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de Godoy LL, Lim KC, Rajan A, Verma G, Hanaoka M, O’Rourke DM, Lee JYK, Desai A, Chawla S, Mohan S. Non-Invasive Assessment of Isocitrate Dehydrogenase-Mutant Gliomas Using Optimized Proton Magnetic Resonance Spectroscopy on a Routine Clinical 3-Tesla MRI. Cancers (Basel) 2023; 15:4453. [PMID: 37760422 PMCID: PMC10526791 DOI: 10.3390/cancers15184453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/22/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE The isocitrate dehydrogenase (IDH) mutation has become one of the most important prognostic biomarkers in glioma management, indicating better treatment response and prognosis. IDH mutations confer neomorphic activity leading to the conversion of alpha-ketoglutarate (α-KG) to 2-hydroxyglutarate (2HG). The purpose of this study was to investigate the clinical potential of proton MR spectroscopy (1H-MRS) in identifying IDH-mutant gliomas by detecting characteristic resonances of 2HG and its complex interplay with other clinically relevant metabolites. MATERIALS AND METHODS Thirty-two patients with suspected infiltrative glioma underwent a single-voxel (SVS, n = 17) and/or single-slice-multivoxel (1H-MRSI, n = 15) proton MR spectroscopy (1H-MRS) sequence with an optimized echo-time (97 ms) on 3T-MRI. Spectroscopy data were analyzed using the linear combination (LC) model. Cramér-Rao lower bound (CRLB) values of <40% were considered acceptable for detecting 2HG and <20% for other metabolites. Immunohistochemical analyses for determining IDH mutational status were subsequently performed from resected tumor specimens and findings were compared with the results from spectral data. Mann-Whitney and chi-squared tests were performed to ascertain differences in metabolite levels between IDH-mutant and IDH-wild-type gliomas. Receiver operating characteristic (ROC) curve analyses were also performed. RESULTS Data from eight cases were excluded due to poor spectral quality or non-tumor-related etiology, and final data analyses were performed from 24 cases. Of these cases, 9/12 (75%) were correctly identified as IDH-mutant or IDH-wildtype gliomas through SVS and 10/12 (83%) through 1H-MRSI with an overall concordance rate of 79% (19/24). The sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 77%, 86%, and 70%, respectively. The metabolite 2HG was found to be significant in predicting IDH-mutant gliomas through the chi-squared test (p < 0.01). The IDH-mutant gliomas also had a significantly higher NAA/Cr ratio (1.20 ± 0.09 vs. 0.75 ± 0.12 p = 0.016) and lower Glx/Cr ratio (0.86 ± 0.078 vs. 1.88 ± 0.66; p = 0.029) than those with IDH wild-type gliomas. The areas under the ROC curves for NAA/Cr and Glx/Cr were 0.808 and 0.786, respectively. CONCLUSIONS Noninvasive optimized 1H-MRS may be useful in predicting IDH mutational status and 2HG may serve as a valuable diagnostic and prognostic biomarker in patients with gliomas.
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Affiliation(s)
- Laiz Laura de Godoy
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Kheng Choon Lim
- Department of Neuroradiology, Singapore General Hospital, Singapore 169609, Singapore;
| | - Archith Rajan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Gaurav Verma
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Mauro Hanaoka
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Donald M. O’Rourke
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (D.M.O.); (J.Y.K.L.)
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - John Y. K. Lee
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (D.M.O.); (J.Y.K.L.)
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - Arati Desai
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
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Veeraiah P, Jansen JFA. Multinuclear Magnetic Resonance Spectroscopy at Ultra-High-Field: Assessing Human Cerebral Metabolism in Healthy and Diseased States. Metabolites 2023; 13:metabo13040577. [PMID: 37110235 PMCID: PMC10143499 DOI: 10.3390/metabo13040577] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
The brain is a highly energetic organ. Although the brain can consume metabolic substrates, such as lactate, glycogen, and ketone bodies, the energy metabolism in a healthy adult brain mainly relies on glucose provided via blood. The cerebral metabolism of glucose produces energy and a wide variety of intermediate metabolites. Since cerebral metabolic alterations have been repeatedly implicated in several brain disorders, understanding changes in metabolite levels and corresponding cell-specific neurotransmitter fluxes through different substrate utilization may highlight the underlying mechanisms that can be exploited to diagnose or treat various brain disorders. Magnetic resonance spectroscopy (MRS) is a noninvasive tool to measure tissue metabolism in vivo. 1H-MRS is widely applied in research at clinical field strengths (≤3T) to measure mostly high abundant metabolites. In addition, X-nuclei MRS including, 13C, 2H, 17O, and 31P, are also very promising. Exploiting the higher sensitivity at ultra-high-field (>4T; UHF) strengths enables obtaining unique insights into different aspects of the substrate metabolism towards measuring cell-specific metabolic fluxes in vivo. This review provides an overview about the potential role of multinuclear MRS (1H, 13C, 2H, 17O, and 31P) at UHF to assess the cerebral metabolism and the metabolic insights obtained by applying these techniques in both healthy and diseased states.
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Affiliation(s)
- Pandichelvam Veeraiah
- Scannexus (Ultra-High-Field MRI Center), 6229 EV Maastricht, The Netherlands
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
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3
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Hosseini SA, Hosseini E, Hajianfar G, Shiri I, Servaes S, Rosa-Neto P, Godoy L, Nasrallah MP, O’Rourke DM, Mohan S, Chawla S. MRI-Based Radiomics Combined with Deep Learning for Distinguishing IDH-Mutant WHO Grade 4 Astrocytomas from IDH-Wild-Type Glioblastomas. Cancers (Basel) 2023; 15:cancers15030951. [PMID: 36765908 PMCID: PMC9913426 DOI: 10.3390/cancers15030951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate the potential of quantitative radiomic data extracted from conventional MR images in discriminating IDH-mutant grade 4 astrocytomas from IDH-wild-type glioblastomas (GBMs). A cohort of 57 treatment-naïve patients with IDH-mutant grade 4 astrocytomas (n = 23) and IDH-wild-type GBMs (n = 34) underwent anatomical imaging on a 3T MR system with standard parameters. Post-contrast T1-weighted and T2-FLAIR images were co-registered. A semi-automatic segmentation approach was used to generate regions of interest (ROIs) from different tissue components of neoplasms. A total of 1050 radiomic features were extracted from each image. The data were split randomly into training and testing sets. A deep learning-based data augmentation method (CTGAN) was implemented to synthesize 200 datasets from the training sets. A total of 18 classifiers were used to distinguish two genotypes of grade 4 astrocytomas. From generated data using 80% training set, the best discriminatory power was obtained from core tumor regions overlaid on post-contrast T1 using the K-best feature selection algorithm and a Gaussian naïve Bayes classifier (AUC = 0.93, accuracy = 0.92, sensitivity = 1, specificity = 0.86, PR_AUC = 0.92). Similarly, high diagnostic performances were obtained from original and generated data using 50% and 30% training sets. Our findings suggest that conventional MR imaging-based radiomic features combined with machine/deep learning methods may be valuable in discriminating IDH-mutant grade 4 astrocytomas from IDH-wild-type GBMs.
