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Abstract #0500

Fluid suppression in CEST imaging affects predominantly IDH-mutant 1p/19q retained gliomas with T2-FLAIR mismatch

Stefano Casagranda1, Laura Mancini2,3, Guillaume Gautier1, Philippe Peter1, Bruno Lopez1, Sebastian Brandner4,5, Enrico De Vita2,6, Xavier Golay2,3, and Sotirios Bisdas2,3
1Olea Medical, La Ciotat, France, 2Lysholm Dept of Neuroradiology, University College of London Hospitals NHS Foundation Trust, London, United Kingdom, 3Institute of Neurology UCL, London, United Kingdom, 4National Hospital for Neurology & Neurosurgery, University College of London Hospitals NHS Foundation Trust, London, United Kingdom, 5Department of Neurodegenerative Disease, Institute of Neurology UCL, London, United Kingdom, 6Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

CEST is a novel MR technique helpful for predicting IDH and 1p/19q status in gliomas. The asymmetry-based methods however are sensitive to fluid signal and recent studies have shown that a significant proportion of IDH-mutant 1p/19q retained gliomas have T2-FLAIR mismatch, indicating the presence of a more fluid microenvironment. This work shows how fluid-suppressed CEST imaging metrics have an impact on amide and amine signals in glioma, with highest effect on IDH-mutant 1p/19q retained with T2-FLAIR mismatch. The combined use of asymmetry-based and fluid-suppressed CEST metrics could be a valuable tool for glioma staging more robust than asymmetry-based metrics alone.

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