We thank Dr. I. Verma for the lentiviral Ca2Cre-shp53 vector. The work was supported by funds from the Canadian Institutes of Health Research (CIHR MOP 137113) to AEK.

Animal studies were performed in accordance with the Institutional Animal Care and Use Committee (IACUC) of McGill University and procedures were approved by the Animal Welfare Committee of McGill University (animal use protocol # 2009-5754).
1. Generation of CA2Cre-shp53 Lentiviral Titre
NOTE: The following protocol is the same as that described in Xia et al.6, with minor modifications.
<ol>
	<li>Preparation of lentivirus (for 15 cm x 10 cm dishes)
	<ol>
		<li>On day 1, plate healthy HEK293T cells (7.5 x 106 cells per 10 cm dish) with 10 mL of Dulbecco&#39;s modified Eagle medium) (DMEM), 10% fetal bovine serum (FBS), and 1% pen/strep. Culture in a 37 &#176;C, 5% CO2 incubator.</li>
		<li>Prepare the mix for calcium-phosphate transfection (mixture for 15 plates). Prepare tube A containing 225 &#181;g (15 &#181;g/plate) of the lentiviral vector (Ca2Cre-shp53), 75 &#181;g (5 &#181;g/plate) of PsPAX2 plasmid (containing HIV-1 gag and HIV-1 pol genes), 75 &#181;g (5 &#181;g/plate) of pMD2.G plasmid (containing VSV-G gene) for packaging, a final concentration of 0.15 M of CaCl2 and fill the tube with distilled H2O up to 3.75 mL. Prepare tube B containing 3.75 mL of 2x HEPES-buffered saline (HBS; 50 mM HEPES, pH 7.05, 280 mM NaCl, 10 mM KCl, 1.5 mM Na2HPO4&#183;2H2O, and 12 mM D-dextrose).</li>
		<li>Vortex tube A and add it dropwise to tube B under continuous vortexing. 
		NOTE: The total volume will be 7.5 mL.</li>
		<li>Incubate at room temperature in the dark for 20&#8722;30 min.</li>
		<li>Approximately 9 h after plating the cells, add 500 &#181;L of the transfection mixture dropwise into the cell medium (7.5 mL/15 dishes: 0.5 mL per dish).</li>
		<li>Swirl gently each dish to mix, and incubate all dishes at 37 &#176;C, 5% CO2.</li>
		<li>On day 2, 12&#8722;18 h after transfection, replace the media with 10 mL of antibiotic-free reduced serum media (Table of Materials) per 10 cm dish. Place dishes back in the 37 &#176;C, 5% CO2 incubator.</li>
		<li>On day 3, collect the media containing lentiviruses expressing Ca2Cre-shp53 and filter through 0.45 &#956;m filters. Replenish the media with fresh antibiotic-free reduced serum media. 
		NOTE: The collected media can be kept at 4 &#176;C for no more than 3 days.</li>
		<li>On day 4, collect, for a second time, the media containing the lentivirus and filter through a 0.45 &#181;m filter. Keep at 4 &#176;C (for no more than 3 days).</li>
		<li>Combine the virus supernatants from steps 1.1.8 and 1.1.9. Concentrate them through centrifugal filter units (Table of Materials) by centrifuging at 1,372 x g for 30 min at 4 &#176;C. Repeat the process until all the collected media has passed through the columns. 
		NOTE: After each centrifugation, 100&#8722;200 &#956;L of concentrated filtrate can be harvested.</li>
		<li>Collect and mix the concentrated filtrates in a 15 mL ice-cold tube. Mix the concentrated lentiviruses well and then aliquot (e.g., 100 &#956;L/ tube). Store at -80 &#176;C.</li>
	</ol>
	</li>
	<li>Lentiviral titration 
	NOTE: Immortalized mouse embryonic fibroblasts (MEFs) expressing a loxP-flanked allele of green fluorescent protein (GFP) are used in this protocol for the quantification of viral titer. However, any cell line with a loxP-GFP allele should be suitable for this step.
	<ol>
		<li>Culture cells expressing a loxP-flanked allele of GFP with DMEM, 10% FBS and 1% pen/strep at 37 &#176;C, 5% CO2.</li>
		<li>Plate 2 x 105 cells in two 50 mm wells of a 6-well plate. 
		NOTE: The cells of one well will be used for lentiviral infection while that of the other will be used as a negative control.</li>
		<li>The next day, replenish the cells with 2 mL of DMEM, 10% FBS, and 1% pen/strep 2 h before lentiviral infection.</li>
		<li>Add 20 &#181;L of the CA2Cre-shp53 lentivirus (the volume may vary when needed) in the lentiviral infection well.</li>
		<li>After 3 days in culture, determine the frequency of the Cre-induced GFP-positive cells by flow cytometry, as shown in Figure 1. Wash cells with phosphate-buffered saline (PBS), detach by trypsinization and collect cells by centrifugation at 112 x g.</li>
		<li>Wash the cells twice with PBS. Finally, suspend the cells in 100 &#181;L of PBS. Determine the percentage of GFP positive cells by a cell analyzer (Table of Materials).</li>
		<li>Calculate the lentivirus infectious/functional titer using the following formula: 
		<img alt="Equation 1" src="/files/ftp_upload/60565/60565equ01.jpg" /> 
		where F is the frequency of GFP-positive cells and calculated by subtracting the frequency of GFP -positive cells after infection (Fi) from the frequency of GFP-positive cells (background) prior to infection (Fc) as shown in Figure 1 (F = Fi-Fc), Cn is the number of plated cells (2 x 105), V is the volume of the inoculum (mL), and DF is the virus dilution factor. 
		NOTE: The infectious/functional concentration = ~2 x 106 TU/mL.</li>
	</ol>
	</li>
</ol>
2. Intratracheal Intubation of Lentiviruses in LSL-KRASG12D Mice
NOTE: The method of intratracheal intubation was used as described in the published protocol by Vandivort et al.9. In this protocol, mice LSL-KRASG12D mice in C57BL/6 background are used at age 6&#8722;8 weeks. A home-made working procedure board is used as described in Vandivort et al.9. The board is positioned in front of the experimenter in a convenient workspace (approximately 1 m2).
<ol>
	<li>Prepare a spirometer by removing the plunger of a 1 mL syringe and loading 60 &#181;L of PBS into the syringe.</li>
	<li>Attach a 22 G catheter tip into the syringe and set aside.</li>
	<li>Anaesthetize the mice by intraperitoneal injection of a 1 &#181;L/g of mouse body weight of ketamine (50 mg/mL)/xylazine (5 mg/mL)/acepromazine (1 mg/mL) cocktail. Ensure proper sedation of the mouse by a low respiratory rate (1 breath every 2 s).</li>
	<li>Aspirate 20 &#181;L of CA2Cre-shp53 lentivirus into a pipettor and set aside.</li>
	<li>Position the sedated mouse on the working procedure board by hooking its upper incisors into the thread of the board. 
	NOTE: The mouse&#39;s dorsum should be flat against the platform.</li>
	<li>Tape the caudal portion of the thoracic cavity to the platform to ensure alignment of the mouse during the procedure.</li>
	<li>Adjust a gooseneck illuminator between 80&#8722;100% intensity and place the light 1&#8722;2 cm from the skin surface.</li>
	<li>From behind the platform, draw the tongue out of the oral cavity of the mouse using sterile forceps.</li>
	<li>While securing the tongue, insert a depressor into the oral cavity of the mouse then release the tongue.</li>
	<li>Position the gooseneck on the main stem bronchi to illuminate trachea. 
	NOTE: The trachea may be visible through the action of respiration, causing fluctuation of the light.</li>
	<li>When the trachea is clearly viewed, insert the spirometer prepared (syringe with PBS and catheter) into the tracheal path.</li>
	<li>Remove the depressor and observe the rise and fall of PBS in the syringe with each breath. 
	NOTE: This is an indicator that the catheter is properly positioned into the trachea.</li>
	<li>Remove the syringe containing PBS while maintaining the catheter inside the trachea as the previous position.</li>
	<li>Deposit the 20 &#181;L CA2Cre-shp53 lentivirus into the center of the catheter.</li>
	<li>While keeping the catheter in place, inject 300 &#181;L of air into the catheter using an empty syringe to ensure proper distribution of lentivirus in the lungs.</li>
	<li>Keep the catheter in place and reinsert the spirometer into the catheter. 
	NOTE: The rise and fall of the PBS bubble will ensure that the procedure is successful.</li>
	<li>Remove the catheter and tape. Place the animal in a warm and dry place until it is revived.</li>
</ol>
3. Ultrasound Imaging of Lung Tumors in Mice
NOTE: Ultrasound imaging was performed after 7 and 18 weeks of lentiviral intubation using the system listed in Table of Materials; however, any model can be used for the analysis.
<ol>
	<li>One day prior to imaging, remove fur from the chest area of the intubated mouse. 
	NOTE: Mouse should be sedated during this step by placing them in an induction chamber of 3% isoflurane and 2L/minute O2.</li>
	<li>On the day of imaging, set up the workspace as shown in Figure 2. Turn on the heating pump for ultrasound gel and the temperature monitor.</li>
	<li>Set up a warm 33 &#176;C incubator to place the mice in post-imaging.</li>
	<li>Place the three-dimensional (3D) motor (Figure 2F) on the integrated rail system.</li>
	<li>Make sure that the 3D motor and the transducer mounting system are securely in place.</li>
	<li>Connect a preferred transducer (frequency: 40 MHz; Figure 2E and Table of Materials) for tumor measurements perpendicular to the 3D motor.</li>
	<li>Start a new study on the ultrasound software.
	<ol>
		<li>Select Study Browser, then select New at the bottom of the screen.</li>
		<li>Select New Study, a new window will appear that enables the addition of a Study Name in addition to further information about the study, i.e., date of study, name of researcher, etc.</li>
		<li>Fill in the information in Series Name, i.e., Animal ID, Strain, Weight, Date of Birth, etc.</li>
		<li>Select Done, the program will change for B-mode.</li>
	</ol>
	</li>
	<li>Put a heating lamp in a convenient position above the animal platform.</li>
	<li>Place the mouse in the induction chamber (3.5% isoflurane). 
	NOTE: Proper anesthetization is confirmed by unconsciousness of the mouse, and slower respiratory rate of around 1 breath per 2 seconds.</li>
	<li>When the mouse is sedated, change the connection of the anesthetic machine to be directed towards the animal platform, reduce isoflurane to 2.5%.</li>
	<li>Place the mouse on the animal platform in decubitus ventral, with its oral cavity directed towards the anesthetics tube.</li>
	<li>Apply lubricant on the eyes of the mouse.</li>
	<li>Place the mouse in decubitus dorsal and tape its hands and feet firmly onto the animal platform.</li>
	<li>Apply a small layer of ultrasound gel on the mouse chest.</li>
	<li>Lower the acquisition probe using the height-control knob to touch the surface of the mouse chest. Position the probe such that the heart of the mouse is approximately centered.</li>
	<li>Use the micro-knobs to acquire images of the whole chest, from both extremities, in the transverse orientation ideally gathering 500 frames per mouse (number of frames may vary depending on personal choice).</li>
	<li>Once imaging is done, remove the gel from the chest of the mouse and place the mouse in the warm incubator.</li>
</ol>
4. 2D Analysis of Ultrasound Images
<ol>
	<li>After opening acquired frames on the ultrasound software, scan the frames for tumors.</li>
	<li>For small initiating tumors, count the number of B-lines periodically every 10 frames for the full length of the 500 frames acquired. 
	Therefore, B-lines are counted in a total of 50 images, each image is separated by 10 frames. B-lines are characterized by longitudinal white straight lines fully traversing the screen.</li>
	<li>For 2D measurements of large tumors, select the linear tool and measure the width and length of the tumor present.</li>
	<li>To calculate the volume of the tumors, use the following formula: 
	<img src="/files/ftp_upload/60565/60565equ02.jpg" /> 
	where L and W are the length and width of the tumor, respectively.</li>
</ol>