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Affiliation(s)
- Seyyed Ali Hosseini
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montréal, QC H4H 1R3, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, QC H3A 2B4, Canada
- Correspondence: (S.A.H.); (S.C.); Tel.: +1-438-929-6575 (S.A.H.); +1-215-615-1662 (S.C.)
| | - Elahe Hosseini
- Department of Electrical and Computer Engineering, Kharazmi University, Tehran 15719-14911, Iran
| | - Ghasem Hajianfar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran 19956-14331, Iran
| | - Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva, Switzerland
| | - Stijn Servaes
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montréal, QC H4H 1R3, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, QC H3A 2B4, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montréal, QC H4H 1R3, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, QC H3A 2B4, Canada
| | - Laiz Godoy
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - MacLean P. Nasrallah
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donald M. O’Rourke
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence: (S.A.H.); (S.C.); Tel.: +1-438-929-6575 (S.A.H.); +1-215-615-1662 (S.C.)
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McCarthy L, Verma G, Hangel G, Neal A, Moffat BA, Stockmann JP, Andronesi OC, Balchandani P, Hadjipanayis CG. Application of 7T MRS to High-Grade Gliomas. AJNR Am J Neuroradiol 2022; 43:1378-1395. [PMID: 35618424 PMCID: PMC9575545 DOI: 10.3174/ajnr.a7502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/11/2022] [Indexed: 01/26/2023]
Abstract
MRS, including single-voxel spectroscopy and MR spectroscopic imaging, captures metabolites in high-grade gliomas. Emerging evidence indicates that 7T MRS may be more sensitive to aberrant metabolic activity than lower-field strength MRS. However, the literature on the use of 7T MRS to visualize high-grade gliomas has not been summarized. We aimed to identify metabolic information provided by 7T MRS, optimal spectroscopic sequences, and areas for improvement in and new applications for 7T MRS. Literature was found on PubMed using "high-grade glioma," "malignant glioma," "glioblastoma," "anaplastic astrocytoma," "7T," "MR spectroscopy," and "MR spectroscopic imaging." 7T MRS offers higher SNR, modestly improved spatial resolution, and better resolution of overlapping resonances. 7T MRS also yields reduced Cramér-Rao lower bound values. These features help to quantify D-2-hydroxyglutarate in isocitrate dehydrogenase 1 and 2 gliomas and to isolate variable glutamate, increased glutamine, and increased glycine with higher sensitivity and specificity. 7T MRS may better characterize tumor infiltration and treatment effect in high-grade gliomas, though further study is necessary. 7T MRS will benefit from increased sample size; reductions in field inhomogeneity, specific absorption rate, and acquisition time; and advanced editing techniques. These findings suggest that 7T MRS may advance understanding of high-grade glioma metabolism, with reduced Cramér-Rao lower bound values and better measurement of smaller metabolite signals. Nevertheless, 7T is not widely used clinically, and technical improvements are necessary. 7T MRS isolates metabolites that may be valuable therapeutic targets in high-grade gliomas, potentially resulting in wider ranging neuro-oncologic applications.
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Affiliation(s)
- L McCarthy
- From the Department of Neurosurgery (L.M., C.G.H.), Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
| | - G Verma
- BioMedical Engineering and Imaging Institute (G.V., P.B.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - G Hangel
- Department of Neurosurgery (G.H.)
- High-field MR Center (G.H.), Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - A Neal
- Department of Medicine (A.N.), Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Department of Neurology (A.N.), Royal Melbourne Hospital, Melbourne, Australia
| | - B A Moffat
- The Melbourne Brain Centre Imaging Unit (B.A.M.), Department of Radiology, The University of Melbourne, Melbourne, Australia
| | - J P Stockmann
- A. A. Martinos Center for Biomedical Imaging (J.P.S., O.C.A.), Massachusetts General Hospital, Charlestown, Massachusetts
- Harvard Medical School (J.P.S., O.C.A.), Boston, Massachusetts
| | - O C Andronesi
- A. A. Martinos Center for Biomedical Imaging (J.P.S., O.C.A.), Massachusetts General Hospital, Charlestown, Massachusetts
- Harvard Medical School (J.P.S., O.C.A.), Boston, Massachusetts
| | - P Balchandani
- BioMedical Engineering and Imaging Institute (G.V., P.B.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - C G Hadjipanayis
- From the Department of Neurosurgery (L.M., C.G.H.), Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
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5
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Bumes E, Fellner C, Fellner FA, Fleischanderl K, Häckl M, Lenz S, Linker R, Mirus T, Oefner PJ, Paar C, Proescholdt MA, Riemenschneider MJ, Rosengarth K, Weis S, Wendl C, Wimmer S, Hau P, Gronwald W, Hutterer M. Validation Study for Non-Invasive Prediction of IDH Mutation Status in Patients with Glioma Using In Vivo 1H-Magnetic Resonance Spectroscopy and Machine Learning. Cancers (Basel) 2022; 14:cancers14112762. [PMID: 35681741 PMCID: PMC9179368 DOI: 10.3390/cancers14112762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The enzyme isocitrate dehydrogenase (IDH) affects glioma cell metabolism in multiple ways. Mutation of IDH is not only indicative of the presence of astrocytoma or oligodendroglioma but it also comes with a better prognosis and constitutes a promising therapeutic target. Therefore, determination of IDH mutation status is essential in clinical practice. In most patients, tissue can be obtained by resection or biopsy to determine IDH status histologically. However, in some cases, this is not possible for technical reasons. We recently showed in a small cohort of patients that non-invasive determination of IDH mutation status using proton magnetic resonance spectroscopy (1H-MRS) at 3.0 Tesla (T) together with machine learning techniques is feasible in a standard clinical setting and with acceptable effort. Here, we demonstrate that our approach showed comparably good results in sensitivity (82.6%) and specificity (72.7%) in a larger validation cohort employing 1H-MRS at 1.5 T in a retrospective, distinct setting. We concluded that our method works well regardless of the magnetic field strength and scanner used, and thus, may improve patient care. Abstract The isocitrate dehydrogenase (IDH) mutation status is an indispensable prerequisite for diagnosis of glioma (astrocytoma and oligodendroglioma) according to the WHO classification of brain tumors 2021 and is a potential therapeutic target. Usually, immunohistochemistry followed by sequencing of tumor tissue is performed for this purpose. In clinical routine, however, non-invasive determination of IDH mutation status is desirable in cases where tumor biopsy is not possible and for monitoring neuro-oncological therapies. In a previous publication, we presented reliable prediction of IDH mutation status employing proton magnetic resonance spectroscopy (1H-MRS) on a 3.0 Tesla (T) scanner and machine learning in a prospective cohort of 34 glioma patients. Here, we validated this approach in an independent cohort of 67 patients, for which 1H-MR spectra were acquired at 1.5 T between 2002 and 2007, using the same data analysis approach. Despite different technical conditions, a sensitivity of 82.6% (95% CI, 61.2–95.1%) and a specificity of 72.7% (95% CI, 57.2–85.0%) could be achieved. We concluded that our 1H-MRS based approach can be established in a routine clinical setting with affordable effort and time, independent of technical conditions employed. Therefore, the method provides a non-invasive tool for determining IDH status that is well-applicable in an everyday clinical setting.
