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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 = 7 sec). 100ml of 20% 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's 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 (DGEρ=3.57±1.79%) was significantly higher than in contralateral
normal appearing white matter (DGEρ=0.22±0.80%) (p<0.01). Futher, DGE
MRI revealed an increased glucose uptake in gray matter regions compared to
white matter of the normal human brain (p<0.001).
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.