title: Direct (17)O MRI with partial volume correction: first experiences in a glioblastoma patient.
abstract: OBJECTIVE
  In tumor cells the energy production is shifted from aerobic to anaerobic metabolization of glucose, which makes the cerebral metabolic rate of oxygen consumption (CMRO2) a diagnostic parameter for tissue viability. Direct oxygen-17 ((17)O) MRI during inhalation of (17)O gas allows for a non-invasive determination of the CMRO2. However, the low spatial resolution and the fast transverse relaxation of (17)O lead to partial volume effects that severely bias the quantification of signal intensities. The aim of this work was to determine the CMRO2 in a tumor patient by (17)O MRI in combination with a partial volume correction (PVC) scheme.
  
  
  METHODS
  Direct (17)O MRI was performed in a glioblastoma patient (F, 51 years) prior to surgery at 7 T. The 'geometric transfer matrix' algorithm for volume of interest based PVC was adapted to (17)O MRI to recover the true signal intensities. We determined the CMRO2 values of gray matter (GM), white matter (WM), cerebrospinal fluid (CSF) and the tumor areas of the contrast enhancing rim (CE), the necrotic center (NE), and the perifocal edema (PE) using a three-phase metabolic model.
  
  
  RESULTS
  Large differences in the signal increase during (17)O2 inhalation were obtained ranging from less than 2% in the tumor center up to more than 20% in GM areas. After PVC of the signal time curves, we determined CMRO2 values of 0.67 ± 0.08 μmol/g/min (WM), 3.57 ± 0.67 μmol/g/min (GM), 0.35 ± 0.09 μmol/g/min (CE), and 0.42 ± 0.05 μmol/g/min (PE). In CSF and NE no oxygen uptake (i.e. CMRO2 = 0) was determined from the corrected signals, well in accordance with the underlying physiology in these regions.
  
  
  CONCLUSIONS
  The results show that PVC has a strong effect on the resulting CMRO2 values obtained by (17)O MRI. We found substantial differences-especially in GM tissue-between corrected and non-corrected CMRO2 values. Additionally, we demonstrated the feasibility of CMRO2 assessment in a glioblastoma patient by (17)O MRI.
authors.affiliation: Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany, s.h.hoffmann@outlook.com.
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Hoffmann
authors.forename: Alexander
authors.initials: A
authors.lastname: Radbruch
authors.forename: Michael
authors.initials: M
authors.lastname: Bock
authors.forename: Wolfhard
authors.initials: W
authors.lastname: Semmler
authors.forename: Armin M
authors.initials: AM
authors.lastname: Nagel
mesh_terms: D000280:Administration, Inhalation; D000465:Algorithms; D016477:Artifacts; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology*; D005909:Glioblastoma / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption; D010103:Oxygen Isotopes / Q000008:administration & dosage / Q000493:pharmacokinetics; D010865:Pilot Projects; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D010103:Oxygen Isotopes; D019275:Radiopharmaceuticals; D010100:Oxygen