Molecular MRI of VEGFR-2 reveals intra-tumor and inter-tumor heterogeneity.

Non-invasive and quantitative imaging of vascular endothelial growth factor receptor-2 (VEGFR-2) expression levels is highly important in cancer diagnosis, prognosis, and patient management. Although various literature reports have investigated the tumor expression levels of VEGFR-2 using imaging techniques such as positron emission tomography, single-photon emission computed tomography, targeted ultrasound, etc., accurate evaluation of the dynamic microdistribution of VEGFR-2 in vivo with good spatial and temporal resolution remains a major challenge. In this issue of the American Journal of Nuclear Medicine and Molecular Imaging, He at al. reported the use of a VEGFR-2 targeted probe for magnetic resonance imaging (MRI) of VEGFR-2 in two glioma models in rats (i.e. C6 and RG2). The heterogeneity of VEGFR-2 expression was non-invasively imaged with MRI and validated with various in vitro, in vivo, and ex vivo experiments. Not only was heterogeneous expression of VEGFR-2 found in different glioma tumors, it was also observed in different regions within the same tumor (e.g. tumor periphery, peri-necrotic area, and tumor interior). This report highlights the complex nature of gliomas, which may offer invaluable insights into tumor heterogeneity and potential clinical management of glioma patients. These patients have dismal clinical outcomes and are in urgent need of better tools to improve brain tumor treatment.