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Abstract #0545

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

Liesbeth Vanherp1,2, Kristof Govaerts1,2, Matteo Riva3,4, Katrien Lagrou5, Greetje Vande Velde1,2, Willy Gsell1,2, and Uwe Himmelreich1,2

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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