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Lopez FV, O'Shea A, Huo Z, DeKosky ST, Trouard TP, Alexander GE, Woods AJ, Bowers D. Frontal-temporal regional differences in brain energy metabolism and mitochondrial function using 31P MRS in older adults. GeroScience 2024; 46:3185-3195. [PMID: 38225480 PMCID: PMC11009166 DOI: 10.1007/s11357-023-01046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/07/2023] [Indexed: 01/17/2024] Open
Abstract
Aging is a major risk for cognitive decline and transition to dementia. One well-known age-related change involves decreased brain efficiency and energy production, mediated in part by changes in mitochondrial function. Damaged or dysfunctional mitochondria have been implicated in the pathogenesis of age-related neurodegenerative conditions like Alzheimer's disease (AD). The aim of the current study was to investigate mitochondrial function over frontal and temporal regions in a sample of 70 cognitively normal older adults with subjective memory complaints and a first-degree family history of AD. We hypothesized cerebral mitochondrial function and energy metabolism would be greater in temporal as compared to frontal regions based on the high energy consumption in the temporal lobes (i.e., hippocampus). To test this hypothesis, we used phosphorous (31P) magnetic resonance spectroscopy (MRS) which is a non-invasive and powerful method for investigating in vivo mitochondrial function via high energy phosphates and phospholipid metabolism ratios. We used a single voxel method (left temporal and bilateral prefrontal) to achieve optimal sensitivity. Results of separate repeated measures analyses of variance showed 31P MRS ratios of static energy, energy reserve, energy consumption, energy demand, and phospholipid membrane metabolism were greater in the left temporal than bilateral prefrontal voxels. Our findings that all 31P MRS ratios were greater in temporal than bifrontal regions support our hypothesis. Future studies are needed to determine whether findings are related to cognition in older adults.
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Affiliation(s)
- Francesca V Lopez
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, PO Box 100165, Gainesville, FL, 32610, USA.
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, Evelyn F. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Zhiguang Huo
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Department of Neurology, Fixel Center for Neurological Diseases, College of Medicine, and Evelyn F. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Theodore P Trouard
- Department of Biomedical Engineering, College of Engineering, and Evelyn F. McKnight Brain Institute, University of Arizona and Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Gene E Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, PO Box 100165, Gainesville, FL, 32610, USA
- Center for Cognitive Aging and Memory, Evelyn F. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, PO Box 100165, Gainesville, FL, 32610, USA
- Department of Neurology, Fixel Center of Neurological Diseases, College of Medicine, University of Florida, Gainesville, FL, USA
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2
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Galijasevic M, Steiger R, Treichl SA, Ho WM, Mangesius S, Ladenhauf V, Deeg J, Gruber L, Ouaret M, Regodic M, Lenhart L, Pfausler B, Grams AE, Petr O, Thomé C, Gizewski ER. Could Phosphorous MR Spectroscopy Help Predict the Severity of Vasospasm? A Pilot Study. Diagnostics (Basel) 2024; 14:841. [PMID: 38667486 PMCID: PMC11049300 DOI: 10.3390/diagnostics14080841] [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: 02/22/2024] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology of this adverse event. Using phosphorous magnetic resonance spectrocopy (31P-MRS), we calculated the cerebral magnesium (Mg) and pH levels in 13 patients who suffered from aSAH. The values between the group that developed clinically significant vasospasm (n = 7) and the group that did not (n = 6) were compared. The results of this study show significantly lower cerebral Mg levels (p = 0.019) and higher pH levels (p < 0.001) in the cumulative group (all brain voxels together) in patients who developed clinically significant vasospasm. Further clinical studies on a larger group of carefully selected patients are needed in order to predict clinically significant vasospasm.
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Affiliation(s)
- Malik Galijasevic
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Ruth Steiger
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Stephanie Alice Treichl
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.A.T.); (W.M.H.); (O.P.); (C.T.)
| | - Wing Man Ho
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.A.T.); (W.M.H.); (O.P.); (C.T.)
| | - Stephanie Mangesius
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Valentin Ladenhauf
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Johannes Deeg
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Leonhard Gruber
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Miar Ouaret
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Milovan Regodic
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Lukas Lenhart
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Bettina Pfausler
- Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Astrid Ellen Grams
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Ondra Petr
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.A.T.); (W.M.H.); (O.P.); (C.T.)
