Abstract #0545

CryptoCEST, a promising tool for differential diagnosis and treatment monitoring of fungal brain lesions

Liesbeth Vanherp^1,2, Kristof Govaerts^1,2, Matteo Riva^3,4, Katrien Lagrou⁵, Greetje Vande Velde^1,2, Willy Gsell^1,2, and Uwe Himmelreich^1,2

¹Biomedical MRI, KU Leuven, Leuven, Belgium, ²MoSAIC, KU Leuven, Leuven, Belgium, ³Laboratory of Tumor Immunology and Immunotherapy, KU Leuven, Leuven, Belgium, ⁴Department of Neurosurgery, Erasme Hospital, Brussels, Belgium, ⁵Laboratory of Clinical Bacteriology and Mycology, KU Leuven, Leuven, Belgium

Differential diagnosis of fungal brain infections from other types of lesions is challenging. We assessed the presence of fungal metabolites in Cryptococcus lesions using in vivo MR spectroscopy and CEST. Hereby, we studied the use of trehalose, a disaccharide and fungal biomarker, for endogenous contrast in CEST imaging. Using the novel CryptoCEST technique, we were able to non-invasively differentiate Cryptococcus lesions from glioma. However, no significant effect of antifungal treatment on the CEST contrast was observed. If translated to the clinic, this technique has great potential in assisting in the differential diagnosis and specific spatial localization of cryptococcal brain lesions.

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