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Dynamic glucose-enhanced MRI: clinical perspectives and challenges
{Purpose: To investigate dynamic glucose-enhanced (DGE) magnetic resonance imaging (MRI) at 7 Tesla (7T) in the healthy human brain and newly diagnosed untreated glioblastoma patients. Methods and Materials: Eleven newly diagnosed glioblastoma patients and eight healthy volunteers were included in this prospective ethic approved study. DGE MRI was performed at a 7T whole-body scanner (Siemens,Healthcare,Erlangen,Germany) using an in-house developed adiabatically-prepared chemical exchange sensitive spin-lock (CESL) sequence (temporal resolution \textequals 7 sec). 100ml of 20\textpercent D-glucose were injected intravenously during DGE MRI. Gadolinium contrast-enhanced T1-w images were obtained along the clinical standard MRI protocol at 3T. Mean signal intensities of (1)the tumor regions vs. normal appearing white matter, and (2)gray matter vs. white matter, were compared by using the Student\textquotesingles t-test. Results: No adverse effects were observed in patients and volunteers related to glucose injections. The DGE contrast allowed for the identification of pathophysiologically increased glucose uptake in the tumor area in all patients. The mean signal intensity of the glucose enhancing tumor region over all patients (DGE$\varrho$\textequals3.57$\pm$1.79\textpercent) was significantly higher than in contralateral normal appearing white matter (DGE$\varrho$\textequals0.22$\pm$0.80\textpercent) (p\textless0.01). Futher, DGE MRI revealed an increased glucose uptake in gray matter regions compared to white matter of the normal human brain (p\textless0.001). Conclusion: DGE MRI may provide complementary information about the metabolic heterogeneity of tumors, with implications for biopsy targeting, patient therapy and response monitoring. Furthermore, glucose enhanced MRI could open up the field of metabolic imaging without the limitations set by ionizing radiation and high expenses associated with radioisotopes.}
@misc{item_3032328, title = {{Dynamic glucose-enhanced MRI: clinical perspectives and challenges}}, journal = {{Insights into Imaging}}, abstract = {{Purpose: To investigate dynamic glucose-enhanced (DGE) magnetic resonance imaging (MRI) at 7 Tesla (7T) in the healthy human brain and newly diagnosed untreated glioblastoma patients. Methods and Materials: Eleven newly diagnosed glioblastoma patients and eight healthy volunteers were included in this prospective ethic approved study. DGE MRI was performed at a 7T whole-body scanner (Siemens,Healthcare,Erlangen,Germany) using an in-house developed adiabatically-prepared chemical exchange sensitive spin-lock (CESL) sequence (temporal resolution \textequals 7 sec). 100ml of 20\textpercent D-glucose were injected intravenously during DGE MRI. Gadolinium contrast-enhanced T1-w images were obtained along the clinical standard MRI protocol at 3T. Mean signal intensities of (1)the tumor regions vs. normal appearing white matter, and (2)gray matter vs. white matter, were compared by using the Student\textquotesingles t-test. Results: No adverse effects were observed in patients and volunteers related to glucose injections. The DGE contrast allowed for the identification of pathophysiologically increased glucose uptake in the tumor area in all patients. The mean signal intensity of the glucose enhancing tumor region over all patients (DGE$\varrho$\textequals3.57$\pm$1.79\textpercent) was significantly higher than in contralateral normal appearing white matter (DGE$\varrho$\textequals0.22$\pm$0.80\textpercent) (p\textless0.01). Futher, DGE MRI revealed an increased glucose uptake in gray matter regions compared to white matter of the normal human brain (p\textless0.001). Conclusion: DGE MRI may provide complementary information about the metabolic heterogeneity of tumors, with implications for biopsy targeting, patient therapy and response monitoring. Furthermore, glucose enhanced MRI could open up the field of metabolic imaging without the limitations set by ionizing radiation and high expenses associated with radioisotopes.}}, volume = {9}, pages = {S265}, year = {2018}, slug = {item_3032328}, author = {Paech, D and Schuenke, P and K\"ohler, C and Bachert, P and Ladd, M and Bendszus, M and Schlemmer, H-P and Zaiss, M and Radbruch, A} }