Adam Elkhaled1,
Joanna J. Phillips2, Susan M. Chang3, Soonmee Cha1,
Sarah J. Nelson1, 4
1Department
of Radiology and Biomedical Imaging, University of California, San Francisco,
San Francisco, CA, United States; 2Department of Pathology, University
of California, San Francisco, San Francisco, CA, United States; 3Department
of Neurological Surgery, University of California San Francisco, San
Francisco, CA, United States; 4Bioengineering and Therapeutic
Sciences, University of California, San Francisco, San Francisco, CA, United
States
Although Gd-based contrast agents can help interrogate tumor margins in patients with glioblastoma multiforme (GBM) by exploiting permeable vasculature, the full extent of infiltrative disease remains difficult to assess. This study sought to analyze the metabolic profiles of non-enhancing image-guided tissue samples from patients with GBM using the NMR technique of 1H HR-MAS spectroscopy. Results indicated that while NE tumor was as cellular as contrast-enhancing tumor, it nevertheless demonstrated an altered metabolic profile indicating that infiltrative tumor resembles grade III glioma, which lacks the vascularity and necrosis of GBM. This information may assist in defining surgical margins and residual tumor.