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Abstract #4241

23Na-MRI demonstrates a sodium gradient within gliomas as a biomarker of tumor heterogeneity

Fulvio Zaccagna1, Frank Riemer1, Mary A. McLean2, James T. Grist1, Joshua Kaggie1, Rolf F Schulte3, Sarah Hilborne1, Tomasz Matys1, Jonathan H. Gillard1, Colin Watts4, Stephen J. Price4, Martin J. Graves1, and Ferdia A. Gallagher1

1Department of Radiology, University of Cambridge, Cambridge, United Kingdom, 2Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom, 3GE Global Research, Munich, Germany, 4Neurosurgery Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom

Glioma grade and the extent of local infiltration are important factors for guiding management. Imaging tumor heterogeneity may also improve diagnosis and therapy planning. 23Na-MRI has been used here to demonstrate a gradient in sodium concentration across gliomas: necrosis greater than viable tissue greater than edema. This gradient was evident in all 17 tumors analyzed and is consistent with the expected underlying histopathology; concentration is increasing throughout the evolution from edema, dominated by the extracellular compartment, to the necrotic core, dominated by dead cells and broken sodium pumps. 23Na-MRI may therefore represent an imaging biomarker of tumor heterogeneity in glioma.

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