Abstract #0897

Quantification of regional pathophysiology in Glioblastoma Multiforme

Paula L Croal^1,2, Kevin J Ray^2,3, Ruichong Ma⁴, Alex K Smith⁵, Moss Y Zhao^1,2, Benjamin Harris^4,6, Puneet Plaha^4,7, Simon Lord^4,6, Nicola R Sibson³, and Michael A Chappell^1,2

¹Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom, ²Wellcome Centre for Integrative Neuroscience, University of Oxford, Oxford, United Kingdom, ³Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom, ⁴Oxford University Hospitals NHS Trust, Oxford, United Kingdom, ⁵Wellcome Centre for Integrative Neuroscience, university of Oxford, Oxford, United Kingdom, ⁶Department of Oncology, University of Oxford, Oxford, United Kingdom, ⁷Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom

Patients with glioblastoma multiforme (GBM) have extremely poor prognosis due to therapy resistance, aggressiveness, and poor understanding of pathophysiology. Here, we use APT-CEST and ASL MRI to noninvasively probe both pH and perfusion in ten patients with primary GBM, prior to surgical/therapeutic intervention. We observe an overall increase in APT and CBF contrast, consistent with both intracellular alkalosis and angiogenesis. Clustering analysis revealed a strong regional association between pH and CBF in 9/10 patients suggestive of similar spatial disruptions. The ability to image concomitant changes in pH and perfusion may provide a novel way to stratify patients for targeted therapeutics.

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