From the Divisions of Radiology (D.P., C.K., S.B., D.B., P. Bäumer, H.P.S., M.Z., A.R.) and Medical Physics in Radiology (P.S., J.W., P. Bachert, M.E.L.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Departments of Neuroradiology (C.K., M.B., A.R.), Neurology (S.M., W.W.), and Neurosurgery (A.U.), University Hospital Heidelberg, Heidelberg, Germany; Faculty of Physics and Astronomy and Faculty of Medicine, University of Heidelberg, Heidelberg, Germany (M.E.L.); and Max-Planck-Institute for Biological Cybernetics, Tuebingen, Germany (M.Z.).
Radiology. 2017 Dec;285(3):914-922. doi: 10.1148/radiol.2017162351. Epub 2017 Jun 16.
Purpose To evaluate the ability to detect intracerebral regions of increased glucose concentration at T1ρ-weighted dynamic glucose-enhanced (DGE) magnetic resonance (MR) imaging at 7.0 T. Materials and Methods This prospective study was approved by the institutional review board. Nine patients with newly diagnosed glioblastoma and four healthy volunteers were included in this study from October 2015 to July 2016. Adiabatically prepared chemical exchange-sensitive spin-lock imaging was performed with a 7.0-T whole-body unit with a temporal resolution of approximately 7 seconds, yielding the time-resolved DGE contrast. T1ρ-weighted DGE MR imaging was performed with injection of 100 mL of 20% d-glucose via the cubital vein. Glucose enhancement, given by the relative signal intensity change at T1ρ-weighted MR imaging (DGEρ), was quantitatively investigated in brain gray matter versus white matter of healthy volunteers and in tumor tissue versus normal-appearing white matter of patients with glioblastoma. The median signal intensities of the assessed brain regions were compared by using the Wilcoxon rank-sum test. Results In healthy volunteers, the median signal intensity in basal ganglia gray matter (DGEρ = 4.59%) was significantly increased compared with that in white matter tissue (DGEρ = 0.65%) (P = .028). In patients, the median signal intensity in the glucose-enhanced tumor region as displayed on T1ρ-weighted DGE images (DGEρ = 2.02%) was significantly higher than that in contralateral normal-appearing white matter (DGEρ = 0.08%) (P < .0001). Conclusion T1ρ-weighted DGE MR imaging in healthy volunteers and patients with newly diagnosed, untreated glioblastoma enabled visualization of brain glucose physiology and pathophysiologically increased glucose uptake and may have the potential to provide information about glucose metabolism in tumor tissue. RSNA, 2017 Online supplemental material is available for this article.
目的 评估在 7.0T 下 T1ρ 加权动态葡萄糖增强(DGE)磁共振(MR)成像中检测脑内葡萄糖浓度增加区域的能力。
材料与方法 本前瞻性研究获得了机构审查委员会的批准。2015 年 10 月至 2016 年 7 月,共纳入 9 例新诊断为胶质母细胞瘤的患者和 4 名健康志愿者。使用 7.0T 全身磁共振成像仪进行绝热化学交换敏感自旋锁定成像,时间分辨率约为 7 秒,获得时间分辨的 DGE 对比。通过肘静脉注射 100ml20%d-葡萄糖进行 T1ρ 加权 DGE MR 成像。在健康志愿者的脑灰质与白质之间以及胶质母细胞瘤患者的肿瘤组织与正常白质之间,定量研究 T1ρ 加权 DGE MR 成像的葡萄糖增强,由 T1ρ 加权 MR 成像(DGEρ)的相对信号强度变化表示。采用 Wilcoxon 秩和检验比较评估脑区的中位数信号强度。
结果 在健康志愿者中,基底节灰质的中位数信号强度(DGEρ=4.59%)明显高于白质组织(DGEρ=0.65%)(P=0.028)。在患者中,T1ρ 加权 DGE 图像上显示的葡萄糖增强肿瘤区域的中位数信号强度(DGEρ=2.02%)明显高于对侧正常白质(DGEρ=0.08%)(P<0.0001)。
结论 在健康志愿者和新诊断、未经治疗的胶质母细胞瘤患者中,T1ρ 加权 DGE MR 成像可显示脑葡萄糖生理学和病理生理上增加的葡萄糖摄取,并可能提供有关肿瘤组织葡萄糖代谢的信息。
RSNA,2017 年
在线补充材料可在本文中获取。