<ol>
	<li>Eisenstein, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Personalized+medicine:+Special+treatment.">Personalized medicine: Special treatment.</a> Nature. 513, 8 (2014).</li><li>Karachaliou, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=KRAS+mutations+in+lung+cancer.">KRAS mutations in lung cancer.</a> Clinical Lung Cancer. 14 (3), 205-214 (2013).</li><li>Jackson, E. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+lung+tumor+initiation+and+progression+using+conditional+expression+of+oncogenic+K-ras.">Analysis of lung tumor initiation and progression using conditional expression of oncogenic K-ras.</a> Genes &amp; Development. 15 (24), 3243-3248 (2001).</li><li>DuPage, M., Dooley, A. L., Jacks, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Conditional+mouse+lung+cancer+models+using+adenoviral+or+lentiviral+delivery+of+Cre+recombinase.">Conditional mouse lung cancer models using adenoviral or lentiviral delivery of Cre recombinase.</a> Nature Protocol. 4 (7), 1064-1072 (2009).</li><li>Chen, J., Lecuona, E., Briva, A., Welch, L. C., Sznajder, J. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Carbonic+anhydrase+II+and+alveolar+fluid+reabsorption+during+hypercapnia.">Carbonic anhydrase II and alveolar fluid reabsorption during hypercapnia.</a> American Journal of Respiratory Cell and Molecular Biology. 38 (1), 32-37 (2008).</li><li>Xia, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reduced+cell+proliferation+by+IKK2+depletion+in+a+mouse+lung-cancer+model.">Reduced cell proliferation by IKK2 depletion in a mouse lung-cancer model.</a> Nature Cell Biology. 17 (4), 532 (2015).</li><li>Demi, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determination+of+a+potential+quantitative+measure+of+the+state+of+the+lung+using+lung+ultrasound+spectroscopy.">Determination of a potential quantitative measure of the state of the lung using lung ultrasound spectroscopy.</a> Scientific Reports. 7, 12746 (2017).</li><li>Mohanty, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+the+Lung+Parenchyma+Using+Ultrasound+Multiple+Scattering.">Characterization of the Lung Parenchyma Using Ultrasound Multiple Scattering.</a> Ultrasound in Medicine and Biology. 43, 993-1003 (2017).</li><li>Vandivort, T. C., An, D., Parks, W. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+Improved+Method+for+Rapid+Intubation+of+the+Trachea+in+Mice.">An Improved Method for Rapid Intubation of the Trachea in Mice.</a> Journal of Visualized Experiments. (108), e53771 (2016).</li><li>Saraogi, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lung+ultrasound:+Present+and+future.">Lung ultrasound: Present and future.</a> Lung India. 32 (3), 250-257 (2015).</li><li>Gargani, L., Volpicelli, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+I+do+it:+lung+ultrasound.">How I do it: lung ultrasound.</a> Cardiovascular Ultrasound. 12, 25 (2014).</li><li>Soldati, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+the+Physical+Basis+of+Pulmonary+Sonographic+Interstitial+Syndrome.">On the Physical Basis of Pulmonary Sonographic Interstitial Syndrome.</a> Journal of Ultrasound in Medicine. 35 (10), 2975 (2016).</li><li>Raes, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High-Resolution+Ultrasound+and+Photoacoustic+Imaging+of+Orthotopic+Lung+Cancer+in+Mice:+New+Perspectives+for+Onco-Pharmacology.">High-Resolution Ultrasound and Photoacoustic Imaging of Orthotopic Lung Cancer in Mice: New Perspectives for Onco-Pharmacology.</a> PLoS One. 11 (4), 15 (2016).</li><li>Lakshman, M., Needles, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Screening+and+quantification+of+the+tumor+microenvironment+with+micro-ultrasound+and+photoacoustic+imaging.">Screening and quantification of the tumor microenvironment with micro-ultrasound and photoacoustic imaging.</a> Nature Methods. 12 (4), 372 (2015).</li><li>Chichra, A., Makaryus, M., Chaudhri, P., Narasimhan, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+for+the+Pulmonary+Consultant.">Ultrasound for the Pulmonary Consultant.</a> Clinical Medicine Insights: Circulatory Respiratory and Pulmonary Medicine. 10, 9 (2016).</li></ol>

