Walchhofer Lisa Maria, Steiger Ruth, Rietzler Andreas, Kerschbaumer Johannes, Freyschlag Christian Franz, Stockhammer Günther, Gizewski Elke Ruth, Grams Astrid Ellen
Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Cancers (Basel). 2021 May 26;13(11):2598. doi: 10.3390/cancers13112598.
: Glioblastoma multiforme (GBM) is a highly malignant primary brain tumor with infiltration of, on conventional imaging, normal-appearing brain parenchyma. Phosphorus magnetic resonance spectroscopy (31P-MRS) enables the investigation of different energy and membrane metabolites. The aim of this study is to investigate regional differences of 31P-metabolites in GBM brains. : In this study, we investigated 32 patients (13 female and 19 male; mean age 63 years) with naïve GBM using 31P-MRS and conventional MRI. Contrast-enhancing (CE), T2-hyperintense, adjacent and distant ipsilateral areas of the contralateral brain and the brains of age- and gender-matched healthy volunteers were assessed. Moreover, the 31P-MRS results were correlated with quantitative diffusion parameters. : Several metabolite ratios between the energy-dependent metabolites and/or the membrane metabolites differed significantly between the CE areas, the T2-hyperintense areas, the more distant areas, and even the brains of healthy volunteers. pH values and Mg concentrations were highest in visible tumor areas and decreased with distance from them. These results are in accordance with the literature and correlated with quantitative diffusion parameters. : This pilot study shows that 31P-MRS is feasible to show regional differences of energy and membrane metabolism in brains with naïve GBM, particularly between the different "normal-appearing" regions and between the contralateral hemisphere and healthy controls. Differences between various genetic mutations or clinical applicability for follow-up monitoring have to be assessed in a larger cohort.
多形性胶质母细胞瘤（GBM）是一种高度恶性的原发性脑肿瘤，在传统影像学上表现为浸润正常外观的脑实质。磷磁共振波谱（31P-MRS）能够研究不同的能量和膜代谢物。本研究的目的是调查GBM患者脑部31P代谢物的区域差异。：在本研究中，我们使用31P-MRS和传统MRI对32例初发GBM患者（13例女性和19例男性；平均年龄63岁）进行了研究。评估了增强（CE）、T2高信号、对侧脑的相邻和远处同侧区域以及年龄和性别匹配的健康志愿者的脑部。此外，31P-MRS结果与定量扩散参数相关。：能量依赖性代谢物和/或膜代谢物之间的几种代谢物比率在CE区域、T2高信号区域、更远的区域甚至健康志愿者的脑部之间存在显著差异。pH值和镁浓度在可见肿瘤区域最高，并随与肿瘤的距离增加而降低。这些结果与文献一致，并与定量扩散参数相关。：这项初步研究表明，31P-MRS对于显示初发GBM患者脑部能量和膜代谢的区域差异是可行的，特别是在不同的“正常外观”区域之间以及对侧半球与健康对照之间。各种基因突变之间的差异或随访监测的临床适用性必须在更大的队列中进行评估。