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.A.T.); (W.M.H.); (O.P.); (C.T.)
| | - Elke Ruth Gizewski
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (S.M.); (V.L.); (J.D.); (L.G.); (M.O.); (M.R.); (L.L.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
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3
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Sun P, Wu Z, Lin L, Hu G, Zhang X, Wang J. MR-Nucleomics: The study of pathological cellular processes with multinuclear magnetic resonance spectroscopy and imaging in vivo. NMR IN BIOMEDICINE 2023; 36:e4845. [PMID: 36259659 DOI: 10.1002/nbm.4845] [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: 04/06/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
Clinical medicine has experienced a rapid development in recent decades, during which therapies targeting specific cellular signaling pathways, or specific cell surface receptors, have been increasingly adopted. While these developments in clinical medicine call for improved precision in diagnosis and treatment monitoring, modern medical imaging methods are restricted mainly to anatomical imaging, lagging behind the requirements of precision medicine. Although positron emission tomography and single photon emission computed tomography have been used clinically for studies of metabolism, their applications have been limited by the exposure risk to ionizing radiation, the subsequent limitation in repeated and longitudinal studies, and the incapability in assessing downstream metabolism. Magnetic resonance spectroscopy (MRS) or spectroscopic imaging (MRSI) are, in theory, capable of assessing molecular activities in vivo, although they are often limited by sensitivity. Here, we review some recent developments in MRS and MRSI of multiple nuclei that have potential as molecular imaging tools in the clinic.
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Affiliation(s)
- Peng Sun
- Clinical & Technical Support, Philips Healthcare, China
| | - Zhigang Wu
- Clinical & Technical Support, Philips Healthcare, China
| | - Liangjie Lin
- Clinical & Technical Support, Philips Healthcare, China
| | - Geli Hu
- Clinical & Technical Support, Philips Healthcare, China
| | | | - Jiazheng Wang
- Clinical & Technical Support, Philips Healthcare, China
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4
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Ren J, Yu F, Greenberg BM. ATP line splitting in association with reduced intracellular magnesium and pH: a brain 31 P MR spectroscopic imaging (MRSI) study of pediatric patients with myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGADs). NMR IN BIOMEDICINE 2023; 36:e4836. [PMID: 36150743 DOI: 10.1002/nbm.4836] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 09/06/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Over the past four decades, ATP, the obligatory energy molecule for keeping all cells alive and functioning, has been thought to contribute only one set of signals in brain 31 P MR spectra. Here we report for the first time the observation of two separate β-ATP peaks in brain spectra acquired from patients with myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGADs) using 3D MRSI at 7 T. In voxel spectra with β-ATP line splitting, these two peaks are separated by 0.46 ± 0.18 ppm (n = 6). Spectral lineshape analysis indicates that the upper field β-ATP peak is smaller in relative intensity (24 ± 11% versus 76 ± 11%), and narrower in linewidth (56.8 ± 10.3 versus 41.2 ± 10.3 Hz) than the downfield one. Data analysis also reveals a similar line splitting for the intracellular inorganic phosphate (Pi ) signal, which is characterized by two components with a smaller separation (0.16 ± 0.09 ppm) and an intensity ratio (26 ± 7%:74 ± 7%) comparable to that of β-ATP. While the major components of Pi and β-ATP correspond to a neutral intracellular pH (6.99 ± 0.01) and a free Mg2+ level (0.18 ± 0.02 mM, by Iotti's conversion formula) as found in healthy subjects, their minor counterparts relate to a slightly acidic pH (6.86 ± 0.07) and a 50% lower [Mg2+ ] (0.09 ± 0.02 mM), respectively. Data correlation between β-ATP and Pi signals appears to suggest an association between an increased [H+ ] and a reduced [Mg2+ ] in MOGAD patients.