The authors have nothing to disclose.

We demonstrate a method that can assess lung tumor growth in the Cre-inducible LSL-KRAS G12D mouse model by ultrasound. This method can be used for evaluating the effect of pharmacological inhibitors on lung tumor growth. It can also be used to compare lung tumor growth between mice of different genetic backgrounds. Using this technique does not require specialized computational skills, however, it is important to be systematic in the number of frames used for analysis to allow for proper comparison if the method is used for comparing different groups of mice.
The intratracheal intubation of ~2 x 106 TU/mL Ca2Cre-shp53 in LSL-KRAS G12D mice led to the formation of precursor lesions after 7 weeks of infection. These appear as longitudinal white lines on sonographic images and are called B-lines (Figure 3B)12. The average number of B-lines per mouse was 141.6 &#177; 41.52 (Figure 3E). We chose to visualize initiating tumors at 7 weeks post-infection since this timepoint would include various types of precursor lesions; atypical adenomatous hyperplasia, epithelial hyperplasia and adenoma3. The formation of precursor lesions on the lung was verified by H&#38;E staining after 8 weeks of lentiviral infection (Figure 4A). After 18 weeks of viral intubation, the tumors are large enough to allow 2D volume measurements in the ultrasound software (Figure 3C). Analysis of ultrasound images was done at the 18-week timepoint in order to include the quantification of well-developed adenoma and adenocarcinoma3. The formation of these types of tumors was confirmed at 20 weeks post-infection by H&#38;E staining analysis (Figure 4B). 3D volume measurements are also possible by the ultrasound software but require high level of expertise. The titre described in this protocol is optimal for the formation of lung tumors that can be properly visualized and quantified in 2D.
Other imaging techniques can also be used to monitor lung tumor growth in mice, such as CT imaging and BLI13. However, CT imaging requires delivering a radiation dose to the tumor, which might affect tumor growth upon repeated assays13. Moreover, it requires the use of contrast agents for accurate tumor measurements13. BLI is an important imaging technique that is often used for quantifying tumor proliferation; however, its main limitation is its dependence on metabolic activities and the presence of ATP and O213. The advantage of ultrasound imaging lies in it being a non-invasive, non-irradiating, speedy and inexpensive technique for acquiring images of the lung parenchyma13. Ultrasound has been previously used to monitor growth of orthotopic human tumors xenografted in lung and pancreas of mice13,14. Raes et al. have been successful in longitudinally monitoring the growth of a single human lung tumor implanted near the posterior diaphragmic surface in mice via ultrasound13. The difference in the LSL-KRAS G12D mouse model is having spontaneous development of lung tumors that can be monitored from initiation to progression and this development can be compared between mice groups. Also, there are numerous tumors being developed on the lung of the LSL-KRAS G12D mouse model, that eventually grow, and might even merge together to form large tumors (Figure 4B). This urged the need to use a method that can monitor lung tumor initiation and progression in this mouse model. We optimized the 2D brightness (B) mode analysis to allow quantitative assessment of lung tumors developed in this mouse model.
A possible limitation with ultrasound imaging is the presence of false positives15. These are seen when a highly reflective surface is present (diaphragm or liver) that interrupts the trajectory of the beam and might create a virtual object mimicking a true object15. Such images could be false tumors but can be bypassed upon proper examination; a large tumor is usually dynamic whereas a virtual object would be static.
Ultrasound imaging for the LSL-KRAS mouse model is ideal due to the non-invasive nature of this technique. The method of analysis used in our lab to monitor lung tumor progression in the LSL-KRAS mouse model is fast and user-friendly.

