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Advanced MR Techniques for Preoperative Glioma Characterization: Part 1.

ABSTRACT: Preoperative clinical magnetic resonance imaging (MRI) protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation or lack thereof. This review describes current methods, limits, and applications of advanced MRI for the preoperative assessment of glioma, summarizing the level of clinical validation of different techniques. In this first part, we discuss dynamic susceptibility contrast and dynamic contrast-enhanced MRI, arterial spin labeling, diffusion-weighted MRI, vessel imaging, and magnetic resonance fingerprinting. The second part of this review addresses magnetic resonance spectroscopy, chemical exchange saturation transfer, susceptibility-weighted imaging, MRI-PET, MR elastography, and MR-based radiomics applications. Evidence Level: 3 Technical Efficacy: Stage 2.

SUBMITTER: Hirschler L

PROVIDER: S-EPMC10946498 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Advanced MR Techniques for Preoperative Glioma Characterization: Part 1.

Hirschler Lydiane L Sollmann Nico N Schmitz-Abecassis Bárbara B Pinto Joana J Arzanforoosh Fatemehsadat F Barkhof Frederik F Booth Thomas T Calvo-Imirizaldu Marta M Cassia Guilherme G Chmelik Marek M Clement Patricia P Ercan Ece E Fernández-Seara Maria A MA Furtner Julia J Fuster-Garcia Elies E Grech-Sollars Matthew M Guven Nazmiye Tugay NT Hatay Gokce Hale GH Karami Golestan G Keil Vera C VC Kim Mina M Koekkoek Johan A F JAF Kukran Simran S Mancini Laura L Nechifor Ruben Emanuel RE Özcan Alpay A Ozturk-Isik Esin E Piskin Senol S Schmainda Kathleen K Svensson Siri F SF Tseng Chih-Hsien CH Unnikrishnan Saritha S Vos Frans F Warnert Esther E Zhao Moss Y MY Jancalek Radim R Nunes Teresa T Emblem Kyrre E KE Smits Marion M Petr Jan J Hangel Gilbert G

Journal of magnetic resonance imaging : JMRI 20230303 6

Preoperative clinical magnetic resonance imaging (MRI) protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation or lack thereof. This review describes current m ...[more]

PMID: 36866773

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Project description:ObjectiveSummarize evidence for use of advanced MRI techniques as monitoring biomarkers in the clinic, and highlight the latest bench-to-bedside developments.MethodsExperts in advanced MRI techniques applied to high-grade glioma treatment response assessment convened through a European framework. Current evidence regarding the potential for monitoring biomarkers in adult high-grade glioma is reviewed, and individual modalities of perfusion, permeability, and microstructure imaging are discussed (in Part 1 of two). In Part 2, we discuss modalities related to metabolism and/or chemical composition, appraise the clinic readiness of the individual modalities, and consider post-processing methodologies involving the combination of MRI approaches (multiparametric imaging) or machine learning (radiomics).ResultsHigh-grade glioma vasculature exhibits increased perfusion, blood volume, and permeability compared with normal brain tissue. Measures of cerebral blood volume derived from dynamic susceptibility contrast-enhanced MRI have consistently provided information about brain tumor growth and response to treatment; it is the most clinically validated advanced technique. Clinical studies have proven the potential of dynamic contrast-enhanced MRI for distinguishing post-treatment related effects from recurrence, but the optimal acquisition protocol, mode of analysis, parameter of highest diagnostic value, and optimal cut-off points remain to be established. Arterial spin labeling techniques do not require the injection of a contrast agent, and repeated measurements of cerebral blood flow can be performed. The absence of potential gadolinium deposition effects allows widespread use in pediatric patients and those with impaired renal function. More data are necessary to establish clinical validity as monitoring biomarkers. Diffusion-weighted imaging, apparent diffusion coefficient analysis, diffusion tensor or kurtosis imaging, intravoxel incoherent motion, and other microstructural modeling approaches also allow treatment response assessment; more robust data are required to validate these alone or when applied to post-processing methodologies.ConclusionConsiderable progress has been made in the development of these monitoring biomarkers. Many techniques are in their infancy, whereas others have generated a larger body of evidence for clinical application.

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Advanced MR Techniques for Preoperative Glioma Characterization: Part 1.

Publications

Advanced MR Techniques for Preoperative Glioma Characterization: Part 1.

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