Al.pone.0055841.gPET iImaging of Multiple MyelomaFigure 5. Graph representing tumor to muscle and blood respectively at early and late time-points. The Tumor/Muscle and Tumor/Blood ratios at 2 h and 24 h respectively calculated from the MIP images (SUVs). The ratios were higher at 24 h indicating improved contrast after clearance of the radioactive probe from the background tissues over time. doi:10.1371/journal.pone.0055841.gConfirmation of 5TGM1 Tumor Burden by Histological and Serum Protein Electrophoresis (SPEP) AnalysisA representative hematoxylin and eosin (H E) slide of a 5TGM1 s.c. tumor tissue from those imaged in Figure 4 is shown in Figure 7A. The tumor cells show irregularly shaped nuclei and increased mitosis consistent with myeloma pathogenic features. The SPEP test is used get 4EGI-1 Clinically to measure clonal c-globulin (M protein) in the blood to quantify disease burden in MM. SPEP analysis was performed on all tumor-bearing mice. Qualitative and quantitative analyses of the SPEP gels indicated increased Mprotein (gamma protein band) in tumor bearing mice as compared to non-tumor control mice.Figure 6. Graph representing in vivo blocking of 64Cu-CBTE1A1P-LLP2A. Averaged tumor MIP SUV’s (N = 4) calculated from small animal PET images in the presence and absence of the blocking agent, LLP2A. Inset-Representative MIP image showing mice with similar tumors in the nape of the neck imaged in the absence (L) and presence (R) of the blocking agent (LLP2A). Mice were imaged with small animal PET and 64Cu-CB-TE1A1P-LLP2A at 2 h post-injection (0.9 MBq, 0.05 mg, 27 pmol, (SA: 37 MBq/mg). Blocking dose: ,200 fold excess than the tracer amount. P,0.05. doi:10.1371/journal.pone.0055841.AKT inhibitor 2 chemical information gBinding of 64Cu-CB-TE1A1P-LLP2A to Human RPMI-8226 Myeloma CellsBinding of 64Cu-CB-TE1A1P-LLP2A was evaluated in human MM cell line RPMI-8226 in vitro. RPMI-8226 cell uptake experiments demonstrated high uptake of 64Cu-CB-TE1A1PLLP2A that was significantly blocked in the presence of excess LLP2A (P,0.0001) (Figure 8).DiscussionThis study demonstrates novel imaging of MM tumors using a high-affinity, VLA-4 (integrin a4b1) targeted PET probe, in a s.c. and i.p. (extra-osseous) immunocompetent mouse model of MM. Clinically, MM is characterized by the presence of end-organ damage such as lytic bone disease, anemia, hypercalcemia, and renal insufficiency [30]. While laboratory tests such as serum protein electrophoresis (SPEP), 18325633 urine protein electrophoresis, bone marrow evaluation, and serum free light chains are key to making a preliminary diagnosis, molecular imaging assists in locating the tumor lesion within the bone and outside the bone. Imaging of the skeleton, with the aim to rule out lytic bone lesions, is important to discriminate MM from its precursor states. FDG-PET/CT fusion imaging has the ability to detect diffuse or focal lesions in the bone marrow prior to destruction of mineralized bone as well asextramedullary disease in patients [31,32]. However, FDG-PET/ CT is often not effective at imaging subsets of myeloma patients presenting drug resistant (DR) tumors due to intrinsically limited metabolic rates of the DR tumors [33?5]. Moreover, FDG-PET/ CT also has limitations in the diagnosis or staging of clinically organ-confined or locally recurrent disease since FDG uptake is increased in cells and tissues undergoing rapid division, growth, and inflammatory response. These processes are transient and are not necessarily tumor-specific [36,37]. VLA-4 b.Al.pone.0055841.gPET iImaging of Multiple MyelomaFigure 5. Graph representing tumor to muscle and blood respectively at early and late time-points. The Tumor/Muscle and Tumor/Blood ratios at 2 h and 24 h respectively calculated from the MIP images (SUVs). The ratios were higher at 24 h indicating improved contrast after clearance of the radioactive probe from the background tissues over time. doi:10.1371/journal.pone.0055841.gConfirmation of 5TGM1 Tumor Burden by Histological and Serum Protein Electrophoresis (SPEP) AnalysisA representative hematoxylin and eosin (H E) slide of a 5TGM1 s.c. tumor tissue from those imaged in Figure 4 is shown in Figure 7A. The tumor cells show irregularly shaped nuclei and increased mitosis consistent with myeloma pathogenic features. The SPEP test is used clinically to measure clonal c-globulin (M protein) in the blood to quantify disease burden in MM. SPEP analysis was performed on all tumor-bearing mice. Qualitative and quantitative analyses of the SPEP gels indicated increased Mprotein (gamma protein band) in tumor bearing mice as compared to non-tumor control mice.Figure 6. Graph representing in vivo blocking of 64Cu-CBTE1A1P-LLP2A. Averaged tumor MIP SUV’s (N = 4) calculated from small animal PET images in the presence and absence of the blocking agent, LLP2A. Inset-Representative MIP image showing mice with similar tumors in the nape of the neck imaged in the absence (L) and presence (R) of the blocking agent (LLP2A). Mice were imaged with small animal PET and 64Cu-CB-TE1A1P-LLP2A at 2 h post-injection (0.9 MBq, 0.05 mg, 27 pmol, (SA: 37 MBq/mg). Blocking dose: ,200 fold excess than the tracer amount. P,0.05. doi:10.1371/journal.pone.0055841.gBinding of 64Cu-CB-TE1A1P-LLP2A to Human RPMI-8226 Myeloma CellsBinding of 64Cu-CB-TE1A1P-LLP2A was evaluated in human MM cell line RPMI-8226 in vitro. RPMI-8226 cell uptake experiments demonstrated high uptake of 64Cu-CB-TE1A1PLLP2A that was significantly blocked in the presence of excess LLP2A (P,0.0001) (Figure 8).DiscussionThis study demonstrates novel imaging of MM tumors using a high-affinity, VLA-4 (integrin a4b1) targeted PET probe, in a s.c. and i.p. (extra-osseous) immunocompetent mouse model of MM. Clinically, MM is characterized by the presence of end-organ damage such as lytic bone disease, anemia, hypercalcemia, and renal insufficiency [30]. While laboratory tests such as serum protein electrophoresis (SPEP), 18325633 urine protein electrophoresis, bone marrow evaluation, and serum free light chains are key to making a preliminary diagnosis, molecular imaging assists in locating the tumor lesion within the bone and outside the bone. Imaging of the skeleton, with the aim to rule out lytic bone lesions, is important to discriminate MM from its precursor states. FDG-PET/CT fusion imaging has the ability to detect diffuse or focal lesions in the bone marrow prior to destruction of mineralized bone as well asextramedullary disease in patients [31,32]. However, FDG-PET/ CT is often not effective at imaging subsets of myeloma patients presenting drug resistant (DR) tumors due to intrinsically limited metabolic rates of the DR tumors [33?5]. Moreover, FDG-PET/ CT also has limitations in the diagnosis or staging of clinically organ-confined or locally recurrent disease since FDG uptake is increased in cells and tissues undergoing rapid division, growth, and inflammatory response. These processes are transient and are not necessarily tumor-specific [36,37]. VLA-4 b.