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Affiliation(s)
- Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Fang Yu
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin M Greenberg
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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5
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A Multi-Disciplinary Approach to Diagnosis and Treatment of Radionecrosis in Malignant Gliomas and Cerebral Metastases. Cancers (Basel) 2022; 14:cancers14246264. [PMID: 36551750 PMCID: PMC9777318 DOI: 10.3390/cancers14246264] [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: 10/16/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Radiation necrosis represents a potentially devastating complication after radiation therapy in brain tumors. The establishment of the diagnosis and especially the differentiation from progression and pseudoprogression with its therapeutic implications requires interdisciplinary consent and monitoring. Herein, we want to provide an overview of the diagnostic modalities, therapeutic possibilities and an outlook on future developments to tackle this challenging topic. The aim of this report is to provide an overview of the current morphological, functional, metabolic and evolving imaging tools described in the literature in order to (I) identify the best criteria to distinguish radionecrosis from tumor recurrence after the radio-oncological treatment of malignant gliomas and cerebral metastases, (II) analyze the therapeutic possibilities and (III) give an outlook on future developments to tackle this challenging topic. Additionally, we provide the experience of a tertiary tumor center with this important issue in neuro-oncology and provide an institutional pathway dealing with this problem.
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6
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Ley-Ngardigal S, Bertolin G. Approaches to monitor ATP levels in living cells: where do we stand? FEBS J 2022; 289:7940-7969. [PMID: 34437768 DOI: 10.1111/febs.16169] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/30/2021] [Accepted: 08/25/2021] [Indexed: 01/14/2023]
Abstract
ATP is the most universal and essential energy molecule in cells. This is due to its ability to store cellular energy in form of high-energy phosphate bonds, which are extremely stable and readily usable by the cell. This energy is key for a variety of biological functions such as cell growth and division, metabolism, and signaling, and for the turnover of biomolecules. Understanding how ATP is produced and hydrolyzed with a spatiotemporal resolution is necessary to understand its functions both in physiological and in pathological contexts. In this review, first we will describe the organization of the electron transport chain and ATP synthase, the main molecular motor for ATP production in mitochondria. Second, we will review the biochemical assays currently available to estimate ATP quantities in cells, and we will compare their readouts, strengths, and weaknesses. Finally, we will explore the palette of genetically encoded biosensors designed for microscopy-based approaches, and show how their spatiotemporal resolution opened up the possibility to follow ATP levels in living cells.
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Affiliation(s)
- Seyta Ley-Ngardigal
- CNRS, Univ Rennes, IGDR (Genetics and Development Institute of Rennes), Rennes, France.,LVMH Research Perfumes and Cosmetics, Saint-Jean-de-Braye, France
| | - Giulia Bertolin
- CNRS, Univ Rennes, IGDR (Genetics and Development Institute of Rennes), Rennes, France
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7
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Zhou J, Zaiss M, Knutsson L, Sun PZ, Ahn SS, Aime S, Bachert P, Blakeley JO, Cai K, Chappell MA, Chen M, Gochberg DF, Goerke S, Heo HY, Jiang S, Jin T, Kim SG, Laterra J, Paech D, Pagel MD, Park JE, Reddy R, Sakata A, Sartoretti-Schefer S, Sherry AD, Smith SA, Stanisz GJ, Sundgren PC, Togao O, Vandsburger M, Wen Z, Wu Y, Zhang Y, Zhu W, Zu Z, van Zijl PCM. Review and consensus recommendations on clinical APT-weighted imaging approaches at 3T: Application to brain tumors. Magn Reson Med 2022; 88:546-574. [PMID: 35452155 PMCID: PMC9321891 DOI: 10.1002/mrm.29241] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 12/16/2022]
Abstract
Amide proton transfer-weighted (APTw) MR imaging shows promise as a biomarker of brain tumor status. Currently used APTw MRI pulse sequences and protocols vary substantially among different institutes, and there are no agreed-on standards in the imaging community. Therefore, the results acquired from different research centers are difficult to compare, which hampers uniform clinical application and interpretation. This paper reviews current clinical APTw imaging approaches and provides a rationale for optimized APTw brain tumor imaging at 3 T, including specific recommendations for pulse sequences, acquisition protocols, and data processing methods. We expect that these consensus recommendations will become the first broadly accepted guidelines for APTw imaging of brain tumors on 3 T MRI systems from different vendors. This will allow more medical centers to use the same or comparable APTw MRI techniques for the detection, characterization, and monitoring of brain tumors, enabling multi-center trials in larger patient cohorts and, ultimately, routine clinical use.
