECT, single-photon emission computed tomography; 99mTc-HMPAO, 99mTc-hexamethylpropyleneamineoxime; BBB, blood-brain barrier; μCT, microcomputed tomography; PEG-GNP, polyethylene glycosylated gold nanoparticle; OCT, optical coherence tomography; SR-PCI, synchrotron radiation phase contrast imaging.