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Affiliation(s)
- Elisabeth Bumes
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, 93055 Regensburg, Germany; (R.L.); (P.H.); (M.H.)
- Correspondence: ; Tel.: +49-941-944-18751
| | - Claudia Fellner
- Department of Radiology and Division of Neuroradiology, Regensburg University Hospital, 93055 Regensburg, Germany; (C.F.); (C.W.)
| | - Franz A. Fellner
- Central Institute of Radiology, Kepler University Hospital, 4021 Linz, Austria;
| | - Karin Fleischanderl
- Division of Molecular Pathology, Neuromed Campus, Kepler University Hospital, 4020 Linz, Austria; (K.F.); (S.L.)
| | - Martina Häckl
- Institute of Functional Genomics, University of Regensburg, 93053 Regensburg, Germany; (M.H.); (T.M.); (P.J.O.); (W.G.)
| | - Stefan Lenz
- Division of Molecular Pathology, Neuromed Campus, Kepler University Hospital, 4020 Linz, Austria; (K.F.); (S.L.)
| | - Ralf Linker
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, 93055 Regensburg, Germany; (R.L.); (P.H.); (M.H.)
| | - Tim Mirus
- Institute of Functional Genomics, University of Regensburg, 93053 Regensburg, Germany; (M.H.); (T.M.); (P.J.O.); (W.G.)
| | - Peter J. Oefner
- Institute of Functional Genomics, University of Regensburg, 93053 Regensburg, Germany; (M.H.); (T.M.); (P.J.O.); (W.G.)
| | - Christian Paar
- Institute of Laboratory Medicine, Kepler University Hospital, 4021 Linz, Austria;
| | | | | | - Katharina Rosengarth
- Department of Neurosurgery, Regensburg University Hospital, 93053 Regensburg, Germany; (M.A.P.); (K.R.)
| | - Serge Weis
- Division of Neuropathology, Neuromed Campus, Kepler University Hospital, 4020 Linz, Austria;
| | - Christina Wendl
- Department of Radiology and Division of Neuroradiology, Regensburg University Hospital, 93055 Regensburg, Germany; (C.F.); (C.W.)
| | - Sibylle Wimmer
- Institute of Neuroradiology, Neuromed Campus, Kepler University Hospital, 4020 Linz, Austria;
| | - Peter Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, 93055 Regensburg, Germany; (R.L.); (P.H.); (M.H.)
| | - Wolfram Gronwald
- Institute of Functional Genomics, University of Regensburg, 93053 Regensburg, Germany; (M.H.); (T.M.); (P.J.O.); (W.G.)
| | - Markus Hutterer
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, 93055 Regensburg, Germany; (R.L.); (P.H.); (M.H.)
- Department of Neurology with Acute Geriatrics, Saint John of God Hospital Linz, 4021 Linz, Austria
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Koprivica D, Martinho RP, Novakovic M, Jaroszewicz MJ, Frydman L. A denoising method for multidimensional magnetic resonance spectroscopy and imaging based on compressed sensing. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2022; 338:107187. [PMID: 35292421 DOI: 10.1016/j.jmr.2022.107187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Both in spectroscopy and imaging, t1-noise arising from instabilities such as temperature alterations, field-related frequency drifts, electronic and sample-spinning instabilities, or motions in in vivo experiments, affects many 2D Magnetic Resonance experiments. This work introduces a post-processing method that aims to attenuate t1-noise, by suitably averaging multiple signals/representations that have been reconstructed from the sampled data. The ensuing Compressed Sensing Multiplicative (CoSeM) denoising starts from a fully sampled 2D MR data set, discards random indirect-domain points, and makes up for these missing, masked data, by a compressed sensing reconstruction of the now incompletely sampled 2D data set. This procedure is repeated for multiple renditions of the masked data -some of which will have been more strongly affected by t1-noise than others. This leads to a large set of 2D NMR spectra/images compatible with the collected data; CoSeM chooses out of these those renditions that reduce the noise according to a suitable criterion, and then sums up their spectra/images leading to a reduction in t1-noise. The performance of the method was assessed in synthetic data, as well as in numerous different experiments: 2D solid and solution state NMR, 2D localized MRS of live brains, and 2D abdominal MRI. Throughout all these data, CoSeM processing evidenced 2-3 fold increases in SNR, without introducing biases, false peaks, or spectral/image blurring. CoSeM also retains a quantitative linearity in the information -allowing, for instance, reliable T1 inversion-recovery MRI mapping experiments.
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Affiliation(s)
- David Koprivica
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Ricardo P Martinho
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Mihajlo Novakovic
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Michael J Jaroszewicz
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Lucio Frydman
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel.
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Weng G, Radojewski P, Sheriff S, Kiefer C, Schucht P, Wiest R, Maudsley AA, Slotboom J. SLOW: A novel spectral editing method for whole-brain MRSI at ultra high magnetic field. Magn Reson Med 2022; 88:53-70. [PMID: 35344608 PMCID: PMC9212787 DOI: 10.1002/mrm.29220] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE At ultra-high field (UHF), B1 + -inhomogeneities and high specific absorption rate (SAR) of adiabatic slice-selective RF-pulses make spatial resolved spectral-editing extremely challenging with the conventional MEGA-approach. The purpose of the study was to develop a whole-brain resolved spectral-editing MRSI at UHF (UHF, B0 ≥ 7T) within clinical acceptable measurement-time and minimal chemical-shift-displacement-artifacts (CSDA) allowing for simultaneous GABA/Glx-, 2HG-, and PE-editing on a clinical approved 7T-scanner. METHODS Slice-selective adiabatic refocusing RF-pulses (2π-SSAP) dominate the SAR to the patient in (semi)LASER based MEGA-editing sequences, causing large CSDA and long measurement times to fulfill SAR requirements, even using SAR-minimized GOIA-pulses. Therefore, a novel type of spectral-editing, called SLOW-editing, using two different pairs of phase-compensated chemical-shift selective adiabatic refocusing-pulses (2π-CSAP) with different refocusing bandwidths were investigated to overcome these problems. RESULTS Compared to conventional echo-planar spectroscopic imaging (EPSI) and MEGA-editing, SLOW-editing shows robust refocusing and editing performance despite to B1 + -inhomogeneity, and robustness to B0 -inhomogeneities (0.2 ppm ≥ ΔB0 ≥ -0.2 ppm). The narrow bandwidth (∼0.6-0.8 kHz) CSAP reduces the SAR by 92%, RF peak power by 84%, in-excitation slab CSDA by 77%, and has no in-plane CSDA. Furthermore, the CSAP implicitly dephases water, lipid and all the other signals outside of range (≥ 4.6 ppm and ≤1.4 ppm), resulting in additional water and lipid suppression (factors ≥ 1000s) at zero SAR-cost, and no spectral aliasing artifacts. CONCLUSION A new spectral-editing has been developed that is especially suitable for UHF, and was successfully applied for 2HG, GABA+, PE, and Glx-editing within 10 min clinical acceptable measurement time.