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Affiliation(s)
- Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Moritz Zaiss
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Institute of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Linda Knutsson
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medical Radiation Physics, Lund University, Lund, Sweden.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Silvio Aime
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Peter Bachert
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Jaishri O Blakeley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kejia Cai
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael A Chappell
- Mental Health and Clinical Neurosciences and Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Daniel F Gochberg
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Physics, Vanderbilt University, Nashville, Tennessee, USA
| | - Steffen Goerke
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tao Jin
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science and Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - John Laterra
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Mark D Pagel
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ravinder Reddy
- Center for Advance Metabolic Imaging in Precision Medicine, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - A Dean Sherry
- Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Chemistry and Biochemistry, University of Texas at Dallas, Richardson, Texas, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Greg J Stanisz
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Pia C Sundgren
- Department of Diagnostic Radiology/Clinical Sciences Lund, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Osamu Togao
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter C M van Zijl
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
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8
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Tang PLY, Méndez Romero A, Jaspers JPM, Warnert EAH. The potential of advanced MR techniques for precision radiotherapy of glioblastoma. MAGMA (NEW YORK, N.Y.) 2022; 35:127-143. [PMID: 35129718 PMCID: PMC8901515 DOI: 10.1007/s10334-021-00997-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
As microscopic tumour infiltration of glioblastomas is not visible on conventional magnetic resonance (MR) imaging, an isotropic expansion of 1-2 cm around the visible tumour is applied to define the clinical target volume for radiotherapy. An opportunity to visualize microscopic infiltration arises with advanced MR imaging. In this review, various advanced MR biomarkers are explored that could improve target volume delineation for radiotherapy of glioblastomas. Various physiological processes in glioblastomas can be visualized with different advanced MR techniques. Combining maps of oxygen metabolism (CMRO2), relative cerebral blood volume (rCBV), vessel size imaging (VSI), and apparent diffusion coefficient (ADC) or amide proton transfer (APT) can provide early information on tumour infiltration and high-risk regions of future recurrence. Oxygen consumption is increased 6 months prior to tumour progression being visible on conventional MR imaging. However, presence of the Warburg effect, marking a switch from an infiltrative to a proliferative phenotype, could result in CMRO2 to appear unaltered in high-risk regions. Including information on biomarkers representing angiogenesis (rCBV and VSI) and hypercellularity (ADC) or protein concentration (APT) can omit misinterpretation due to the Warburg effect. Future research should evaluate these biomarkers in radiotherapy planning to explore the potential of advanced MR techniques to personalize target volume delineation with the aim to improve local tumour control and/or reduce radiation-induced toxicity.
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Affiliation(s)
- Patrick L Y Tang
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Alejandra Méndez Romero
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Jaap P M Jaspers
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Esther A H Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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9
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Korzowski A, Weckesser N, Franke VL, Breitling J, Goerke S, Schlemmer HP, Ladd ME, Bachert P, Paech D. Mapping an Extended Metabolic Profile of Gliomas Using High-Resolution 31P MRSI at 7T. Front Neurol 2022; 12:735071. [PMID: 35002914 PMCID: PMC8733158 DOI: 10.3389/fneur.2021.735071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Phosphorus magnetic resonance spectroscopic imaging (31P MRSI) is of particular interest for investigations of patients with brain tumors as it enables to non-invasively assess altered energy and phospholipid metabolism in vivo. However, the limited sensitivity of 31P MRSI hampers its broader application at clinical field strengths. This study aimed to identify the additional value of 31P MRSI in patients with glioma at ultra-high B0 = 7T, where the increase in signal-to-noise ratio may foster its applicability for clinical research. High-quality, 3D 31P MRSI datasets with an effective voxel size of 5.7 ml were acquired from the brains of seven patients with newly diagnosed glioma. An optimized quantification model was implemented to reliably extract an extended metabolic profile, including low-concentrated metabolites such as extracellular inorganic phosphate, nicotinamide adenine dinucleotide [NAD(H)], and uridine diphosphoglucose (UDPG), which may act as novel tumor markers; a background signal was extracted as well, which affected measures of phosphomonoesters beneficially. Application of this model to the MRSI datasets yielded high-resolution maps of 12 different 31P metabolites, showing clear metabolic differences between white matter (WM) and gray matter, and between healthy and tumor tissues. Moreover, differences between tumor compartments in patients with high-grade glioma (HGG), i.e., gadolinium contrast-enhancing/necrotic regions (C+N) and peritumoral edema, could also be suggested from these maps. In the group of patients with HGG, the most significant changes in metabolite intensities were observed in C+N compared to WM, i.e., for phosphocholine +340%, UDPG +54%, glycerophosphoethanolamine −45%, and adenosine-5′-triphosphate −29%. Furthermore, a prominent signal from mobile phospholipids appeared in C+N. In the group of patients with low-grade glioma, only the NAD(H) intensity changed significantly by −28% in the tumor compared to WM. Besides the potential of 31P MRSI at 7T to provide novel insights into the biochemistry of gliomas in vivo, the attainable spatial resolutions improve the interpretability of 31P metabolite intensities obtained from malignant tissues, particularly when only subtle differences compared to healthy tissues are expected. In conclusion, this pilot study demonstrates that 31P MRSI at 7T has potential value for the clinical research of glioma.
