ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Brain Tumor Imaging - Focus on PET-MRI

Tuesday 2 June 2015

John Bassett Theatre 102

16:00 - 18:00


Fernando E. Boada, Ph.D., Greg Zaharchuk, M.D., Ph.D.

16:00 0479.   Combined Functional and Metabolic Assessment of Brain Tumors using Hybrid MR-PET Imaging
Beatrice Sacconi1, Roy Raad2, Joon Lee3, Howard Fine4, John Golfinos5, Girish Manokar Fatterpekar6, Fernando Boada7, Kent Friedman3, James Babb3, and Rajan Jain3
1Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Rome, Italy, 2Radiology, NYU School of medicine, New York, New York, United States, 3Radiology, NYU School of Medicine, New York, New York, United States, 4Neuro-oncology, NYU Langone Medical Center, New York, New York, United States, 5Neurosurgery, NYU Langone Medical Center, New York, New York, United States, 6Radiology, NYU Langone Medical Center, New York, New York, United States, 7Neurosurgery, Psichiatry and Radiology, NYU Langone Medical Center, New York, New York, United States

Combined functional (MR perfusion) and metabolic (FDG-PET) assessment of brain tumors using hybrid MR-PET provides good accuracy and complimentary information about brain tumors which could be useful as a diagnostic and surveillance tool. PWI and tumor blood volume estimation performs better as compared to FDG uptake assessment in differentiating low versus high-grade tumors as well as in differentiating recurrent tumor from treatment/radiation induced necrosis in previously treated patients in a concurrent hybrid setting.

16:12 0480.   Multimodal MR/PET imaging for characterization of hypoxia in human glioblastoma - permission withheld
Christine Preibisch1,2, Mathias Lukas3, Anne Kluge1, Severin Keinath3, Vivien Tóth1,4, Kuangyu Shi3, Thomas Pyka3, and Stefan Förster3
1Department of Neuroradiology, Klinikum rechts der Isar der TU München, Munich, Germany, 2Clinic for Neurology, Klinikum rechts der Isar der TU München, Munich, Germany, 3Department of Nuclear Medicine, Klinikum rechts der Isar der TU München, Munich, Germany, 4Department of Radiology, Klinikum rechts der Isar der TU München, Munich, Germany

Preliminary multimodal MR/PET data from 18 patients with glioblastoma are presented with the aim of a comprehensive characterization of tumor pathophysiology. A semi-quantitative BOLD-based parameter, related to vascular de-oxygenation, termed relative oxygen extraction fraction (rOEF), was acquired simultaneously with 18F-FET PET, which has been shown to be valuable for detecting highly malignant tumor tissue. In a small subgroup of four patients, hypoxia related 18F-FMISO PET was acquired. These preliminary data support the utility of 18F-FET and rCBV as markers for viable malignant tumor tissue. With respect to hypoxia, more patient data and more sophisticated analyses are clearly needed.

16:24 0481.   Neuroimaging based (PET and MR) measurements of cerebral oxygen extraction fraction (OEF) in patients with brain tumors
Parinaz Massoumzadeh1, Safa Najmi2, Jonathan McConathy1, Andrei Vlassenko1, An Hongyu3, Yi Su1, Daniel Marcus1, Keith Rich4, and Tammie Benzinger1
1Mallinckrodt Institute of Radiology, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, United States, 2Department of of Neurology, Tabriz Medical University, Tabriz, East Azarbaijan, Iran, 3Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, United States,4Neurological Surgery, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, United States

Cerebral hypoxia can potentially impact treatment outcome and brain tumor patient survival. Preliminary results of a non-contrast oxygen sensitive magnetic resonance (MR) procedure for measuring brain and brain tumoral oxygen extraction fraction (OEF) are presented and compared with the results obtain using15O positron emission tomography (15O-PET) technique. Both MR and 15O-PET can measure OEF in brain tumors and in peritumoral edema, however, BOLD MR fails in regions with signal loss on SWI or T2*. Both techniques have tremendous potential and may offer new insight into the underlying physiology of brain tumors.

16:36 0482.   
Automatic Internal Carotid Arteries Segmentation for Estimation of an Image Derived Input Function with MR-PET
Nuno André da Silva1, Liliana Lourenco Caldeira1, Jörg Mauler1, Hans Herzog1, and N Jon Shah1,2
1Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany, 2JARA - Faculty of Medicine, RWTH Aachen University, Aachen, Germany

In this study we investigate an automatic segmentation of internal carotid arteries to obtain an image derived input function for data acquired in the MR-BrainPET. The excellent co-registration achieved with a simultaneous measurement is explored with an automatic segmentation method in order to reduce the workload and intra/inter-observer variability.

16:48 0483.   Comparison of DTI and 11C-methionine PET for reliable prediction of tumor cell density in gliomas
Manabu Kinoshita1, Hideyuki Arita2, Naoki Kagawa2, Yoshiyuki Watanabe3, Jun Hatazawa4, Naoya Hashimoto2, and Toshiki Yoshimine2
1Neurosurgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Osaka, Japan, 2Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan, 3Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan, 4Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

Imaging and predicting tumor cell density or tumor cell invasion is challenging. The authors have compared diffusion tensor imaging (DTI) and 11C-methionine PET in terms of tumor cell density prediction by use of 98 stereotactically sampled glioma tissues from 37 patients. Tumor cell density showed a statistically significant positive correlation with MET-TNR (p<0.0001, R2=0.43) and negative correlation with rADC (p=0.0096, R2=0.09), while rFA did not correlate with tumor cell density. Multiple regression analysis revealed that MET-TNR was the solo statistically significant factor for tumor cell density prediction (MET-TNR: p<0.0001, rADC: p=0.06).

