title: Mesoscopic imaging of glioblastomas: Are diffusion, perfusion and spectroscopic measures influenced by the radiogenetic phenotype?
abstract: The purpose of this study was to identify markers from perfusion, diffusion, and chemical shift imaging in glioblastomas (GBMs) and to correlate them with genetically determined and previously published patterns of structural magnetic resonance (MR) imaging. Twenty-six patients (mean age 60 years, 13 female) with GBM were investigated. Imaging consisted of native and contrast-enhanced 3D data, perfusion, diffusion, and spectroscopic imaging. In the presence of minor necrosis, cerebral blood volume (CBV) was higher (median ± SD, 2.23% ± 0.93) than in pronounced necrosis (1.02% ± 0.71), pcorr= 0.0003. CBV adjacent to peritumoral fluid-attenuated inversion recovery (FLAIR) hyperintensity was lower in edema (1.72% ± 0.31) than in infiltration (1.91% ± 0.35), pcorr= 0.039. Axial diffusivity adjacent to peritumoral FLAIR hyperintensity was lower in severe mass effect (1.08*10-3mm2/s ± 0.08) than in mild mass effect (1.14*10-3mm2/s ± 0.06), pcorr= 0.048. Myo-inositol was positively correlated with a marker for mitosis (Ki-67) in contrast-enhancing tumor, r = 0.5, pcorr= 0.0002. Changed CBV and axial diffusivity, even outside FLAIR hyperintensity, in adjacent normal-appearing matter can be discussed as to be related to angiogenesis pathways and to activated proliferation genes. The correlation between myo-inositol and Ki-67 might be attributed to its binding to cell surface receptors regulating tumorous proliferation of astrocytic cells.
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|2 Department of Radiology, University Medical Centre Basel, Switzerland.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Theo
authors.initials: T
authors.lastname: Demerath
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Carl Philipp
authors.initials: CP
authors.lastname: Simon-Gabriel
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|4 Medical Physics, Department of Radiology, Medical Centre-University of Freiburg, Germany.
authors.forename: Elias
authors.initials: E
authors.lastname: Kellner
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Schwarzwald
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|4 Medical Physics, Department of Radiology, Medical Centre-University of Freiburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lange
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|5 Department of Neurosurgery, Medical Centre-University of Freiburg, Germany.
authors.forename: Dieter Henrik
authors.initials: DH
authors.lastname: Heiland
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|6 Department of Functional and Stereotactic Neurosurgery, Medical Centre-University of Freiburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Reinacher
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|7 Institute of Neuropathology, Medical Centre-University of Freiburg, Germany.
authors.forename: Ori
authors.initials: O
authors.lastname: Staszewski
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Mast
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|4 Medical Physics, Department of Radiology, Medical Centre-University of Freiburg, Germany.
authors.forename: Valerij G
authors.initials: VG
authors.lastname: Kiselev
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Egger
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.affiliation: 3 Faculty of Medicine, University of Freiburg, Germany.|5 Department of Neurosurgery, Medical Centre-University of Freiburg, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Weyerbrock
authors.affiliation: 1 Department of Neuroradiology, Medical Centre-University of Freiburg, Germany.|3 Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Irina
authors.initials: I
authors.lastname: Mader
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D003952:Diagnostic Imaging; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007521:Isocitrate Dehydrogenase / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D018810:Magnetic Resonance Angiography; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
chemical_list: D019394:Ki-67 Antigen; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human
keywords: Radiogenomics; diffusion imaging; glioblastoma; perfusion imaging; proton spectroscopy