As the leading cause of cancer-related deaths worldwide, lung cancer remains refractory to treatments, mainly due to lack of relevant pre-clinical models that can recapitulate the disease in the lab1. Around 25% of lung cancer cases are due to mutations in the KRAS oncogene2. KRAS-driven lung cancer is often associated with poor prognosis and low response to therapy, highlighting the importance of further studies in this disease2.
We optimized a method that allows the relative evaluation of lung tumor growth in real time in KRAS lung cancer-induced immune-competent mice. We use Lox-Stop-Lox KRAS G12D (LSL-KRAS G12D) mice in which the KRAS G12D oncogene can be expressed by Cre lentiviral vectors3,4. These vectors are driven by carbonic anhydrase 2, allowing the viral infection to take place specifically in alveolar epithelial cells5. In addition, to accelerate the initiation and progression of lung tumors, the lentiviral construct also expresses P53 shRNA from an U6/H1 promoter (the lentiviral construct herein will be referred to as Ca2Cre-shp53)6. The biological relevance of this method lies in the natural course of lung tumor development in mice as opposed to xenografts of non-orthotopic tumors in mice. An obstacle using the orthotopic method is monitoring lung tumor growth without sacrificing the mouse. To overcome this limitation, we optimized ultrasound imaging to permit the analysis of lung tumor progression in two-dimensional (2D) mode in this mouse model. Initiating tumors at 7 weeks post-infection are reflected as B-lines in ultrasound images, which can be counted, but will not reflect the exact number of tumors present on the lung. B-lines are characterized by laser-like vertical white lines arising from the pleural line in the lung parenchyma7,8. Large tumors can be visualized after 18 weeks of infection. The relative volume of these tumors is quantified by 2D measurements done on ultrasound.
This method is optimal for researchers investigating the effect of pharmacological drugs on lung tumor growth in the LSL-KRAS G12D mouse model. In addition, lung tumor progression can be compared between mice with different genetic lineages, to examine the importance of the presence or absence of certain genes/proteins on the development of lung tumor volume.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.45 &#956;m Acrodisc Syringe Filters</td>
			<td>Pall Corporation</td>
			<td>PN 4614</td>
			<td></td>
		</tr>
		<tr>
			<td>100-mm Cell Cultre Plate</td>
			<td>CELLSTAR</td>
			<td>664 160</td>
			<td></td>
		</tr>
		<tr>
			<td>6-well Cell Culture Plate</td>
			<td>CELLSTAR</td>
			<td>657 160</td>
			<td></td>
		</tr>
		<tr>
			<td>Amicon Ultra - 15 Centrifugal Filter Units</td>
			<td>Merck Millipore Ltd.</td>
			<td>UFC910024</td>
			<td></td>
		</tr>
		<tr>
			<td>BD LSR-Fortessa</td>
			<td>BD Biosciences</td>
			<td>649225B 3024</td>
			<td></td>
		</tr>
		<tr>
			<td>CA2Cre-shp53 lentiviral vector</td>
			<td></td>
			<td></td>
			<td>From Dr. I Verma Laboratory</td>
		</tr>
		<tr>
			<td>DMEM</td>
			<td>Multicell</td>
			<td>319-005-CL</td>
			<td></td>
		</tr>
		<tr>
			<td>FBS</td>
			<td>Multicell</td>
			<td>80450</td>
			<td></td>
		</tr>
		<tr>
			<td>LSL-KRASG12D mouse</td>
			<td>JAX Mice</td>
			<td>8179</td>
			<td></td>
		</tr>
		<tr>
			<td>MX550S; Centre Transmit: 40 MHz</td>
			<td>FUJIFILM VisualSonics</td>
			<td>51070</td>
			<td></td>
		</tr>
		<tr>
			<td>OptiMEM</td>
			<td>gibco</td>
			<td>11058-021</td>
			<td></td>
		</tr>
		<tr>
			<td>Pen/strep</td>
			<td>Multicell</td>
			<td>450-201-EL</td>
			<td></td>
		</tr>
		<tr>
			<td>pMD2.G</td>
			<td>Addgene</td>
			<td>12259</td>
			<td></td>
		</tr>
		<tr>
			<td>PsPAX2</td>
			<td>Addgene</td>
			<td>12260</td>
			<td></td>
		</tr>
		<tr>
			<td>VEVO-3100</td>
			<td>FUJIFILM VisualSonics</td>
			<td>51072-50</td>
			<td></td>
		</tr>
	</tbody>
</table>

detection of lung tumor progression in mice by ultrasound imaging

With ~1.6 million victims per year, lung cancer contributes tremendously to the worldwide burden of cancer. Lung cancer is partly driven by genetic alterations in oncogenes such as the KRAS oncogene, which constitutes ~25% of lung cancer cases. The difficulty in therapeutically targeting KRAS-driven lung cancer partly stems from having poor models that can mimic the progression of the disease in the lab. We describe a method that permits the relative quantification of primary KRAS lung tumors in a Cre-inducible LSL-KRAS G12D mouse model via ultrasound imaging. This method relies on brightness (B)-mode acquisition of the lung parenchyma. Tumors that are initially formed in this model are visualized as B-lines and can be quantified by counting the number of B-lines present in the acquired images. These would represent the relative tumor number formed on the surface of the mouse lung. As the formed tumors develop with time, they are perceived as deep clefts within the lung parenchyma. Since the circumference of the formed tumor is well-defined, calculating the relative tumor volume is achieved by measuring the length and width of the tumor and applying them in the formula used for tumor caliper measurements. Ultrasound imaging is a non-invasive, fast and user-friendly technique that is often used for tumor quantifications in mice. Although artifacts may appear when obtaining ultrasound images, it has been shown that this imaging technique is more advantageous for tumor quantifications in mice compared to other imaging techniques such as computed tomography (CT) imaging and bioluminescence imaging (BLI). Researchers can investigate novel therapeutic targets using this technique by comparing lung tumor initiation and progression between different groups of mice.

