Science to Practice: Monitoring Oncolytic Virus Therapy with Chemical Exchange Saturation Transfer MR Imaging--Wishful Thinking?

Farrar et al demonstrate that modifying an oncolytic virus (OV) so that it produces excess protein when it infects a cancer cell is a process that can be detected both in vitro and in vivo in infected cancer cells by using chemical exchange saturation transfer (CEST) magnetic resonance (MR) imaging. The effect is at the limits of MR imaging detection (approximately 1%), but experience with functional MR imaging of the brain, with comparably small effects, should give pause to anyone who immediately writes this observation off as an exercise in wishful thinking. OVs are improving in their specificity, virulence, and ability to induce immune responses. Now, they have been modified to express proteins that are detectable with CEST MR imaging early after delivery into a tumor. This is clearly a surprising and hopeful development in the long road of OVs from the laboratory to the clinic.