Biopsy Confirmed Glioma Recurrence Predicted by Multi-Modal Neuroimaging Metrics

Abstract

Histopathological verification is currently required to differentiate tumor recurrence from treatment effects related to adjuvant therapy in patients with glioma. To bypass the complications associated with collecting neural tissue samples, non-invasive classification methods are needed to alleviate the burden on patients while providing vital information to clinicians. However, uncertainty remains as to which tissue features on magnetic resonance imaging (MRI) are useful. The primary objective of this study was to quantitatively assess the reliability of combining MRI and diffusion tensor imaging metrics to discriminate between tumor recurrence and treatment effects in histopathologically identified biopsy samples. Additionally, this study investigates the noise adjuvant radiation therapy introduces when discriminating between tissue types. In a sample of 41 biopsy specimens, from a total of 10 patients, we derived region-of-interest samples from MRI data in the ipsilateral hemisphere that encompassed biopsies obtained during resective surgery. This study compares normalized intensity values across histopathology classifications and contralesional volumes reflected across the midline. Radiation makes noninvasive differentiation of abnormal-nontumor tissue to tumor recurrence much more difficult. This is because radiation exhibits opposing behavior on key MRI modalities: specifically, on post-contrast T1, FLAIR, and GFA. While radiation makes noninvasive differentiation of tumor recurrence more difficult, using a novel analysis of combined MRI metrics combined with clinical annotation and histopathological correlation, we observed that it is possible to successfully differentiate tumor tissue from other tissue types. Additional work will be required to expand upon these findings.

Amide proton transfer-weighted and arterial spin labeling imaging may improve differentiation between high-grade glioma recurrence and radiation-induced brain injury

“…Currently, histopathological diagnosis obtained through biopsy or surgical resection remains the gold standard for diagnosing TR or RIBI in accordance with established medical practices. However, invasive procedures carry inherent risks and may not always be feasible, especially when dealing with lesions located in critical areas of the brain [ 8 ]. Additionally, histopathological analysis may not always yield definitive results due to the challenge of distinguishing between tumor cells and radiation therapy-induced changes in cases involving extensive radiation therapy [ 9 ].…”

Glioma Imaging by O-(2-18F-Fluoroethyl)-L-Tyrosine PET and Diffusion-Weighted MRI and Correlation With Molecular Phenotypes, Validated by PET/MR-Guided Biopsies

“…Currently, glioma diagnosis, grading, and molecular phenotyping mainly rely on postoperative histological examination, which requires obtaining a tumor sample using surgical resection or needle biopsy. In order to promote micro-invasive or non-invasive presurgical diagnosis, several studies have investigated the association of glioma molecular markers with specific tumoral imaging characteristics, including diffusion-weighted MRI (DWI), dynamic contrast-enhanced perfusion-weighted imaging (DCE-PWI), and magnetic resonance spectrometry (MRS) ( 9 , 10 ). The increasing application of PET has improved the diagnosis and clinical management of gliomas ( 11 , 12 ).…”

Difusión y relaxometría por resonancia magnética nuclear en tumores cerebrales

“…Hevia-Montiel y colaboradores, proponen detectar y cuantificar los cambios morfológicos a partir de imágenes por resonancia magnética, cuya ventaja es el diagnóstico no invasivo en los pacientes [20]. Algunas opciones de tratamiento que se usan para pacientes con tumores cerebrales son: la resección quirúrgica, la radioterapia de cerebro completo, esta hace que la diferencia no invasiva del tejido anormal sea mucho más difícil de ser analizada [21], la radiocirugía estereostática y el tratamiento sistémico, como terapia dirigida o inmunológica. La imageonología por resonancia magnética (IRM) anatómicas del tumor se pueden obtener a través de las técnicas inversión recuperación atenuada de fluido (por sus siglas en ingles FLAIR), difusión, perfusión, T1 ponderado y T2 ponderado usando un contraste (gadolinio) después de que se mandó la secuencia, estas técnicas proporcionan información sobre la morfología y estructura de la lesión y se usan de forma rutinaria en la práctica clínica para la detección y evaluación de la respuesta al tratamiento para metástasis cerebrales [22], [23].…”