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Affiliation(s)
- Guodong Weng
- Institute for Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging (SCAN), University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Institute for Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging (SCAN), University of Bern, Bern, Switzerland
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami School of Medicine, Miami, Florida, USA
| | - Claus Kiefer
- Institute for Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging (SCAN), University of Bern, Bern, Switzerland
| | - Philippe Schucht
- Department of Neurosurgery, Inselspital Bern and University Hospital, Bern, Switzerland
| | - Roland Wiest
- Institute for Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging (SCAN), University of Bern, Bern, Switzerland
| | - Andrew A Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, Florida, USA
| | - Johannes Slotboom
- Institute for Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging (SCAN), University of Bern, Bern, Switzerland
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8
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Kumar M, Nanga RPR, Verma G, Wilson N, Brisset JC, Nath K, Chawla S. Emerging MR Imaging and Spectroscopic Methods to Study Brain Tumor Metabolism. Front Neurol 2022; 13:789355. [PMID: 35370872 PMCID: PMC8967433 DOI: 10.3389/fneur.2022.789355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) provides a non-invasive biochemical profile of brain tumors. The conventional 1H-MRS methods present a few challenges mainly related to limited spatial coverage and low spatial and spectral resolutions. In the recent past, the advent and development of more sophisticated metabolic imaging and spectroscopic sequences have revolutionized the field of neuro-oncologic metabolomics. In this review article, we will briefly describe the scientific premises of three-dimensional echoplanar spectroscopic imaging (3D-EPSI), two-dimensional correlation spectroscopy (2D-COSY), and chemical exchange saturation technique (CEST) MRI techniques. Several published studies have shown how these emerging techniques can significantly impact the management of patients with glioma by determining histologic grades, molecular profiles, planning treatment strategies, and assessing the therapeutic responses. The purpose of this review article is to summarize the potential clinical applications of these techniques in studying brain tumor metabolism.
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Affiliation(s)
- Manoj Kumar
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Ravi Prakash Reddy Nanga
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Gaurav Verma
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Neil Wilson
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | | | - Kavindra Nath
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
- *Correspondence: Sanjeev Chawla
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9
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Guo R, Ma C, Li Y, Zhao Y, Wang T, Li Y, El Fakhri G, Liang ZP. High-Resolution Label-Free Molecular Imaging of Brain Tumor. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3049-3052. [PMID: 34891886 DOI: 10.1109/embc46164.2021.9630623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Molecular imaging has long been recognized as an important tool for diagnosis, characterization, and monitoring of treatment responses of brain tumors. Magnetic resonance spectroscopic imaging (MRSI) is a label-free molecular imaging technique capable of mapping metabolite distributions non-invasively. Several metabolites detectable by MRSI, including Choline, Lactate and N-Acetyl Aspartate, have been proved useful biomarkers for brain tumor characterization. However, clinical application of MRSI has been limited by poor resolution, small spatial coverage, low signal-to-noise ratio and long scan time. This work presents a novel MRSI method for fast, high-resolution metabolic imaging of brain tumor. This method synergistically integrates fast acquisition sequence, sparse sampling, subspace modeling and machine learning to enable 3D mapping of brain metabolites with a spatial resolution of 2.0×3.0×3.0 mm3 in a 7-minute scan. Experimental results obtained from patients with diagnosed brain tumor showed great promise for capturing small-size tumors and revealing intra-tumor metabolic heterogeneities.Clinical Relevance - This paper presents a novel technique for label-free molecular imaging of brain tumor. With further development, this technology may enable many potential clinical applications, from tumor detection, characterization, to assessment of treatment efficacy.
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10
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Abdel Razek AAK, Alksas A, Shehata M, AbdelKhalek A, Abdel Baky K, El-Baz A, Helmy E. Clinical applications of artificial intelligence and radiomics in neuro-oncology imaging. Insights Imaging 2021; 12:152. [PMID: 34676470 PMCID: PMC8531173 DOI: 10.1186/s13244-021-01102-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022] Open
Abstract
This article is a comprehensive review of the basic background, technique, and clinical applications of artificial intelligence (AI) and radiomics in the field of neuro-oncology. A variety of AI and radiomics utilized conventional and advanced techniques to differentiate brain tumors from non-neoplastic lesions such as inflammatory and demyelinating brain lesions. It is used in the diagnosis of gliomas and discrimination of gliomas from lymphomas and metastasis. Also, semiautomated and automated tumor segmentation has been developed for radiotherapy planning and follow-up. It has a role in the grading, prediction of treatment response, and prognosis of gliomas. Radiogenomics allowed the connection of the imaging phenotype of the tumor to its molecular environment. In addition, AI is applied for the assessment of extra-axial brain tumors and pediatric tumors with high performance in tumor detection, classification, and stratification of patient's prognoses.
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Affiliation(s)
| | - Ahmed Alksas
- Biomaging Lab, Department of Bioengineering, University of Louisville, Louisville, KY, 40292, USA
| | - Mohamed Shehata
- Biomaging Lab, Department of Bioengineering, University of Louisville, Louisville, KY, 40292, USA
| | - Amr AbdelKhalek
- Internship at Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Khaled Abdel Baky
- Department of Diagnostic Radiology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Ayman El-Baz
- Biomaging Lab, Department of Bioengineering, University of Louisville, Louisville, KY, 40292, USA
| | - Eman Helmy
- Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Elgomheryia Street, Mansoura, 3512, Egypt.
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11
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Morrison MA, Lupo JM. 7-T Magnetic Resonance Imaging in the Management of Brain Tumors. Magn Reson Imaging Clin N Am 2021; 29:83-102. [PMID: 33237018 DOI: 10.1016/j.mric.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article provides an overview of the current status of ultrahigh-field 7-T magnetic resonance (MR) imaging in neuro-oncology, specifically for the management of patients with brain tumors. It includes a discussion of areas across the pretherapeutic, peritherapeutic, and posttherapeutic stages of patient care where 7-T MR imaging is currently being exploited and holds promise. This discussion includes existing technical challenges, barriers to clinical integration, as well as our impression of the future role of 7-T MR imaging as a clinical tool in neuro-oncology.
