title: Glioblastoma Induces Vascular Dysregulation in Nonenhancing Peritumoral Regions in Humans.
abstract: OBJECTIVE
  Glioblastoma is an invasive primary brain malignancy that typically infiltrates the surrounding tissue with malignant cells. It disrupts cerebral blood flow through a variety of biomechanical and biochemical mechanisms. Thus, neuroimaging focused on identifying regions of vascular dysregulation may reveal a marker of tumor spread. The purpose of this study was to use blood oxygenation level-dependent (BOLD) functional MRI (fMRI) to compare the temporal dynamics of the enhancing portion of a tumor with those of brain regions without apparent tumors.
  
  
  METHODS
  Patients with pathologically proven glioblastoma underwent preoperative resting-state BOLD fMRI, T1-weighted contrast-enhanced MRI, and FLAIR MRI. The contralesional control hemisphere, contrast-enhancing tumor, and peritu-moral edema were segmented by use of structural images and were used to extract the time series of these respective regions. The parameter estimates (beta values) for the two regressors and resulting z-statistic images were used as a metric to compare the similarity of the tumor dynamics to those of other brain regions.
  
  
  RESULTS
  The time course of the contrast-enhancing tumor was significantly different from that of the rest of the brain (p < 0.05). Similarly, the control signal intensity was significantly different from the tumor signal intensity (p < 0.05). Notably, the temporal dynamics in the peritumoral edema, which did not contain enhancing tumor, were most similar to the those of enhancing tumor than to those of control regions.
  
  
  CONCLUSIONS
  The findings show that the disruption in vascular regulation induced by a glioblastoma can be detected with BOLD fMRI and that the spatial distribution of these disruptions is localized to the immediate vicinity of the tumor and peritumoral edema.
authors.affiliation: 1 Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.|2 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, L352, San Francisco, CA 94143-0628.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Chow
authors.affiliation: 3 Department of Radiology, North Shore University Hospital, Long Island, NY.
authors.forename: Craig I
authors.initials: CI
authors.lastname: Horenstein
authors.affiliation: 4 Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Peter
authors.initials: P
authors.lastname: Canoll
authors.affiliation: 1 Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Angela
authors.initials: A
authors.lastname: Lignelli
authors.affiliation: 1 Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.|5 Department of Biomedical Engineering, Columbia University, New York, NY.
authors.forename: Elizabeth M C
authors.initials: EM
authors.lastname: Hillman
authors.affiliation: 1 Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.|3 Department of Radiology, North Shore University Hospital, Long Island, NY.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Filippi
authors.affiliation: 1 Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Jack
authors.initials: J
authors.lastname: Grinband
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain; D001932:Brain Neoplasms / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D003287:Contrast Media; D004487:Edema / Q000097:blood / Q000503:physiopathology; D005260:Female; D005909:Glioblastoma / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood
chemical_list: D003287:Contrast Media; D010100:Oxygen
keywords: functional imaging; glioblastoma; neurovascular coupling; resting-state functional MRI; vascular dysregulation