17:00 0484.   pH-Weighted Molecular MRI in Brain Tumors
Benjamin M Ellingson1,2, Robert J Harris3, William H Yong4, Whitney Pope3, Debiao Li5, Linda M Liau6, and Timothy F Cloughesy7
1Radiology, UCLA, Los Angeles, CA, United States, 2Psychiatry & Biobehavioral Sciences, UCLA, CA, United States, 3Radiology, UCLA, CA, United States,4Pathology, UCLA, CA, United States, 5Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, CA, United States, 6Neurosurgery, UCLA, CA, United States, 7Neurology, UCLA, CA, United States

A decrease in pH within the tumor microenvironment results in malignant transformation, resistance to radiation therapy, resistance to specific chemotherapies, increased probability of metastasis, immunosuppression, increased tumor invasion, increased rate of mutation, increased chromosomal rearrangements, altered gene expression, and angiogenesis. A non-invasive imaging method for evaluating tumor tissue pH will be valuable for early detection of treatment response, tumor progression, and/or treatment failure in malignant tumors. Our preliminary data suggests that chemical exchange saturation transfer (CEST) imaging, a new MRI technique, can be used to identify tumor tissue with low pH (acidic tissue) by targeting MR excitation of amine protons on glutamine, a major source of fuel for tumor cells.

17:12 0485.   
Applying a length and offset varied saturation (LOVARS) CEST method for Imaging Cerebral Glioma
Xiaolei Song1, Yan Bai2, Erning Zhang2, Xiaowei He1,3, Panli Zuo4, Dapeng Shi2, Michael T. McMahon1, Benjamin Schmitt5, and Meiyun Wang2
1The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, United States, 2Department of Radiology, Henan Provincial People¡¯s Hospital, Zhengzhou, Henan, China, 3School of Information Sciences and Technology, Northwest University, Xi'an, Shaanxi, China, 4MR Collaborations NE Asia, Siemens Healthcare, Beijing, China, 5Healthcare Sector, Siemens Ltd Australia, Macquarie Park, Australia

We integrated a length and offset varied saturation (LOVARS) CEST method on a 3.0T MR scanner for improved APT imaging on patients with gliomas. Instead of sweeping different frequency offsets as conventional APT imaging, the LOVARS scheme collects only 2 offsets with different pre-saturation time for 3-4 cycles for improving CNR efficiency. In multiple patients with cerebral gliomas confirmed by histopathology, LOVARS phase maps clearly show improved CNR and well-defined tumor boundary, also reducing the total scan time and SAR effect. In addition, the phase contrast showed differences between patients, which may allow differentiation of tumor types as APT.

17:24 0486.   
The Role of Preoperative Functional MRI in Brain Tumour Resection by Awake Craniotomy: Initial Experience in 20 Glioma Patients
Melanie Morrison1,2, Laleh Golestanirad2,3, Fred Tam1, Gregory Hare4,5, Marco Garavaglia5, Simon Graham1,2, and Sunit Das4,6
1Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada, 2Medical Biophysics, University of Toronto, Toronto, Ontario, Canada, 3Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, Massachusetts, United States, 4Keenan Research Centre, St. Michael's Hospital, Toronto, Ontario, Canada, 5Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada, 6Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada

Preoperative functional magnetic resonance imaging (fMRI) has been used to assist with the surgical management of glioma patients. This work presents initial experiences using preoperative fMRI in the treatment of 20 glioma patients. The influence of fMRI results on surgical planning has been assessed and fMRI activation maps have been validated with intraoperative mapping results via electrical stimulation. Positive outcomes of this work go towards encouraging the extended use of fMRI for neurosurgical application.

17:36 0487.   Simultaneous Measurement of DSC- and DCE-MRI Parameters using Dual-Echo Spiral with a Standard Dose of Gadolinium in Comparison to Single-Echo GRE-EPI Methods in Brain Tumors
Kathleen M Schmainda1, Melissa Prah2, Leslie C Baxter3, Eric S Paulson4, Sharmeen Maze3, James Pipe3, Dingui Wang3, Josef Debbins3, and Leland Hu5
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, 2Radiology, Medical College of Wisconsin, WI, United States, 3Barrow Neurological Institute, Phoenix, AZ, United States, 4Medical College of Wisconsin, WI, United States, 5Mayo Clinic, Scottsdale, AZ, United States

Previously the dual-echo gradient-echo spiral-based (DEGES) method proved to be one of the most accurate for the determination of relative cerebral blood volume (rCBV) values in brain tumors. The DEGES method also enables the simultaneous collection of DSC and DCE (dynamic contrast enhanced) data, all with just a single dose of gadolinium (Gd) contrast agent. This study demonstrates that DEGES provides results equivalent to those obtained with the more proven GRE-EPI DSC MRI methods. This motivates a more widespread evaluation and adoption of this approach for the collection of multiparameter perfusion data in brain tumors.

17:48 0488.   Time-shift Resting-state Functional Connectivity MRI in Supratentorial glioma, a preliminary study
Jianrui Li1, Qiang Xu2, Zhiqiang Zhang1, and Guangming Lu1
1Medical Imaging, Jingling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China, 2Medical Imaging, Jingling Hospital, School of Medicine, Nanjing, Jiangsu, China

Time-shift functional connectivity based resting-state fMRI has proven a non-invasive and effective tool for measuring hemodynamic property of brain, and has been applied to reflect perfusion abnormality in cerebral diseases, such as ischemic stroke [1], moya-moya disease [2] and epilepsy [3]. In this work, we preliminarily assessed the feasibility of this approach on diagnosis assessment of supratentorial glioma.