The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma
Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration ba...
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| Format: | Article |
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MDPI AG
2024-03-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/10/3/33 |
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| author | Abinand C. Rejimon Karthik K. Ramesh Anuradha G. Trivedi Vicki Huang Eduard Schreibmann Brent D. Weinberg Lawrence R. Kleinberg Hui-Kuo G. Shu Hyunsuk Shim Jeffrey J. Olson |
| author_facet | Abinand C. Rejimon Karthik K. Ramesh Anuradha G. Trivedi Vicki Huang Eduard Schreibmann Brent D. Weinberg Lawrence R. Kleinberg Hui-Kuo G. Shu Hyunsuk Shim Jeffrey J. Olson |
| author_sort | Abinand C. Rejimon |
| collection | DOAJ |
| description | Current diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its elevated choline (Cho) and decreased N-acetylaspartate (NAA). We present the clinical translatability of spectroscopic imaging with a Cho/NAA ≥ 5x threshold for delineating a biopsy target in a patient diagnosed with non-enhancing glioma. Then, we describe the relationship between the undertreated tumor detected with metabolite imaging and overall survival (OS) from a pilot study of newly diagnosed GBM patients treated with belinostat and chemoradiation. Each cohort (control and belinostat) were split into subgroups using the median difference between pre-radiotherapy Cho/NAA ≥ 2x and the treated T1-weighted contrast-enhanced (T1w-CE) volume. We used the Kaplan–Meier estimator to calculate median OS for each subgroup. The median OS was 14.4 months when the difference between Cho/NAA ≥ 2x and T1w-CE volumes was higher than the median compared with 34.3 months when this difference was lower than the median. The T1w-CE volumes were similar in both subgroups. We find that patients who had lower volumes of undertreated tumors detected via spectroscopy had better survival outcomes. |
| first_indexed | 2024-04-24T17:47:26Z |
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| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-04-24T17:47:26Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-96083e5061b6430facb2085954d788392024-03-27T14:06:03ZengMDPI AGTomography2379-13812379-139X2024-03-0110342844310.3390/tomography10030033The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed GlioblastomaAbinand C. Rejimon0Karthik K. Ramesh1Anuradha G. Trivedi2Vicki Huang3Eduard Schreibmann4Brent D. Weinberg5Lawrence R. Kleinberg6Hui-Kuo G. Shu7Hyunsuk Shim8Jeffrey J. Olson9Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USADepartment of Radiation Oncology, Johns Hopkins University, Baltimore, MD 21218, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USAWinship Cancer Institute, Emory University, Atlanta, GA 30322, USACurrent diagnostic and therapeutic approaches for gliomas have limitations hindering survival outcomes. We propose spectroscopic magnetic resonance imaging as an adjunct to standard MRI to bridge these gaps. Spectroscopic MRI is a volumetric MRI technique capable of identifying tumor infiltration based on its elevated choline (Cho) and decreased N-acetylaspartate (NAA). We present the clinical translatability of spectroscopic imaging with a Cho/NAA ≥ 5x threshold for delineating a biopsy target in a patient diagnosed with non-enhancing glioma. Then, we describe the relationship between the undertreated tumor detected with metabolite imaging and overall survival (OS) from a pilot study of newly diagnosed GBM patients treated with belinostat and chemoradiation. Each cohort (control and belinostat) were split into subgroups using the median difference between pre-radiotherapy Cho/NAA ≥ 2x and the treated T1-weighted contrast-enhanced (T1w-CE) volume. We used the Kaplan–Meier estimator to calculate median OS for each subgroup. The median OS was 14.4 months when the difference between Cho/NAA ≥ 2x and T1w-CE volumes was higher than the median compared with 34.3 months when this difference was lower than the median. The T1w-CE volumes were similar in both subgroups. We find that patients who had lower volumes of undertreated tumors detected via spectroscopy had better survival outcomes.https://www.mdpi.com/2379-139X/10/3/33spectroscopic MRIstereotactic biopsysurvival biomarkersgliomasradiotherapybelinostat |
| spellingShingle | Abinand C. Rejimon Karthik K. Ramesh Anuradha G. Trivedi Vicki Huang Eduard Schreibmann Brent D. Weinberg Lawrence R. Kleinberg Hui-Kuo G. Shu Hyunsuk Shim Jeffrey J. Olson The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma Tomography spectroscopic MRI stereotactic biopsy survival biomarkers gliomas radiotherapy belinostat |
| title | The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma |
| title_full | The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma |
| title_fullStr | The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma |
| title_full_unstemmed | The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma |
| title_short | The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma |
| title_sort | utility of spectroscopic mri in stereotactic biopsy and radiotherapy guidance in newly diagnosed glioblastoma |
| topic | spectroscopic MRI stereotactic biopsy survival biomarkers gliomas radiotherapy belinostat |
| url | https://www.mdpi.com/2379-139X/10/3/33 |
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