After obtaining a lentiviral infectious titer of ~2 x 106 TU/mL (Figure 1), the Ca2Cre-shp53 lentivirus was intratracheally injected when LSL-KRAS G12D mice reached an appropriate age (6&#8722;8 weeks)9. Ultrasound imaging was performed after 7 weeks of infection upon initiation of tumors (Figure 3B). Imaging was done at 7 weeks in order to include the various types of precursor lesions that occur in the LSL-KRASG12D mouse model, ranging from hyperplasia to adenoma3 as shown in Figure 4A after 8 weeks of infection. Imaging earlier than 6 weeks will not ensure the inclusion of adenoma-forming tumors in the analysis3. These precursor lesions are visualized as B-lines in ultrasound and can be counted by eye since they can be identified as narrow beams of white light vertically traversing the screen and are the result of a strong reflection of ultrasound wave (Figure 3B)10. B-lines represent small tumors that are on the surface of the lungs; tumors being initiated in deeper structures of the lung such as close to the trachea will not be reflected as B-lines. The number of tumors being initiated on the pleural surface can be quantified by counting the B-lines, since they are too small for volume measurements. We acquired 500 frames spanning the full lung area in 5 mice. B-lines were counted every 10 frames; thus, they were counted in a total of 50 images per mouse that span the full 500 frames acquired. The scatter plot in Figure 3D shows the sum of B-lines counted in every 10 images (100 frames) for 5 mice. The number of B-lines per mouse is then summed up to include B-lines present in the full lung area. The mean quantity of B-lines representing tumors in the five mice was 141.6 &#177; 41.52 (Figure 3E). Figure 3A shows an ultrasound image acquired of a non-infected mouse lung, for comparison.
According to Jackson et al.3, 16 weeks post-intubation includes adenoma as well as adenocarcinoma, which are tumor types of interest in KRAS lung cancer. To ensure inclusion of these types of tumors when analyzing volume measurements via ultrasound in our model, we imaged the lungs of mice at 18 weeks post-infection. In order to quantify the volume of the large tumors via ultrasound, we used 2D analysis on the ultrasound software. Large tumors appear as deep clefts interrupting the pleural surface as shown in the image of Figure 3C. When a tumor is spotted, we measure the length (L) and width (W) of the tumor, using the measurement tool of the ultrasound software. Once obtained, L and W are applied in the conventional formula used for calculating tumor volume (protocol step 4.4). We analyzed the tumor volume of 10 mice, as shown in Figure 3F, where the number of tumors formed in each mouse ranged from 5 to 26 tumors. The volumes of all tumors formed per mouse are then summed up to represent the tumor volume per mouse. For this analysis, we assume that the tumors formed in the lungs of mice are epileptic in shape, thus the width of the tumor is considered as perpendicular to the imaging plane. Relative volume quantification can be done when linear size of tumors reaches 0.3 mm (either length or width). After analyzing the lung parenchyma of 10 mice, the average tumor volume obtained was 31.8 &#177; 6.61 mm3 (Figure 3G). Hematoxylin and Eosin (H&#38;E) staining analysis on lung sections confirmed the formation of large tumors at 20 weeks post-infection (Figure 4B) and confirmed formation of adenoma and adenocarcinoma. It should be noted that as tumor growth progresses, different tumors might merge together to form large ones, as shown in Figure 4B. Although the ultrasound software permits 3D analysis of tumors, this type of analysis proved difficult in our model, mainly due to the high dynamic movement of the primary tumors formed that is consistent with lung sliding (movement of the pleural line with respiration) as well as cardiac beats11. We reasoned that 2D analysis would provide consistency in relative tumor volume measurements, especially when comparing lung tumor progression between different groups of mice.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/60565/60565fig01.jpg" /> 
Figure 1: Flow cytometry analysis of MEFs with a GFP LoxP-allele. Representative flow cytometry images showing frequency of GFP-positive MEFs that are non-infected (Fc) (A) and infected (Fi) with the Ca2Cre-shp53 lentivirus (B). <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/60565/60565fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/60565/60565fig02.jpg" /> 
Figure 2: Workspace of integrated rail system of ultrasound imaging. (A) X-axis micro-knob. (B) Y-axis micro-knob. (C) Animal platform. (D) Height control knob of scan head-probe. (E) Transducer. (F) 3D motor. (G) Heating lamp. (H) Anesthetics tube. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/60565/60565fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/60565/60565fig03.jpg" /> 
Figure 3: Representative ultrasound images of mouse lungs before and after lung tumor induction. (A) Image of a non-infected mouse lung section. Red arrows point to ribs (R) and the pleural surface (PS) of the lung. (B) Image of a mouse lung 7 weeks after tumor induction by intratracheal intubation of lentivirus. Arrows indicate B-lines reflecting small tumors on the lung surface. (C) Image of a mouse lung section 18 weeks after tumor induction. Blue lines indicate measurements of the length (L: mm) and width (W: mm) of the tumor shown. (D) Scatter plot showing B-line quantification in 10 images spanning 500 frames (each image is separated by 10 frames). (E) Quantification of relative tumor number in lungs at 7 weeks post-induction. (F) Scatter plot showing the relative volume of the different tumors formed in the lungs of 10 mice at 18 weeks post-infection. (G) Quantification of lung tumor volume in mice (n = 10). <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/60565/60565fig03large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/60565/60565fig04.jpg" /> 
Figure 4: Representative H&#38;E staining of LSL-KRAS G12D lung sections. (A) Lung section at 8 weeks post-infection at 500 &#181;m magnification. Arrows point at precursor lesions formed at this timepoint, which are reflected as B-lines in ultrasound. Black arrows point at magnified lesions at 60 &#181;m. (B) Lung section at 20 weeks post-infection at 2 mm magnification. Arrowheads of the same color show different tumors that have merged together. Arrows show magnified tumors at 60 &#181;m. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/60565/60565fig04large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>

Watch this Scientific Journal Video about Detection of Lung Tumor Progression in Mice by Ultrasound Imaging at JoVE.com

Detection of Lung Tumor Progression in Mice by Ultrasound Imaging

This protocol describes the steps taken to induce KRAS lung tumors in mice as well as the quantification of formed tumors by ultrasound imaging. Small tumors are visualized in early timepoints as B-lines. At later timepoints, relative tumor volume measurements are achieved by the measurement tool in the ultrasound software.

