RT Journal Article
SR Electronic
T1 A Multiparametric Model for Mapping Cellularity in Glioblastoma Using Radiographically Localized Biopsies
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A5112
A1 P.D. Chang
A1 H.R. Malone
A1 S.G. Bowden
A1 D.S. Chow
A1 B.J.A. Gill
A1 T.H. Ung
A1 J. Samanamud
A1 Z.K. Englander
A1 A.M. Sonabend
A1 S.A. Sheth
A1 G.M. McKhann II
A1 M.B. Sisti
A1 L.H. Schwartz
A1 A. Lignelli
A1 J. Grinband
A1 J.N. Bruce
A1 P. Canoll
YR 2017
UL http://www.ajnr.org/content/early/2017/03/02/ajnr.A5112.abstract
AB BACKGROUND AND PURPOSE: The complex MR imaging appearance of glioblastoma is a function of underlying histopathologic heterogeneity. A better understanding of these correlations, particularly the influence of infiltrating glioma cells and vasogenic edema on T2 and diffusivity signal in nonenhancing areas, has important implications in the management of these patients. With localized biopsies, the objective of this study was to generate a model capable of predicting cellularity at each voxel within an entire tumor volume as a function of signal intensity, thus providing a means of quantifying tumor infiltration into surrounding brain tissue.MATERIALS AND METHODS: Ninety-one localized biopsies were obtained from 36 patients with glioblastoma. Signal intensities corresponding to these samples were derived from T1-postcontrast subtraction, T2-FLAIR, and ADC sequences by using an automated coregistration algorithm. Cell density was calculated for each specimen by using an automated cell-counting algorithm. Signal intensity was plotted against cell density for each MR image.RESULTS: T2-FLAIR (r = −0.61) and ADC (r = −0.63) sequences were inversely correlated with cell density. T1-postcontrast (r = 0.69) subtraction was directly correlated with cell density. Combining these relationships yielded a multiparametric model with improved correlation (r = 0.74), suggesting that each sequence offers different and complementary information.CONCLUSIONS: Using localized biopsies, we have generated a model that illustrates a quantitative and significant relationship between MR signal and cell density. Projecting this relationship over the entire tumor volume allows mapping of the intratumoral heterogeneity in both the contrast-enhancing tumor core and nonenhancing margins of glioblastoma and may be used to guide extended surgical resection, localized biopsies, and radiation field mapping.AbbreviationsCEcontrast-enhancingHPFhigh-power fieldNEnonenhancing