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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