With ~1.6 million victims per year, lung cancer contributes tremendously to the worldwide burden of cancer. Lung cancer is partly driven by genetic ...

detection-of-lung-tumor-progression-in-mice-by-ultrasound-imaging

Nanyang Technological University

Research

JoVE Journal

Cancer Research

6.6K Views.  Sir Mortimer B. Davis-Jewish General Hospital. This protocol describes the steps taken to induce KRAS lung tumors in mice as well as the quantification of formed tumors by ultrasound imaging. Small tumors are visualized in early timepoints as B-lines. At later timepoints, relative tumor volume measurements are achieved by the measurement tool in the ultrasound software.

Video: Detection of Lung Tumor Progression in Mice by Ultrasound Imaging

Lung Tumor Cell Recruitment Assay

To investigate the molecular mechanisms governing tumor metastasis, various assays using the mouse as a model animal have been proposed. Here, we demonstrate a simple assay to evaluate tumor cell extravasation or micrometastasis. In this assay, tumor cells were injected through the tail vein, and after a short period, the lungs were dissected and digested to count the accumulated labeled tumor cells. This assay skips the initial step of primary tumor invasion into the blood vessel and facilitates the study of events in the distant organ where tumor metastasis occurs. The number of cells injected into the blood vessel can be optimized to observe a limited number of metastases. It has been reported that stromal cells in the distant organ contribute to metastasis. Thus, this assay could be a useful tool to explore potential therapeutic drugs or devices for prevention of tumor metastasis.

This manuscript describes a method to quantify tumor cell accumulation in the lungs in an animal model of tumor metastasis.

To investigate the molecular mechanisms governing tumor metastasis, various assays using the mouse as a model animal have been proposed. Here, we ...

A Murine Orthotopic Bladder Tumor Model and Tumor Detection System

This protocol describes the generation of bladder tumors in female C57BL/6J mice using the murine bladder cancer cell line MB49, which has been modified to secrete human Prostate Specific Antigen (PSA), and the procedure for the confirmation of tumor implantation. In brief, mice are anesthetized using injectable drugs and are made to lay in the dorsal position. Urine is vacated from the bladder and 50 &#181;L of poly-L-lysine (PLL) is slowly instilled at a rate of 10 &#181;L/20 s using a 24 G IV catheter. It is left in the bladder for 20 min by stoppering the catheter. The catheter is removed and PLL is vacated by gentle pressure on the bladder. This is followed by instillation of the murine bladder cancer cell line (1 x 105 cells/50 &#181;L) at a rate of 10 &#181;L/20 s. The catheter is stoppered to prevent premature evacuation. After 1 h, the mice are revived with a reversal drug, and the bladder is vacated. The slow instillation rate is important, as it reduces vesico-ureteral reflux, which can cause tumors to occur in the upper urinary tract and in the kidneys. The cell line should be well re-suspended to reduce clumping of cells, as this can lead to uneven tumor sizes after implantation.
This technique induces tumors with high efficiency. Tumor growth is monitored by urinary PSA secretion. PSA marker monitoring is more reliable than ultrasound or fluorescence imaging for the detection of the presence of tumors in the bladder. Tumors in mice generally reach a maximum size that negatively impacts health by about 3 - 4 weeks if left untreated. By monitoring tumor growth, it is possible to differentiate mice that were cured from those that were not successfully implanted with tumors. With only end-point analysis, the latter may be mistakenly assumed to have been cured by therapy.

This protocol describes the generation of murine orthotopic bladder tumors in female C57BL/6J mice and the monitoring of tumor growth.

This protocol describes the generation of bladder tumors in female C57BL/6J mice using the murine bladder cancer cell line MB49, which has been modified ...

Ex Vivo Imaging of Resident CD8 T Lymphocytes in Human Lung Tumor Slices Using Confocal Microscopy

CD8 T cell are key players in the fight against cancer. In order for CD8 T cells to kill tumor cells they need to enter into the tumor, migrate within the tumor microenvironment and respond adequately to tumor antigens. The recent development of improved imaging approaches, such as 2-photon microscopy, and the use of powerful mouse tumor models have shed light on some of the mechanisms that regulate anti-tumor T cell activities. Whereas such systems have provided valuable insights, they do not always predict human responses. In human, our knowledge in the field mainly comes from a description of fixed tumor samples from human patients, as well as in vitro studies. However, in vitro models lack the complex three-dimensional tumor milieu and, therefore, are incomplete approximations of in vivo T cell activities. Fresh slices made from explanted tissue represent a complex multi-cellular tumor environment that can act as an important link between co-cultured studies and animal models. Originally set up in murine lymph nodes1 and previously described in a JoVE article2, this approach has now been transposed to human tumors to examine the dynamics of both plated3&#160;as well as resident&#160;T cells4.
Here, a protocol for the preparation of human lung tumor slices, immunostaining of resident CD8 T and tumor cells, and tracking of CD8 T lymphocytes within the tumor microenvironment using confocal microscopy is described. This system is uniquely placed to screen for novel immunotherapy agents favoring T cell migration in tumors.

Ex Vivo Imaging of Resident CD8 T Lymphocytes in Human Lung Tumor Slices Using Confocal Microscopy

This protocol describes a method to image resident tumor-infiltrating CD8 T cells labeled with fluorescently coupled antibodies within human lung tumor slices. This technique permits real-time analyses of CD8 T cell migration using confocal microscopy.

CD8 T cell are key players in the fight against cancer. In order for CD8 T cells to kill tumor cells they need to enter into the tumor, migrate within the ...

