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Abstract #0002

2D 1H sLASER long-TE and 3D 31P chemical shift imaging at 3T for monitoring fasting-induced changes in brain tumor tissue

Seyma Alcicek1,2,3,4, Iris Divé2,3,4,5, Dennis C. Thomas1,2,3,4, Vincent Prinz6, Marie-Thérèse Forster6, Marcus Czabanka2,4,5,6, Katharina J. Weber2,3,4,7, Joachim P. Steinbach2,3,4,5, Michael W. Ronellenfitsch2,3,4,5, Elke Hattingen1,2,3,4, Ulrich Pilatus1,2,3,4, and Katharina J. Wenger1,2,3,4
1Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany, 2University Cancer Center Frankfurt (UCT), Frankfurt/Main, Germany, 3Frankfurt Cancer Institute (FCI), Frankfurt/Main, Germany, 4German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Frankfurt/Main, Germany, 5Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany, 6Department of Neurosurgery, University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany, 7Institute of Neuropathology, University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany

Synopsis

Keywords: Tumors (Pre-Treatment), Tumors, Spectroscopy, Treatment, Nutritional interventions, Multinuclear spectroscopic imaging

Motivation: Emerging evidence suggests that fasting could play a key role in cancer treatment, however, its metabolic effects on gliomas require further investigation.

Goal(s): To design a 1H/31P MRSI protocol for non-invasive metabolic monitoring of fasting-induced cerebral changes at individual patient/tumor level, and to assess its technical reliability/reproducibility.

Approach: Twenty-two patients with MRI-suspected glioma were measured with the protocol at baseline and after 72-hour-fasting.

Results: Ketone body accumulation in solid tumors and necrosis was observed after 72-hour-fasting and validated via ex-vivo high-resolution NMR. This may result from neovascularization, the blood-brain barrier compromise, and lack of ketone body consumption in necrosis.

Impact: We report on the validation of a dedicated, multinuclear MRSI protocol with fully automated multiparametric segmentation of glioma sub-regions for monitoring cerebral, fasting-induced changes in patients with glioma.

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Keywords