gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Recurrent glioblastomas show increased microvascular transit time heterogeneity and decreased mitochondrial oxygen tension

Meeting Abstract

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  • Karl Rössler - Department of Neurosurgery Erlangen, Erlangen, Deutschland
  • Kim Mouridsen - Center of Functionally Integrative Neurosciences, Arhus University Hospital, Aarhus, Netherlands
  • Arnd Dörfler - Universitätsklinikum Erlangen, Abteilung Neuroradiologie, Erlangen, Deutschland
  • Max Zimmermann - Department of Neurosurgery Erlangen, Erlangen, Deutschland
  • Stefan Oberndorfer - Department of Neurology, University Clin St.Pölten, St.Pölten, Austria
  • Michael Buchfelder - Universitätsklinikum Erlangen, Klinik für Neurochirurgie, Erlangen, Deutschland
  • Gertraud Heinz - Department of Radiology, University Clinic St.Pölten, St.Pölten, Austria
  • Andreas Stadlbauer - Department of Neurosurgery Erlangen, Erlangen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.03.07

doi: 10.3205/17dgnc197, urn:nbn:de:0183-17dgnc1971

Published: June 9, 2017

© 2017 Rössler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Dynamic susceptibility contrast (DSC) perfusion MRI provide information about differences in macro- and microvasculature when executed with gradient-echo (GE; more sensitive to macrovasculature) and spin-echo (SE; sensitive to microvasculature) contrast. Our aim was to investigate whether there are differences between macro- and microvascular transit time heterogeneity (MVTH and µVTH) and oxygen tension in tissue surrounding mitochondria (PO2mit) in untreated and recurrent glioblastoma.

Methods: Fifty-seven patients with glioblastoma (25 untreated/ 32 recurrent) were examined with a physiological MRI protocol including GE- and SE-DSC perfusion sequences, and a multiparametric quantitative blood-oxygen-level-dependent (qBOLD) approach. Maps of MVTH and µVTH as well as coefficient of variation (MCOV and µCOV) were calculated from GE- and SE-DSC data, respectively, using an extended flow-diffusion equation. This approach was termed VTH mapping. PO2mit maps were calculated from qBOLD data using custom-made software.

Results: The values for µCOV in both untreated and recurrent glioblastoma were significantly lower (P≤0.001) than in normal brain and in the macrovasculature (MCOV) of the lesions. Recurrent glioblastoma showed significant increased µVTH (P=0.014) and µCOV (P=0.039) compared to untreated glioblastoma. This was associated with a significant decreased PO2mit (P=0.008) in recurrent glioblastoma. VTH mapping in the macrovasculature revealed no significant differences between untreated and recurrent glioblastoma.

Conclusion: VTH mapping of the microvasculature using SE-DSC perfusion MRI and mapping of PO2mit using qBOLD provide potential imaging biomarker for investigation of physiological and metabolic alterations responsible for recurrence of glioblastoma. VTH mapping of the macrovasculature using conventional GE-DSC perfusion MRI seems to be less useful.