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Dynamic deuterium metabolic imaging in glioblastoma at 7T
Narjes Ahmadian1, Mark Gosselink2, Sigrid Otto3
1Center for Image Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands. n.ahmadian@umcutrecht.nl.
Objective:
This study investigates the dynamic metabolic characteristics of glioblastoma (GBM) using Deuterium Metabolic Imaging (DMI) at 7 T, aiming to dynamically characterize the Warburg effect in vivo.
Material And Methods:
Five newly diagnosed GBM patients underwent dynamic DMI prior to any treatment. 3D 2H free-induction-decay (FID)-Magnetic resonance spectroscopy imaging (MRSI) measurements (11:44 min per scan) were performed at 7 T during ~ 100 min following [6,6'-2H2]glucose consumption. Venous plasma glucose and plasma 2H-Glc atom percent enrichment (APE) levels were measured during the scan. Brain 2H-glucose (2H-Glc),2H-Glutamate/Glutamine (2H-Glx), 2H-Lactate (2H-Lac), 2H-Lac/2H-Glx were analyzed with a two-level (time and tissue type) Linear Mixed Model.
Results:
Brain 2H-Glc levels were similar across tissue types. 2H-Glx was significantly lower in tumors compared to normal appearing brain tissue (NABT) (p < 0.01). 2H-Lac was significantly higher in tumors compared to NABT (P < 0.01). The 2H-Lac/2H-Glx ratio provided tumor-specific contrast, starting 40-50 min post [6,6'-2H2]glucose consumption. Venous plasma glucose and 2H-Glc APE increased within 50 min and venous 2H-Glc APE stabilized at ~ 60%.
Discussion:
Dynamic DMI at 7 T reveals metabolic alterations in GBM, particularly through the 2H-Lac/2H-Glx ratio. This contrast was primarily driven by decreased 2H-Glx rather than profoundly increased 2H-Lac. These findings support the utility of DMI in assessing metabolic reprogramming in brain tumors.
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