The Establishment of a Lung Colonization Assay for Circulating Tumor Cell Visualization in Lung Tissues

Metastasis is the major cause of cancer death. The role of circulating tumor cells (CTCs) in promoting cancer metastasis, in which lung colonization by CTCs critically contributes to early lung metastatic processes, has been vigorously investigated. As such, animal models are the only approach that captures the full systemic process of metastasis. Given that problems occur in previous experimental designs for examining the contributions of CTCs to blood vessel extravasation, we established an in vivo lung colonization assay in which a long-term-fluorescence cell-tracer, carboxyfluorescein succinimidyl ester (CFSE), was used to label suspended tumor cells and lung perfusion was performed to clear non-specifically trapped CTCs prior to lung removal, confocal imaging, and quantification. Polymeric fibronectin (polyFN) assembled on CTC surfaces has been found to mediate lung colonization in the final establishment of metastatic tumor tissues. Here, to specifically test the requirement of polyFN assembly on CTCs for lung colonization and extravasation, we performed short term lung colonization assays in which suspended Lewis lung carcinoma cells (LLCs) stably expressing FN-shRNA (shFN) or scramble-shRNA (shScr) and pre-labeled with 20 &#956;M of CFSE were intravenously inoculated into C57BL/6 mice. We successfully demonstrated that the abilities of shFN LLC cells to colonize the mouse lungs were significantly diminished in comparison to shScr LLC cells. Therefore, this short-term methodology may be widely applied to specifically demonstrate the ability of CTCs within the circulation to colonize the lungs.

An animal model is needed to decipher the role of circulating tumor cells (CTCs) in promoting lung colonization during cancer metastasis. Here, we established and successfully performed an in vivo assay to specifically test the requirement of polymeric fibronectin (polyFN) assembly on CTCs for lung colonization.

Metastasis is the major cause of cancer death. The role of circulating tumor cells (CTCs) in promoting cancer metastasis, in which lung colonization by ...

Radionuclide-fluorescence Reporter Gene Imaging to Track Tumor Progression in Rodent Tumor Models

Metastasis is responsible for most cancer deaths. Despite extensive research, the mechanistic understanding of the complex processes governing metastasis remains incomplete. In vivo models are paramount for metastasis research, but require refinement. Tracking spontaneous metastasis by non-invasive in vivo imaging is now possible, but remains challenging as it requires long-time observation and high sensitivity. We describe a longitudinal combined radionuclide and fluorescence whole-body in vivo imaging approach for tracking tumor progression and spontaneous metastasis. This reporter gene methodology employs the sodium iodide symporter (NIS) fused to a fluorescent protein (FP). Cancer cells are engineered to stably express NIS-FP followed by selection based on fluorescence-activated cell sorting. Corresponding tumor models are established in mice. NIS-FP expressing cancer cells are tracked non-invasively in vivo at the whole-body level by positron emission tomography (PET) using the NIS radiotracer [18F]BF4-. PET is currently the most sensitive in vivo imaging technology available at this scale and enables reliable and absolute quantification. Current methods either rely on large cohorts of animals that are euthanized for metastasis assessment at varying time points, or rely on barely quantifiable 2D imaging. The advantages of the described method are: (i) highly sensitive non-invasive in vivo 3D PET imaging and quantification, (ii) automated PET tracer production, (iii) a significant reduction in required animal numbers due to repeat imaging options, (iv) the acquisition of paired data from subsequent imaging sessions providing better statistical data, and (v) the intrinsic option for ex vivo confirmation of cancer cells in tissues by fluorescence microscopy or cytometry. In this protocol, we describe all steps required for routine NIS-FP-afforded non-invasive in vivo cancer cell tracking using PET/CT and ex vivo confirmation of in vivo results. This protocol has applications beyond cancer research whenever in vivo localization, expansion and long-time monitoring of a cell population is of interest.

We describe a protocol for preclinical in vivo tracking of cancer metastasis. It is based on a radionuclide-fluorescence reporter combining the sodium iodide symporter, detected by non-invasive [18F]tetrafluoroborate-PET, and a fluorescent protein for streamlined ex vivo confirmation. The method is applicable for preclinical in vivo cell tracking beyond tumor biology.

Metastasis is responsible for most cancer deaths. Despite extensive research, the mechanistic understanding of the complex processes governing metastasis ...

Digital Polymerase Chain Reaction Assay for the Genetic Variation in a Sporadic Familial Adenomatous Polyposis Patient Using the Chip-in-a-tube Format

The quantitative analysis of human genetic variation is crucial for understanding the molecular characteristics of serious medical conditions, such as tumors. Because digital polymerase chain reactions (PCR) enable the precise quantification of DNA copy number variants, they are becoming an essential tool for detecting rare genetic variations, such as drug-resistant mutations. It is expected that molecular diagnoses using digital PCR (dPCR) will be available in clinical practice in the near future; thus, how to efficiently conduct dPCR with human genetic material is a hot topic. Here, we introduce a method to detect Adenomatous polyposis coli (APC) somatic mosaicism using dPCR with the chip-in-a-tube format, which allows eight dPCR reactions to be simultaneously conducted. Care should be taken when filling and sealing the reaction mixture on the chips. This article demonstrates how to avoid the over- and underestimation of positive partitions. Furthermore, we present a simple procedure for collecting the dPCR product from the partitions on the chips, which can then be used to confirm the specific amplification. We hope that this methods report will help promote the dPCR with the chip-in-a-tube method in genetic research.

Digital polymerase chain reaction (PCR) is a useful tool for the high-sensitivity detection of single nucleotide variants and DNA copy number variants. Here, we demonstrate key considerations for measuring rare variants in the human genome using digital PCR with the chip-in-a-tube format.

The quantitative analysis of human genetic variation is crucial for understanding the molecular characteristics of serious medical conditions, such as ...

Real Time Detection of In Vitro Tumor Cell Apoptosis Induced by CD8+ T Cells to Study Immune Suppressive Functions of Tumor-infiltrating Myeloid Cells

Potentiation of the tumor-killing ability of CD8+ T cells in tumors, along with their efficient tumor infiltration, is a key element of successful immunotherapies. Several studies have indicated that tumor infiltrating myeloid cells (e.g., myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs)) suppress cytotoxicity of CD8+ T cells in the tumor microenvironment, and that targeting these regulatory myeloid cells can improve immunotherapies. Here, we present an in vitro assay system to evaluate immune suppressive effects of monocytic-MDSCs and TAMs on the tumor-killing ability of CD8+ T cells. To this end, we first cultured na&#239;ve splenic CD8+ T cells with anti-CD3/CD28 activating antibodies in the presence or absence of suppressor cells, and then co-cultured the pre-activated T cells with target cancer cells in the presence of a fluorogenic caspase-3 substrate. Fluorescence from the substrate in cancer cells was detected by real-time fluorescence microscopy as an indicator of T-cell induced tumor cell apoptosis. In this assay, we can successfully detect the increase of tumor cell apoptosis by CD8+ T cells and its suppression by pre-culture with TAMs or MDSCs. This functional assay is useful for investigating CD8+ T cell suppression mechanisms by regulatory myeloid cells and identifying druggable targets to overcome it via high throughput screening.