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Affiliation(s)
- Andreas Korzowski
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nina Weckesser
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Vanessa L Franke
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Johannes Breitling
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Steffen Goerke
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Mark E Ladd
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Peter Bachert
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Rietzler A, Steiger R, Mangesius S, Walchhofer LM, Gothe RM, Schocke M, Gizewski ER, Grams AE. Energy metabolism measured by 31P magnetic resonance spectroscopy in the healthy human brain. J Neuroradiol 2021; 49:370-379. [PMID: 34871672 DOI: 10.1016/j.neurad.2021.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE Phosphorous magnetic resonance spectroscopy (31P-MRS) allows a non-invasive analysis of phosphorus-containing compounds in vivo. The present study investigated the influence of brain region, hemisphere, age, sex and brain volume on 31P-MRS metabolites in healthy adults. MATERIALS AND METHODS Supratentorial brain 31P-MRS spectra of 125 prospectively recruited healthy volunteers (64 female, 61 male) aged 20 to 85 years (mean: 49.4 ± 16.9 years) were examined with a 3D-31P-MRS sequence at 3T, and the compounds phosphocreatine (PCr), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. From this data, the metabolite ratios PCr/ATP, Pi/ATP and PCr/Pi were calculated for different brain regions. In addition, volumes of gray matter, white matter and cerebrospinal fluid were determined. RESULTS For all metabolite ratios significant regional differences and in several regions sex differences were found. In some brain regions and for some metabolites hemispheric differences were detected. In addition, changes with aging were found, which differed between women and men. CONCLUSIONS The present results indicate that 31P-MRS metabolism varies throughout the brain, with age and between sexes, and therefore have important practical implications for the design and the interpretation of future 31P-MRS studies under physiological conditions and in patients with various cerebral diseases.
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Affiliation(s)
- Andreas Rietzler
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Ruth Steiger
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | | | - Raffaella Matteucci Gothe
- UMIT - Center of Statistical Consulting and Continuing Education, Private University for Health Sciences, Medical Informatics and Technology, Hall, Austria.
| | - Michael Schocke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany.
| | - Elke Ruth Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Astrid Ellen Grams
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
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11
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Changes in Brain Energy and Membrane Metabolism in Glioblastoma following Chemoradiation. Curr Oncol 2021; 28:5041-5053. [PMID: 34940063 PMCID: PMC8700426 DOI: 10.3390/curroncol28060424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022] Open
Abstract
Brain parenchyma infiltration with glioblastoma (GB) cannot be entirely visualized by conventional magnetic resonance imaging (MRI). The aim of this study was to investigate changes in the energy and membrane metabolism measured with phosphorous MR spectroscopy (31P-MRS) in the presumably “normal-appearing” brain following chemoradiation therapy (CRT) in GB patients in comparison to healthy controls. Twenty (seven female, thirteen male) GB patients underwent a 31P-MRS scan prior to surgery (baseline) and after three months of standard CRT (follow-up examination. The regions of interest “contrast-enhancing (CE) tumor” (if present), “adjacent to the (former) tumor”, “ipsilateral distant” hemisphere, and “contralateral” hemisphere were compared, differentiating between patients with stable (SD) and progressive disease (PD). Metabolite ratios PCr/ATP, Pi/ATP, PCr/Pi, PME/PDE, PME/PCr, and PDE/ATP were investigated. In PD, energy and membrane metabolism in CE tumor areas have a tendency to “normalize” under therapy. In different “normal-appearing” brain areas of GB patients, the energy and membrane metabolism either “normalized” or were “disturbed”, in comparison to baseline or controls. Differences were also detected between patients with SD and PD. 31P-MRS might contribute as an additional imaging biomarker for outcome measurement, which remains to be investigated in a larger cohort.
