High-resolution metabolic imaging of high-grade gliomas using 7T-CRT-FID-MRSI

[Display omitted] •We demonstrated reliable and fast whole-brain 3D-MRSI of high-grade gliomas at 7T.•tCho, Gln, and Gly were increased in contrast-enhancing tumor tissue.•Results corresponded well to clinical data, but show more differentiated images.•We found cases of heterogeneity in metabolic im...

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Veröffentlicht in:	NeuroImage clinical Jg. 28; S. 102433
Hauptverfasser:	Hangel, Gilbert, Cadrien, Cornelius, Lazen, Philipp, Furtner, Julia, Lipka, Alexandra, Hečková, Eva, Hingerl, Lukas, Motyka, Stanislav, Gruber, Stephan, Strasser, Bernhard, Kiesel, Barbara, Mischkulnig, Mario, Preusser, Matthias, Roetzer, Thomas, Wöhrer, Adelheid, Widhalm, Georg, Rössler, Karl, Trattnig, Siegfried, Bogner, Wolfgang
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Netherlands Elsevier Inc 01.01.2020 Elsevier
Schlagworte:	7 Tesla Adult Aged Brain Brain Neoplasms - diagnostic imaging Concentric circle trajectories Female Glioma - diagnostic imaging Glycine High-grade glioma Humans Magnetic Resonance Imaging Magnetic resonance spectroscopic imaging Male Metabolic imaging Middle Aged Radiology Regular Reproducibility of Results tCr PT Gln Tau IDH Glu UHF Gly MP2RAGE Cys MRSI MM tCho HGG FOV ROI 7 Tesla 2HG NCE VOI Concentric circle trajectories FWHM GABA Metabolic imaging CRLB T1w iMUSICAL NAAG Magnetic resonance spectroscopic imaging Ser CRT SAR WET Glycine SVS SNR WM T2w FLAIR High-grade glioma GSH WT FID CE GM NAWM NEC TME NAA TE mIns Ctn PET TR macromolecules normal-appearing white matter isocitrate dehydrogenase non-contrast-enhanced echo time wildtype 2-hydroxyglutarate free induction decay glutamate (myo-)inositol repetition time necrotic field of view T1-weighted γ-aminobutyric acid full width at half maximum volume of interest glutamine white matter T2-weighted fluid-attenuated inversion recovery concentric ring trajectories gray matter region of interest signal-to-noise ratio tumor microenvironment serine N-acetyl-aspartyl glutamate cysteine magnetic resonance single-voxel spectroscopy cystathionine total creatine, creatine + phosphocreatine choline-containing compounds taurine specific absorption rate glutathione contrast-enhanced water suppression enhanced through T 1 effects interleaved multichannel spectroscopic data combined by matching image calibration data peritumoral ultra-high-field Cramér–Rao lower bound N-acetyl-aspartate positron emission tomography magnetization-prepared 2 rapid acquisition gradient echoes
ISSN:	2213-1582, 2213-1582
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Zusammenfassung:	[Display omitted] •We demonstrated reliable and fast whole-brain 3D-MRSI of high-grade gliomas at 7T.•tCho, Gln, and Gly were increased in contrast-enhancing tumor tissue.•Results corresponded well to clinical data, but show more differentiated images.•We found cases of heterogeneity in metabolic images not visible in clinical imaging. Successful neurosurgical intervention in gliomas depends on the precision of the preoperative definition of the tumor and its margins since a safe maximum resection translates into a better patient outcome. Metabolic high-resolution imaging might result in improved presurgical tumor characterization, and thus optimized glioma resection. To this end, we validated the performance of a fast high-resolution whole-brain 3D-magnetic resonance spectroscopic imaging (MRSI) method at 7T in a patient cohort of 23 high-grade gliomas (HGG). We preoperatively measured 23 patients with histologically verified HGGs (17 male, 8 female, age 53 ± 15) with an MRSI sequence based on concentric ring trajectories with a 64 × 64 × 39 measurement matrix, and a 3.4 × 3.4 × 3.4 mm3 nominal voxel volume in 15 min. Quantification used a basis-set of 17 components including N-acetyl-aspartate (NAA), total choline (tCho), total creatine (tCr), glutamate (Glu), glutamine (Gln), glycine (Gly) and 2-hydroxyglutarate (2HG). The resultant metabolic images were evaluated for their reliability as well as their quality and compared to spatially segmented tumor regions-of-interest (necrosis, contrast-enhanced, non-contrast enhanced + edema, peritumoral) based on clinical data and also compared to histopathology (e.g., grade, IDH-status). Eighteen of the patient measurements were considered usable. In these patients, ten metabolites were quantified with acceptable quality. Gln, Gly, and tCho were increased and NAA and tCr decreased in nearly all tumor regions, with other metabolites such as serine, showing mixed trends. Overall, there was a reliable characterization of metabolic tumor areas. We also found heterogeneity in the metabolic images often continued into the peritumoral region. While 2HG could not be satisfyingly quantified, we found an increase of Glu in the contrast-enhancing region of IDH-wildtype HGGs and a decrease of Glu in IDH1-mutant HGGs. We successfully demonstrated high-resolution 7T 3D-MRSI in HGG patients, showing metabolic differences between tumor regions and peritumoral tissue for multiple metabolites. Increases of tCho, Gln (related to tumor metabolism), Gly (related to tumor proliferation), as well as decreases in NAA, tCr, and others, corresponded very well to clinical tumor segmentation, but were more heterogeneous and often extended into the peritumoral region.
Bibliographie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2213-1582 2213-1582
DOI:	10.1016/j.nicl.2020.102433