Real Time Detection of In Vitro Tumor Cell Apoptosis Induced by CD8+ T Cells to Study Immune Suppressive Functions of Tumor-infiltrating Myeloid Cells

We describe here a protocol to investigate cytotoxicity of pre-activated CD8+ T cells against cancer cells by detecting apoptotic cancer cells via real-time microscopy. This protocol can investigate mechanisms behind myeloid cell-induced T cell suppression and evaluate compounds aimed at replenishing T cells via blockade of immune suppressive myeloid cells.

Potentiation of the tumor-killing ability of CD8+ T cells in tumors, along with their efficient tumor infiltration, is a key element of successful ...

In Vivo Inhibition of MicroRNA to Decrease Tumor Growth in Mice

MicroRNAs (miRNAs) are important regulators of gene expression through their ability to destabilize mRNA and inhibit translation of target mRNAs. An ever-increasing number of studies have identified miRNAs as potential biomarkers for cancer diagnosis and prognosis, and also as therapeutic targets, adding an extra dimension to cancer evaluation and treatment. In the context of thyroid cancer, tumorigenesis results not only from mutations in important genes, but also from the overexpression of many miRNAs. Accordingly, the role of miRNAs in the control of thyroid gene expression is evolving as an important mechanism in cancer. Herein, we present a protocol to examine the effects of miRNA-inhibitor delivery as a therapeutic modality in thyroid cancer using human tumor xenograft and orthotopic mouse models. After engineering stable thyroid tumoral cells expressing GFP and luciferase, cells are injected into nude mice to develop tumors, which can be followed by bioluminescence. The in vivo inhibition of a miRNA can reduce tumor growth and upregulate miRNA gene targets. This method can be used to assess the importance of a determined miRNA in vivo, in addition to identifying new therapeutic targets.

This protocol describes xenograft and orthotopic mouse models of human thyroid tumorigenesis as a platform to test microRNA-based inhibitor treatments. This approach is ideal to study the function of non-coding RNAs and their potential as new therapeutic targets.

MicroRNAs (miRNAs) are important regulators of gene expression through their ability to destabilize mRNA and inhibit translation of target mRNAs. An ...

Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence

Circulating tumor cells (CTCs) derived from the primary tumor are shed into the bloodstream or lymphatic system. These rare cells (1&#8722;10 cells per mL of blood) warrant a poor prognosis and are correlated with shorter overall survival in several cancers (e.g., breast, prostate and colorectal). Currently, the anti-EpCAM-coated magnetic bead-based CTC capturing system is the gold standard test approved by the U.S. Food and Drug Administration (FDA) for enumerating CTCs in the bloodstream. This test is based on the use of magnetic beads coated with anti-EpCAM markers, which specifically target epithelial cancer cells. Many studies have illustrated that EpCAM is not the optimal marker for CTC detection. Indeed, CTCs are a heterogeneous subpopulation of cancer cells and are able to undergo an epithelial-to-mesenchymal transition (EMT) associated with metastatic proliferation and invasion. These CTCs are able to reduce the expression of cell surface epithelial marker EpCAM, while increasing mesenchymal markers such as vimentin. To address this technical hurdle, other isolation methods based on physical properties of CTCs have been developed. Microfluidic technologies enable a label-free approach to CTC enrichment from whole blood samples. The spiral microfluidic technology uses the inertial and Dean drag forces with continuous flow in curved channels generated within a spiral microfluidic chip. The cells are separated based on the differences in size and plasticity between normal blood cells and tumoral cells. This protocol details the different steps to characterize the programmed death-ligand 1 (PD-L1) expression of CTCs, combining a spiral microfluidic device with customizable immunofluorescence (IF) marker set.

The characterization of circulating tumor cells (CTCs) is a popular topic in translational research. This protocol describes a semi-automatic immunofluorescence (IF) assay for PD-L1 characterization and enumeration of CTCs in non-small cell lung cancer (NSCLC) patient samples.

Circulating tumor cells (CTCs) derived from the primary tumor are shed into the bloodstream or lymphatic system. These rare cells (1&#8722;10 cells per mL ...

Multidimensional Coculture System to Model Lung Squamous Carcinoma Progression

Tumor-stroma interactions play a critical role in the development of lung squamous carcinoma (LUSC). However, understanding how these dynamic interactions contribute to tissue architectural changes observed during tumorigenesis remains challenging due to the lack of appropriate models. In this protocol, we describe the generation of a 3D coculture model using a LUSC primary cell culture known as TUM622. TUM622 cells were established from a LUSC patient-derived xenograft (PDX) and have the unique property to form acinar-like structures when seeded in a basement membrane matrix. We demonstrate that TUM622 acini in 3D coculture recapitulate key features of tissue architecture during LUSC progression as well as the dynamic interactions between LUSC cells and components of the tumor microenvironment (TME), including the extracellular matrix (ECM) and cancer-associated fibroblasts (CAFs). We further adapt our principal 3D culturing protocol to demonstrate how this system could be utilized for various downstream analyses. Overall, this organoid model creates a biologically rich and adaptable platform that enables one to gain insight into the cell-intrinsic and extrinsic mechanisms that promote the disruption of epithelial architectures during carcinoma progression and will aid the search for new therapeutic targets and diagnostic markers.

An in vitro model system was developed to capture tissue architectural changes during lung squamous carcinoma (LUSC) progression in a 3-dimensional (3D) co-culture with cancer-associated fibroblasts (CAFs). This organoid system provides a unique platform to investigate the roles of diverse tumor cell-intrinsic and extrinsic changes that modulate the tumor phenotype.

Tumor-stroma interactions play a critical role in the development of lung squamous carcinoma (LUSC). However, understanding how these dynamic interactions ...