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Affiliation(s)
- Melanie A Morrison
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
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12
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Radiomics and radiogenomics in gliomas: a contemporary update. Br J Cancer 2021; 125:641-657. [PMID: 33958734 PMCID: PMC8405677 DOI: 10.1038/s41416-021-01387-w] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 02/03/2023] Open
Abstract
The natural history and treatment landscape of primary brain tumours are complicated by the varied tumour behaviour of primary or secondary gliomas (high-grade transformation of low-grade lesions), as well as the dilemmas with identification of radiation necrosis, tumour progression, and pseudoprogression on MRI. Radiomics and radiogenomics promise to offer precise diagnosis, predict prognosis, and assess tumour response to modern chemotherapy/immunotherapy and radiation therapy. This is achieved by a triumvirate of morphological, textural, and functional signatures, derived from a high-throughput extraction of quantitative voxel-level MR image metrics. However, the lack of standardisation of acquisition parameters and inconsistent methodology between working groups have made validations unreliable, hence multi-centre studies involving heterogenous study populations are warranted. We elucidate novel radiomic and radiogenomic workflow concepts and state-of-the-art descriptors in sub-visual MR image processing, with relevant literature on applications of such machine learning techniques in glioma management.
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13
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Lan C, Li H, Wang L, Zhang J, Wang X, Zhang R, Yuan X, Wu T, Wu J, Lu M, Ma X. Absolute quantification of 2-hydroxyglutarate on tissue by matrix-assisted laser desorption/ionization mass spectrometry imaging for rapid and precise identification of isocitrate dehydrogenase mutations in human glioma. Int J Cancer 2021; 149:2091-2098. [PMID: 34224582 DOI: 10.1002/ijc.33729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 11/09/2022]
Abstract
Isocitrate dehydrogenase (IDH) gene mutations are important predictive molecular markers to guide surgical strategy in brain cancer therapy. Herein, we presented a method using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) for absolute quantification of 2-hydroxyglutarate (2-HG) on tissues to identify IDH mutations and evaluate tumor residue. This analytical method was tested among 34 glioma patients and validated with gold standard clinical technologies. The cut-off value of 2-HG was set as 0.81 pmol/μg to identify IDH mutant (IDHmt) gliomas with 100% specificity and sensitivity. In addition, 2-HG levels and tumor cell density (TCD) showed positive correlation in IDHmt gliomas by this spatial method. This MALDI MSI-based absolute quantification method has great potentiality for incorporating into surgical workflow in the future.
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Affiliation(s)
- Chunyan Lan
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China.,Peking Union Medical College Graduate School, Beijing, China
| | - Hainan Li
- Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Lei Wang
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China
| | - Jing Zhang
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China
| | - Xiaodong Wang
- Centre for Imaging & Systems Biology, Minzu University of China, Beijing, China
| | - Rumeng Zhang
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China
| | - Xiaoai Yuan
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China
| | - Taihua Wu
- Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Jie Wu
- Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Ming Lu
- Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Xu Ma
- National Centre for Human Genetic Resources, National Research Institute for Health and Family Planning, Beijing, China.,Peking Union Medical College Graduate School, Beijing, China
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14
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Menze B, Isensee F, Wiest R, Wiestler B, Maier-Hein K, Reyes M, Bakas S. Analyzing magnetic resonance imaging data from glioma patients using deep learning. Comput Med Imaging Graph 2021; 88:101828. [PMID: 33571780 PMCID: PMC8040671 DOI: 10.1016/j.compmedimag.2020.101828] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022]
Abstract
The quantitative analysis of images acquired in the diagnosis and treatment of patients with brain tumors has seen a significant rise in the clinical use of computational tools. The underlying technology to the vast majority of these tools are machine learning methods and, in particular, deep learning algorithms. This review offers clinical background information of key diagnostic biomarkers in the diagnosis of glioma, the most common primary brain tumor. It offers an overview of publicly available resources and datasets for developing new computational tools and image biomarkers, with emphasis on those related to the Multimodal Brain Tumor Segmentation (BraTS) Challenge. We further offer an overview of the state-of-the-art methods in glioma image segmentation, again with an emphasis on publicly available tools and deep learning algorithms that emerged in the context of the BraTS challenge.
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Affiliation(s)
- Bjoern Menze
- Quantitative Biomedicine, University of Zurich, Zurich, Switzerland.
| | | | - Roland Wiest
- Support Center for Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland.
| | | | | | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
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15
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Radoul M, Hong D, Gillespie AM, Najac C, Viswanath P, Pieper RO, Costello JF, Luchman HA, Ronen SM. Early Noninvasive Metabolic Biomarkers of Mutant IDH Inhibition in Glioma. Metabolites 2021; 11:metabo11020109. [PMID: 33668509 PMCID: PMC7917625 DOI: 10.3390/metabo11020109] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 80% of low-grade glioma (LGGs) harbor mutant isocitrate dehydrogenase 1/2 (IDH1/2) driver mutations leading to accumulation of the oncometabolite 2-hydroxyglutarate (2-HG). Thus, inhibition of mutant IDH is considered a potential therapeutic target. Several mutant IDH inhibitors are currently in clinical trials, including AG-881 and BAY-1436032. However, to date, early detection of response remains a challenge. In this study we used high resolution 1H magnetic resonance spectroscopy (1H-MRS) to identify early noninvasive MR (Magnetic Resonance)-detectable metabolic biomarkers of response to mutant IDH inhibition. In vivo 1H-MRS was performed on mice orthotopically-implanted with either genetically engineered (U87IDHmut) or patient-derived (BT257 and SF10417) mutant IDH1 cells. Treatment with either AG-881 or BAY-1436032 induced a significant reduction in 2-HG. Moreover, both inhibitors led to a significant early and sustained increase in glutamate and the sum of glutamate and glutamine (GLX) in all three models. A transient early increase in N-acetylaspartate (NAA) was also observed. Importantly, all models demonstrated enhanced animal survival following both treatments and the metabolic alterations were observed prior to any detectable differences in tumor volume between control and treated tumors. Our study therefore identifies potential translatable early metabolic biomarkers of drug delivery, mutant IDH inhibition and glioma response to treatment with emerging clinically relevant therapies.
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Affiliation(s)
- Marina Radoul
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Donghyun Hong
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Chloé Najac
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Russell O. Pieper
- Department of Neurological Surgery, Helen Diller Research Center, University of California, San Francisco, CA 94158, USA; (R.O.P.); (J.F.C.)
