pH-Weighted amine chemical exchange saturation transfer echo planar imaging visualizes infiltrating glioblastoma cells.
Neuro Oncol
; 26(1): 115-126, 2024 01 05.
Article
en En
| MEDLINE
| ID: mdl-37591790
ABSTRACT
BACKGROUND:
Given the invasive nature of glioblastoma, tumor cells exist beyond the contrast-enhancing (CE) region targeted during treatment. However, areas of non-enhancing (NE) tumors are difficult to visualize and delineate from edematous tissue. Amine chemical exchange saturation transfer echo planar imaging (CEST-EPI) is a pH-sensitive molecular magnetic resonance imaging technique that was evaluated in its ability to identify infiltrating NE tumors and prognosticate survival.METHODS:
In this prospective study, CEST-EPI was obtained in 30 patients and areas with elevated CEST contrast ("CEST+" based on the asymmetry in magnetization transfer ratio MTRasym at 3 ppm) within NE regions were quantitated. Median MTRasym at 3 ppm and volume of CESTâ +â NE regions were correlated with progression-free survival (PFS). In 20 samples from 14 patients, image-guided biopsies of these areas were obtained to correlate MTRasym at 3 ppm to tumor and non-tumor cell burden using immunohistochemistry.RESULTS:
In 15 newly diagnosed and 15 recurrent glioblastoma, higher median MTRasym at 3ppm within CESTâ +â NE regions (Pâ =â .007; Pâ =â .0326) and higher volumes of CESTâ +â NE tumor (Pâ =â .020; Pâ <â .001) were associated with decreased PFS. CE recurrence occurred in areas of preoperative CESTâ +â NE regions in 95.4% of patients. MTRasym at 3 ppm was correlated with presence of tumor, cell density, %Ki-67 positivity, and %CD31 positivity (Pâ =â .001; Pâ <â .001; Pâ <â .001; Pâ =â .001).CONCLUSIONS:
pH-weighted amine CEST-EPI allows for visualization of NE tumor, likely through surrounding acidification of the tumor microenvironment. The magnitude and volume of CESTâ +â NE tumor correlates with tumor cell density, degree of proliferating or "active" tumor, and PFS.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Imagen Eco-Planar
/
Glioblastoma
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Neuro Oncol
Asunto de la revista:
NEOPLASIAS
/
NEUROLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos