gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Artikel

Artikel empfehlen

Whole-brain connectivity as a measure for disease burden – moving beyond structure and towards function in MRI imaging of glioma patients

Funktionelle Konnektivität als Maß für die Krankheitslast in der MRT-Bildgebung bei Gliompatienten

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Veit Stöcklein - Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland; Deutsches Krebsforschungszentrum (DKFZ), Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort München, München, Deutschland
  • Sophia Stöcklein - Klinikum der Universität München, Klinik und Poliklinik für Radiologie, München, Deutschland
  • Franziska Galiè - Klinikum der Universität München, Klinik und Poliklinik für Radiologie, München, Deutschland; Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Boston, MA, United States
  • Marcus Unterrainer - Klinikum der Universität München, Klinik für Nuklearmedizin, München, Deutschland
  • Nathalie Lisa Albert - Klinikum der Universität München, Klinik für Nuklearmedizin, München, Deutschland
  • Friedrich-Wilhelm Kreth - Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland; Deutsches Krebsforschungszentrum (DKFZ), Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort München, München, Deutschland
  • Niklas Thon - Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland; Deutsches Krebsforschungszentrum (DKFZ), Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort München, München, Deutschland
  • Jörg-Christian Tonn - Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland; Deutsches Krebsforschungszentrum (DKFZ), Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort München, München, Deutschland
  • Hesheng Liu - Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Boston, MA, United States

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV107

doi: 10.3205/19dgnc131, urn:nbn:de:0183-19dgnc1311

Veröffentlicht: 8. Mai 2019

© 2019 Stöcklein et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Current MRI imaging of glioma patients captures the main lesion well and is able to characterize it further. There is, however, no MRI imaging modality which provides information about the non-lesional brain and consequently about the disease burden of the whole patient brain. We hypothesized that diffuse infiltration of the brain by glioma cells leads to a breakdown of functional networks throughout the whole brain and that this can be quantified using resting-state functional MRI.

Methods: We developed a novel imaging marker in glioma patients based on resting-state functional MRI. Whole brain functional connectivity was calculated for patients’ brains and compared to a healthy control cohort of 1000 volunteers. Abnormality of functional connectivity in glioma patients was quantified and the resulting measure was called the abnormality index (ABI). This novel method to individually quantify the damage to functional connectivity caused by glioma was tested in 37 patients with untreated glioma (14 WHO grade II tumors, 6 grade III, 17 grade IV, IDH1/2 mutations: 19/37). Our results were then correlated with histology, molecular markers, neurocognitive performance, FET-PET results and progression-free as well as overall survival.

Results: We found statistically significant positive correlation of ABI with histology (WHO grade, p=0.002 in the lesional hemisphere and p=0.005 in the non-lesional hemisphere) and FET-PET imaging (SUVmax, p=0.029 lesional hemisphere, p=0.478 non-lesional hemisphere). Neurocognitive performance (Montreal Cognitive Assessment score, p=0.003 lesional hemisphere, p=0.024 non-lesional hemisphere) was negatively correlated. ABI was significantly increased in patients with IDH-wildtype gliomas (p=0.016 lesional hemisphere, p=0.010 non-lesional hemisphere). There was a trend towards better progression-free and overall survival with lower ABI.

Conclusion: We could demonstrate that our imaging marker based on functional MRI was closely correlated with clinically relevant parameters. This shows that there is a potential to enhance the information which can be gained from conventional structural MRI with functional MRI, perhaps allowing for a more holistic assessment of disease burden in the individual glioma patient.