- Brain Tumor Research Center, University of California, San Francisco, CA 94158, USA
| | - Joseph F. Costello
- Department of Neurological Surgery, Helen Diller Research Center, University of California, San Francisco, CA 94158, USA; (R.O.P.); (J.F.C.)
| | - Hema Artee Luchman
- Arnie Charbonneau Cancer Institute and Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Sabrina M. Ronen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
- Brain Tumor Research Center, University of California, San Francisco, CA 94158, USA
- Correspondence: ; Tel.: +1-415-514-4839
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16
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Non-Invasive Prediction of IDH Mutation in Patients with Glioma WHO II/III/IV Based on F-18-FET PET-Guided In Vivo 1H-Magnetic Resonance Spectroscopy and Machine Learning. Cancers (Basel) 2020; 12:cancers12113406. [PMID: 33212941 PMCID: PMC7698334 DOI: 10.3390/cancers12113406] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/08/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Approximately 75–80% of according to the classification of world health organization (WHO) grade II and III gliomas are characterized by a mutation of the isocitrate dehydrogenase (IDH) enzymes, which are very important in glioma cell metabolism. Patients with IDH mutated glioma have a significantly better prognosis than patients with IDH wildtype status, typically seen in glioblastoma WHO grade IV. Here we used a prospective O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography guided single-voxel 1H-magnetic resonance spectroscopy approach to predict the IDH status before surgery. Finally, 34 patients were included in this neuroimaging study, of whom eight had additionally tissue analysis. Using a machine learning technique, we predicted IDH status with an accuracy of 88.2%, a sensitivity of 95.5% and a specificity of 75.0%. It was newly recognized, that two metabolites (myo-inositol and glycine) have a particularly important role in the determination of the IDH status. Abstract Isocitrate dehydrogenase (IDH)-1 mutation is an important prognostic factor and a potential therapeutic target in glioma. Immunohistological and molecular diagnosis of IDH mutation status is invasive. To avoid tumor biopsy, dedicated spectroscopic techniques have been proposed to detect D-2-hydroxyglutarate (2-HG), the main metabolite of IDH, directly in vivo. However, these methods are technically challenging and not broadly available. Therefore, we explored the use of machine learning for the non-invasive, inexpensive and fast diagnosis of IDH status in standard 1H-magnetic resonance spectroscopy (1H-MRS). To this end, 30 of 34 consecutive patients with known or suspected glioma WHO grade II-IV were subjected to metabolic positron emission tomography (PET) imaging with O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) for optimized voxel placement in 1H-MRS. Routine 1H-magnetic resonance (1H-MR) spectra of tumor and contralateral healthy brain regions were acquired on a 3 Tesla magnetic resonance (3T-MR) scanner, prior to surgical tumor resection and molecular analysis of IDH status. Since 2-HG spectral signals were too overlapped for reliable discrimination of IDH mutated (IDHmut) and IDH wild-type (IDHwt) glioma, we used a nested cross-validation approach, whereby we trained a linear support vector machine (SVM) on the complete spectral information of the 1H-MRS data to predict IDH status. Using this approach, we predicted IDH status with an accuracy of 88.2%, a sensitivity of 95.5% (95% CI, 77.2–99.9%) and a specificity of 75.0% (95% CI, 42.9–94.5%), respectively. The area under the curve (AUC) amounted to 0.83. Subsequent ex vivo 1H-nuclear magnetic resonance (1H-NMR) measurements performed on metabolite extracts of resected tumor material (eight specimens) revealed myo-inositol (M-ins) and glycine (Gly) to be the major discriminators of IDH status. We conclude that our approach allows a reliable, non-invasive, fast and cost-effective prediction of IDH status in a standard clinical setting.
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17
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Barekatain Y, Yan VC, Arthur K, Ackroyd JJ, Khadka S, De Groot J, Huse JT, Muller FL. Robust detection of oncometabolic aberrations by 1H- 13C heteronuclear single quantum correlation in intact biological specimens. Commun Biol 2020; 3:328. [PMID: 32587392 PMCID: PMC7316726 DOI: 10.1038/s42003-020-1055-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/29/2020] [Indexed: 01/02/2023] Open
Abstract
Magnetic resonance (MR) spectroscopy has potential to non-invasively detect metabolites of diagnostic significance for precision oncology. Yet, many metabolites have similar chemical shifts, yielding highly convoluted 1H spectra of intact biological material and limiting diagnostic utility. Here, we show that hydrogen–carbon heteronuclear single quantum correlation (1H–13C HSQC) offers dramatic improvements in sensitivity compared to one-dimensional (1D) 13C NMR and significant signal deconvolution compared to 1D 1H spectra in intact biological settings. Using a standard NMR spectroscope with a cryoprobe but without specialized signal enhancing features such as magic angle spinning, metabolite extractions or 13C-isotopic enrichment, we obtain well-resolved 2D 1H–13C HSQC spectra in live cancer cells, in ex vivo freshly dissected xenografted tumors and resected primary tumors. This method can identify tumors with specific oncometabolite alterations such as IDH mutations by 2-hydroxyglutarate and PGD-deleted tumors by gluconate. Results suggest potential of 1H–13C HSQC as a non-invasive diagnostic in precision oncology. Barekatain et al. demonstrate that hydrogen–carbon heteronuclear single quantum correlation (HSQC) spectra, obtained using a standard NMR spectroscope, can detect tumours with specific oncometabolite alterations including IDH1 mutant glioblastoma, suggesting the feasibility of this method as a diagnostic tool.
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Affiliation(s)
- Yasaman Barekatain
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Victoria C Yan
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Kenisha Arthur
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Jeffrey J Ackroyd
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Sunada Khadka
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - John De Groot
- Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Jason T Huse
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Florian L Muller
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA.
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18
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Gonçalves FG, Chawla S, Mohan S. Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma. J Magn Reson Imaging 2020; 52:978-997. [PMID: 32190946 DOI: 10.1002/jmri.27105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 12/14/2022] Open
Abstract
Glioblastoma is the most common and most malignant primary brain tumor. Despite aggressive multimodal treatment, its prognosis remains poor. Even with continuous developments in MRI, which has provided us with newer insights into the diagnosis and understanding of tumor biology, response assessment in the posttherapy setting remains challenging. We believe that the integration of additional information from advanced neuroimaging techniques can further improve the diagnostic accuracy of conventional MRI. In this article, we review the utility of advanced neuroimaging techniques such as diffusion-weighted imaging, diffusion tensor imaging, perfusion-weighted imaging, proton magnetic resonance spectroscopy, and chemical exchange saturation transfer in characterizing and evaluating treatment response in patients with glioblastoma. We will also discuss the existing challenges and limitations of using these techniques in clinical settings and possible solutions to avoiding pitfalls in study design, data acquisition, and analysis for future studies. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3 J. Magn. Reson. Imaging 2020;52:978-997.
