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Multiparameter quantitative histological MRI values in high-grade gliomas: a potential biomarker of tumor progression
Gilles Reuter1,2, Emilie Lommers1,3, Evelyne Balteau1
1GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium.
Background:
Conventional MRI poorly distinguishes brain parenchyma microscopically invaded by high-grade gliomas (HGGs) from the normal brain. By contrast, quantitative histological MRI (hMRI) measures brain microstructure in terms of physical MR parameters influenced by histochemical tissue composition. We aimed to determine the relationship between hMRI parameters in the area surrounding the surgical cavity and the presence of HGG recurrence.
Methods:
Patients were scanned after surgery with an hMRI multiparameter protocol that allowed for estimations of longitudinal relaxation rate (R1) = 1/T1, effective transverse relaxation rate (R2)*=1/T2*, magnetization transfer saturation (MTsat), and proton density. The initial perioperative zone (IPZ) was segmented on the postoperative MRI. Once recurrence appeared on conventional MRI, the area of relapsing disease was delineated (extension zone, EZ). Conventional MRI showing recurrence and hMRI were coregistered, allowing for the extraction of parameters R1, R2*, MTsat, and PD in 3 areas: the overlap area between the IPZ and EZ (OZ), the peritumoral brain zone, PBZ (PBZ = IPZ - OZ), and the area of recurrence (RZ = EZ - OZ).
Results:
Thirty-one patients with HGG who underwent gross-total resection were enrolled. MTsat and R1 were the most strongly associated with tumor progression. MTsat was significantly lower in the OZ and RZ, compared to PBZ. R1 was significantly lower in RZ compared to PBZ. PD was significantly higher in OZ compared to PBZ, and R2* was higher in OZ compared to PBZ or RZ. These changes were detected 4 to 120 weeks before recurrence recognition on conventional MRI.
Conclusions:
HGG recurrence was associated with hMRI parameters' variation after initial surgery, weeks to months before overt recurrence.
Insights
Histological MRI (hMRI) detects high-grade glioma (HGG) recurrence by identifying changes in brain microstructure weeks before conventional MRI. These hMRI parameter variations signal tumor progression after surgery.
Area of Science:
- Neuroimaging
- Oncology
- Medical Physics
Background:
- Conventional MRI struggles to differentiate high-grade gliomas (HGGs) from normal brain tissue.
- Quantitative histological MRI (hMRI) assesses brain microstructure using physical MR parameters linked to tissue composition.
Purpose of the Study:
- To investigate the relationship between hMRI parameters in the post-surgical cavity and the emergence of HGG recurrence.
- To determine if hMRI can predict HGG recurrence earlier than conventional MRI.
Main Methods:
- A multiparameter hMRI protocol was used to estimate R1, R2*, MTsat, and PD in patients post-HGG resection.
- hMRI parameters were analyzed in specific regions: overlap zone (OZ), peritumoral brain zone (PBZ), and recurrence zone (RZ).
- These hMRI parameters were correlated with the appearance of recurrence on conventional MRI.
Main Results:
- Magnetization transfer saturation (MTsat) and longitudinal relaxation rate (R1) showed the strongest association with tumor progression.
- MTsat was significantly lower in the OZ and RZ compared to PBZ; R1 was lower in RZ compared to PBZ.
- These hMRI changes were detectable 4 to 120 weeks prior to recurrence detection via conventional MRI.
Conclusions:
- Variations in hMRI parameters following initial surgery are linked to HGG recurrence.
- hMRI offers potential for early detection of high-grade glioma recurrence, preceding conventional imaging findings.
