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• W4385901612 abstract "Given the invasive nature of glioblastoma, tumor cells exist beyond the contrast enhancing (CE) region targeted during treatment. However, areas of non-enhancing (NE) tumor are difficult to visualize and delineate from edematous tissue. Amine chemical exchange saturation transfer echo planar imaging (CEST-EPI) is a pH-sensitive molecular MRI technique that was evaluated in its ability to identify infiltrating non-enhancing tumor and prognosticate survival.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 3ppm) within NE regions were quantitated. Median MTRasym at 3ppm and volume of CEST+ 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 3ppm to tumor and non-tumor cell burden using immunohistochemistry.In 15 newly diagnosed and 15 recurrent glioblastoma, higher median MTRasym at 3ppm within CEST+ NE regions [p=0.007;p=0.0326] and higher volumes of CEST+ NE tumor [p=0.020;p<0.001] were associated with decreased PFS. CE recurrence occurred in areas of pre-operative CEST+ NE regions in 95.4% of patients. MTRasym at 3ppm was correlated with presence of tumor, cell density, %Ki-67 positivity, and %CD31 positivity [p=0.001;p<0.001;p<0.001;p=0.001].pH-weighted amine CEST-EPI allows for visualization of NE tumor, likely through surrounding acidification of the tumor microenvironment. The magnitude and volume of CEST+NE tumor correlates with tumor cell density, degree of proliferating or active tumor, and PFS." @default.
• W4385901612 created "2023-08-18" @default.
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• W4385901612 date "2023-08-18" @default.
• W4385901612 modified "2023-10-15" @default.
• W4385901612 title "pH-Weighted amine chemical exchange saturation transfer echo planar imaging visualizes infiltrating glioblastoma cells" @default.
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• W4385901612 doi "https://doi.org/10.1093/neuonc/noad150" @default.
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• W4385901612 hasPublicationYear "2023" @default.
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