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Affiliation(s)
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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19
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Magnetic Resonance Spectroscopic Assessment of Isocitrate Dehydrogenase Status in Gliomas: The New Frontiers of Spectrobiopsy in Neurodiagnostics. World Neurosurg 2020; 133:e421-e427. [DOI: 10.1016/j.wneu.2019.09.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/06/2019] [Indexed: 12/21/2022]
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20
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Batsios G, Viswanath P, Subramani E, Najac C, Gillespie AM, Santos RD, Molloy AR, Pieper RO, Ronen SM. PI3K/mTOR inhibition of IDH1 mutant glioma leads to reduced 2HG production that is associated with increased survival. Sci Rep 2019; 9:10521. [PMID: 31324855 PMCID: PMC6642106 DOI: 10.1038/s41598-019-47021-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/09/2019] [Indexed: 02/08/2023] Open
Abstract
70-90% of low-grade gliomas and secondary glioblastomas are characterized by mutations in isocitrate dehydrogenase 1 (IDHmut). IDHmut produces the oncometabolite 2-hydroxyglutarate (2HG), which drives tumorigenesis in these tumors. The phosphoinositide-3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway represents an attractive therapeutic target for IDHmut gliomas, but noninvasive indicators of drug target modulation are lacking. The goal of this study was therefore to identify magnetic resonance spectroscopy (MRS)-detectable metabolic biomarkers associated with IDHmut glioma response to the dual PI3K/(mTOR) inhibitor XL765. 1H-MRS of two cell lines genetically modified to express IDHmut showed that XL765 induced a significant reduction in several intracellular metabolites including 2HG. Importantly, examination of an orthotopic IDHmut tumor model showed that enhanced animal survival following XL765 treatment was associated with a significant in vivo 1H-MRS detectable reduction in 2HG but not with significant inhibition in tumor growth. Further validation is required, but our results indicate that 2HG could serve as a potential noninvasive MRS-detectable metabolic biomarker of IDHmut glioma response to PI3K/mTOR inhibition.
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Affiliation(s)
- Georgios Batsios
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Elavarasan Subramani
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Chloe Najac
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Abigail R Molloy
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States
| | - Russell O Pieper
- Department of Neurological Surgery, Helen Diller Research Center, 1450 3rd Street, University of California, 94143, San Francisco, CA, United States
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, Mission Bay Campus, 1700 4th Street, Byers Hall, University of California, 94158, San Francisco, CA, United States. .,Brain Tumor Research Center, Helen Diller Family Cancer Research Building, 1450 3rd Street, University of California, 94158, San Francisco, CA, United States.
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21
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Affiliation(s)
- Gaurav Verma
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Priti Balchandani
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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22
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Rudie JD, Rauschecker AM, Bryan RN, Davatzikos C, Mohan S. Emerging Applications of Artificial Intelligence in Neuro-Oncology. Radiology 2019; 290:607-618. [PMID: 30667332 DOI: 10.1148/radiol.2018181928] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Due to the exponential growth of computational algorithms, artificial intelligence (AI) methods are poised to improve the precision of diagnostic and therapeutic methods in medicine. The field of radiomics in neuro-oncology has been and will likely continue to be at the forefront of this revolution. A variety of AI methods applied to conventional and advanced neuro-oncology MRI data can already delineate infiltrating margins of diffuse gliomas, differentiate pseudoprogression from true progression, and predict recurrence and survival better than methods used in daily clinical practice. Radiogenomics will also advance our understanding of cancer biology, allowing noninvasive sampling of the molecular environment with high spatial resolution and providing a systems-level understanding of underlying heterogeneous cellular and molecular processes. By providing in vivo markers of spatial and molecular heterogeneity, these AI-based radiomic and radiogenomic tools have the potential to stratify patients into more precise initial diagnostic and therapeutic pathways and enable better dynamic treatment monitoring in this era of personalized medicine. Although substantial challenges remain, radiologic practice is set to change considerably as AI technology is further developed and validated for clinical use.
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Affiliation(s)
- Jeffrey D Rudie
- From the Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., C.D., S.M.); Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.M.R.); and Department of Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Tex (R.N.B.)
| | - Andreas M Rauschecker
- From the Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., C.D., S.M.); Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.M.R.); and Department of Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Tex (R.N.B.)
| | - R Nick Bryan
- From the Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., C.D., S.M.); Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.M.R.); and Department of Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Tex (R.N.B.)
| | - Christos Davatzikos
- From the Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., C.D., S.M.); Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.M.R.); and Department of Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Tex (R.N.B.)
| | - Suyash Mohan
- From the Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., C.D., S.M.); Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.M.R.); and Department of Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Tex (R.N.B.)
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23
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Barisano G, Sepehrband F, Ma S, Jann K, Cabeen R, Wang DJ, Toga AW, Law M. Clinical 7 T MRI: Are we there yet? A review about magnetic resonance imaging at ultra-high field. Br J Radiol 2018; 92:20180492. [PMID: 30359093 DOI: 10.1259/bjr.20180492] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In recent years, ultra-high field MRI (7 T and above) has received more interest for clinical imaging. Indeed, a number of studies have shown the benefits from the application of this powerful tool not only for research purposes, but also in realms of improved diagnostics and patient management. The increased signal-to-noise ratio and higher spatial resolution compared with conventional and high-field clinical scanners allow imaging of small anatomical detail and subtle pathological findings. Furthermore, greater spectral resolution achieved at ultra-high field allows the resolution of metabolites for MR spectroscopic imaging. All these advantages have a significant impact on many neurological diseases, including multiple sclerosis, cerebrovascular disease, brain tumors, epilepsy and neurodegenerative diseases, in part because the pathology can be subtle and lesions small in these diseases, therefore having higher signal and resolution will help lesion detection. In this review, we discuss the main clinical neurological applications and some technical challenges which remain with ultra-high field MRI.
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Affiliation(s)
- Giuseppe Barisano
- 1 Department of Radiology, Keck Medical Center of University of Southern California , Los Angeles, CA , USA.,2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Farshid Sepehrband
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Samantha Ma
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Kay Jann
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Ryan Cabeen
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Danny J Wang
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Arthur W Toga
- 2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Meng Law
- 1 Department of Radiology, Keck Medical Center of University of Southern California , Los Angeles, CA , USA.,2 Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
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24
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Arm J, Al-iedani O, Quadrelli S, Ribbons K, Lea R, Lechner-Scott J, Ramadan S. Reliability of neurometabolite detection with two-dimensional localized correlation spectroscopy at 3T. J Magn Reson Imaging 2018; 48:1559-1569. [DOI: 10.1002/jmri.26036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/20/2018] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jameen Arm
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
| | - Oun Al-iedani
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
| | - Scott Quadrelli
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Princess Alexandra Hospital; Woolloongabba / University of Queensland, Faculty of Medicine; Brisbane Australia
| | - Karen Ribbons
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Department of Neurology; John Hunter Hospital; Lookout Road, New Lambton Heights NSW Australia
| | - Rod Lea
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- Institute of Health and Biomedical Innovation, School of Biomedical Sciences; Queensland University of Technology; Brisbane Australia
| | - Jeannette Lechner-Scott
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Department of Neurology; John Hunter Hospital; Lookout Road, New Lambton Heights NSW Australia
| | - Saadallah Ramadan
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
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25
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2-Hydroxyglutarate Detection by Short Echo Time Magnetic Resonance Spectroscopy in Routine Imaging Study of Brain Glioma at 3.0 T. J Comput Assist Tomogr 2018; 42:469-474. [DOI: 10.1097/rct.0000000000000705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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26
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Interrogating IDH Mutation in Brain Tumor: Magnetic Resonance and Hyperpolarization. Top Magn Reson Imaging 2017; 26:27-32. [PMID: 28079713 DOI: 10.1097/rmr.0000000000000113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Magnetic resonance spectroscopy (MRS) offers the possibility to noninvasively quantify 2HG concentration in the brain in the clinic, thereby serving as a valuable tool for patient-stratification as well as targeted treatment monitoring. Recently, hyperpolarized magnetic resonance techniques have opened up new opportunities for metabolic imaging not possible with conventional MRS in the brain. With over 10,000-fold increase in signal-to-noise ratio (SNR), dynamic metabolic processes can be interrogated in vivo with very high specificity by hyperpolarized MRI. In the following article, we will review relevant clinical studies and practical considerations of MRS and hyperpolarized MRS, as well as discuss some promising preclinical hyperpolarization studies to interrogate real-time metabolism in IDH mutations in vivo.