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Galijašević M, Steiger R, Radović I, Birkl-Toeglhofer AM, Birkl C, Deeg L, Mangesius S, Rietzler A, Regodić M, Stockhammer G, Freyschlag CF, Kerschbaumer J, Haybaeck J, Grams AE, Gizewski ER. Phosphorous Magnetic Resonance Spectroscopy and Molecular Markers in IDH1 Wild Type Glioblastoma. Cancers (Basel) 2021; 13:cancers13143569. [PMID: 34298788 PMCID: PMC8305039 DOI: 10.3390/cancers13143569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/04/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Gliobastoma is one of the deadliest tumors overall, yet the most common malignant brain tumor. The new World Health Organization Classification of Brain Tumors brought changes in how we look at this type of malignancy. Now we know that glioblastoma is rather a spectrum of similar tumors, but with some distinct characteristics that include molecular footprint, response to therapy and with that overall survival, among others. We hypothesised that by employing phosphorous magnetic resonance we will be able to show differences in cellular energy metabolism in these various subtypes of glioblastoma. For example, we found indices of faster cell reproduction and tumor growth in MGMT-methylated and EGFR-amplified tumors. These tumors also could have reduced energetic state or tissue oxygenation due to the increased necrosis. Tumors with EGFR-amplification could have increased apoptotic activity regardless of their MGMT status. Our study indicated various differences in energetic metabolism in tumors with different molecular characteristics, which could potentially be important in future therapeutic strategies. Abstract The World Health Organisation’s (WHO) classification of brain tumors requires consideration of both histological appearance and molecular characteristics. Possible differences in brain energy metabolism could be important in designing future therapeutic strategies. Forty-three patients with primary, isocitrate dehydrogenase 1 (IDH1) wild type glioblastomas (GBMs) were included in this study. Pre-operative standard MRI was obtained with additional phosphorous magnetic resonance spectroscopy (31-P-MRS) imaging. Following microsurgical resection of the tumors, biopsy specimens underwent neuropathological diagnostics including standard molecular diagnosis. The spectroscopy results were correlated with epidermal growth factor (EGFR) and O6-Methylguanine-DNA methyltransferase (MGMT) status. EGFR amplified tumors had significantly lower phosphocreatine (PCr) to adenosine triphosphate (ATP)-PCr/ATP and PCr to inorganic phosphate (Pi)-PCr/Pi ratios, and higher Pi/ATP and phosphomonoesters (PME) to phosphodiesters (PDE)-PME/PDE ratio than those without the amplification. Patients with MGMT-methylated tumors had significantly higher cerebral magnesium (Mg) values and PME/PDE ratio, while their PCr/ATP and PCr/Pi ratios were lower than in patients without the methylation. In survival analysis, not-EGFR-amplified, MGMT-methylated GBMs showed the longest survival. This group had lower PCr/Pi ratio when compared to MGMT-methylated, EGFR-amplified group. PCr/Pi ratio was lower also when compared to the MGMT-unmethylated, EGFR not-amplified group, while PCr/ATP ratio was lower than all other examined groups. Differences in energy metabolism in various molecular subtypes of wild-type-GBMs could be important information in future precision medicine approach.
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Affiliation(s)
- Malik Galijašević
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Ruth Steiger
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Correspondence:
| | - Ivan Radović
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
| | - Anna Maria Birkl-Toeglhofer
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.M.B.-T.); (J.H.)
| | - Christoph Birkl
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Lukas Deeg
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Andreas Rietzler
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Milovan Regodić
- Department of Otorhinolaryngology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
- Department of Radiation Oncology, Medical University of Vienna, 1010 Vienna, Austria
| | - Guenther Stockhammer
- Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | | | - Johannes Kerschbaumer
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.F.F.); (J.K.)
| | - Johannes Haybaeck
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.M.B.-T.); (J.H.)
- Diagnostic and Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, 8010 Graz, Austria
| | - Astrid Ellen Grams
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Elke Ruth Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (I.R.); (C.B.); (L.D.); (S.M.); (A.R.); (A.E.G.); (E.R.G.)
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
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