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Abstract:
Purpose: Dynamic glucose enhanced (DGE) CEST imaging has almost only
been shown at ultra-high field (UHF) due to low effect size. First results in brain
tumour patients of a DGE CEST method with fast 3D imaging developed for
clinical field strength are shown herein.
Methods and Materials: CEST saturated images at different frequency offsets
were acquired at 160 time points before, during and after a glucose injection
(0.3 mg/kg) with 6.3s temporal resolution (Total: 16:45 min) to detect
accumulation in the brain. Two glioblastoma (IDH wild-type, unmethylated
MGMT promoter) patients (1: male, 70y, 2: female, 75y) and 3 healthy controls
were scanned at a clinical 3T System. DGE contrast images were analysed by
subtracting each image from a pre-injection baseline image:
ΔDGE(t)=DGEbaseline - DGE(t).
Results: In the high-grade glioma (1), glucose uptake in the Gadolinium
enhancing region could be detected approximately 4 minutes after injection
with a maximum increase of ΔDGE=0.51±0.078, whereas a contralateral white
matter ROI was barely affected (ΔDGE=0.07±0.085) at the same time point.
The second glioma (2), with the same histology and grading, showed very little
gadolinium enhancement as well as no significant detectable DGE effect.
Healthy controls did not show any significant DGE contrast.
Conclusion: We demonstrated that stable dynamic glucose enhanced imaging
can be accomplished at clinical field strength using optimized saturation and
readout parameters. First results are promising, and indicate that glucoCEST
corresponds more to the disruptions of the blood-brain-barrier with Gadolinium
uptake than to the molecular tumour profile or tumour grading.