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27
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Deep Learning based Radiomics (DLR) and its usage in noninvasive IDH1 prediction for low grade glioma. Sci Rep 2017; 7:5467. [PMID: 28710497 PMCID: PMC5511238 DOI: 10.1038/s41598-017-05848-2] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/25/2017] [Indexed: 02/06/2023] Open
Abstract
Deep learning-based radiomics (DLR) was developed to extract deep information from multiple modalities of magnetic resonance (MR) images. The performance of DLR for predicting the mutation status of isocitrate dehydrogenase 1 (IDH1) was validated in a dataset of 151 patients with low-grade glioma. A modified convolutional neural network (CNN) structure with 6 convolutional layers and a fully connected layer with 4096 neurons was used to segment tumors. Instead of calculating image features from segmented images, as typically performed for normal radiomics approaches, image features were obtained by normalizing the information of the last convolutional layers of the CNN. Fisher vector was used to encode the CNN features from image slices of different sizes. High-throughput features with dimensionality greater than 1.6*104 were obtained from the CNN. Paired t-tests and F-scores were used to select CNN features that were able to discriminate IDH1. With the same dataset, the area under the operating characteristic curve (AUC) of the normal radiomics method was 86% for IDH1 estimation, whereas for DLR the AUC was 92%. The AUC of IDH1 estimation was further improved to 95% using DLR based on multiple-modality MR images. DLR could be a powerful way to extract deep information from medical images.
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28
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Henning A. Proton and multinuclear magnetic resonance spectroscopy in the human brain at ultra-high field strength: A review. Neuroimage 2017; 168:181-198. [PMID: 28712992 DOI: 10.1016/j.neuroimage.2017.07.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/27/2017] [Accepted: 07/10/2017] [Indexed: 12/11/2022] Open
Abstract
Magnetic Resonance Spectroscopy (MRS) allows for a non-invasive and non-ionizing determination of in vivo tissue concentrations and metabolic turn-over rates of more than 20 metabolites and compounds in the central nervous system of humans. The aim of this review is to give a comprehensive overview about the advantages, challenges and advances of ultra-high field MRS with regard to methodological development, discoveries and applications from its beginnings around 15 years ago up to the current state. The review is limited to human brain and spinal cord application at field strength of 7T and 9.4T and includes all relevant nuclei (1H, 31P, 13C).
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Affiliation(s)
- Anke Henning
- Max Plank Institute for Biological Cybernetics, Tübingen, Germany; Institute of Physics, Ernst-Moritz-Arndt University, Greifswald, Germany.
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29
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Showalter MR, Hatakeyama J, Cajka T, VanderVorst K, Carraway KL, Fiehn O. Replication Study: The common feature of leukemia-associated IDH1 and IDH2 mutations is a neomorphic enzyme activity converting alpha-ketoglutarate to 2-hydroxyglutarate. eLife 2017; 6. [PMID: 28653623 PMCID: PMC5487214 DOI: 10.7554/elife.26030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/22/2017] [Indexed: 12/25/2022] Open
Abstract
In 2016, as part of the Reproducibility Project: Cancer Biology, we published a Registered Report (Fiehn et al., 2016), that described how we intended to replicate selected experiments from the paper "The common feature of leukemia-associated IDH1 and IDH2 mutations is a neomorphic enzyme activity converting alpha-ketoglutarate to 2-hydroxyglutarate" (Ward et al., 2010). Here, we report the results of those experiments. We found that cells expressing R172K mutant IDH2 did not display isocitrate-dependent NADPH production above vector control levels, in contrast to the increased production observed with wild-type IDH2. Conversely, expression of R172K mutant IDH2 resulted in increased alpha-ketoglutarate-dependent consumption of NADPH compared to wild-type IDH2 or vector control. These results are similar to those reported in the original study (Figure 2; Ward et al., 2010). Further, expression of R172K mutant IDH2 resulted in increased 2HG levels within cells compared to the background levels observed in wild-type IDH2 and vector control, similar to the original study (Figure 3D; Ward et al., 2010). In primary human AML samples, the 2HG levels observed in samples with mutant IDH1 or IDH2 status were higher than those observed in samples without an IDH mutation, similar to what was observed in the original study (Figure 5C; Ward et al., 2010). Finally, we report meta-analyses for each result.
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Affiliation(s)
| | - Jason Hatakeyama
- Department of Biochemistry and Molecular Medicine, University of California, California, United States.,University of California Davis Comprehensive Cancer Center, University of California, California, United States
| | - Tomas Cajka
- West Coast Metabolomics Center, University of California, Davis, United States
| | - Kacey VanderVorst
- Department of Biochemistry and Molecular Medicine, University of California, California, United States.,University of California Davis Comprehensive Cancer Center, University of California, California, United States
| | - Kermit L Carraway
- Department of Biochemistry and Molecular Medicine, University of California, California, United States.,University of California Davis Comprehensive Cancer Center, University of California, California, United States
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, United States
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30
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Leather T, Jenkinson MD, Das K, Poptani H. Magnetic Resonance Spectroscopy for Detection of 2-Hydroxyglutarate as a Biomarker for IDH Mutation in Gliomas. Metabolites 2017; 7:E29. [PMID: 28629182 PMCID: PMC5488000 DOI: 10.3390/metabo7020029] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 02/02/2023] Open
Abstract
Mutations in the isocitrate dehydrogenase (IDH)1/2 genes are highly prevalent in gliomas and have been suggested to play an important role in the development and progression of the disease. Tumours harbouring these mutations exhibit a significant alteration in their metabolism resulting in the aberrant accumulation of the oncometabolite 2-hydroxygluarate (2-HG). As well as being suggested to play an important role in tumour progression, 2-HG may serve as a surrogate indicator of IDH status through non-invasive detection using magnetic resonance spectroscopy (MRS). In this review, we describe the recent efforts in developing MRS methods for detection and quantification of 2-HG in vivo and provide an assessment of the role of the 2-HG in gliomagenesis and patient prognosis.
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Affiliation(s)
- Thomas Leather
- Centre for Pre-clinical Imaging, Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool L69 3BX, UK.
| | - Michael D Jenkinson
- Institute of Translational Medicine, University of Liverpool, Clinical Science Centre, Lower Lane, Liverpool L9 7LJ, UK.
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, UK.
| | - Kumar Das
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, UK.
| | - Harish Poptani
- Centre for Pre-clinical Imaging, Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool L69 3BX, UK.
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