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| Home > Publications database > P03.15.B BOLD ASYNCHRONY MAPS FOR THE VISUALIZATION OF IDH-MUTANT GLIOMAS - A COMPARISON WITH FET PET |
| Home > Publications database > P03.15.B BOLD ASYNCHRONY MAPS FOR THE VISUALIZATION OF IDH-MUTANT GLIOMAS - A COMPARISON WITH FET PET |
| Abstract | FZJ-2026-01533 |
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2025
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Please use a persistent id in citations: doi:10.1093/neuonc/noaf193.174
Abstract: AbstractBACKGROUNDThe delineation of glioma extent is predominantly based on structural MRI, which is particularly challenging in patients with non-enhancing gliomas. In a previous study by Petridis and colleagues (PMID: 34214170), a novel MR technique called BOLD asynchrony was used to delineate the extent of non-enhancing IDH-mutant gliomas. The hypothesis is that the asynchrony in vascular dynamics as measured by resting-state fMRI correlates with the functional activity and connectivity between tumor and healthy brain tissue and hence, allows the identification of neoplastic tissue. Since amino acid PET using the tracer O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) has proven its added value for glioma delineation in addition to MRI, we compared the method of BOLD asynchrony with FET PET for visualizing the tumor extent in patients with enhancing and non-enhancing gliomas.MATERIAL AND METHODSStructural MRI, FET PET, and resting-state fMRI were acquired for 54 patients with gliomas (n=9, IDH-mutant oligodendroglioma WHO CNS grade 2 or 3; n=9, IDH-mutant astrocytoma WHO CNS grade 3 or 4; n=36, IDH-wildtype glioblastoma), and five healthy controls from the 1000BRAIN study using a 3T-Hybrid PET/MR scanner. MRI and FET PET tumor volumes were segmented and checked by experienced readers. By performing dual-regression on the fMRI data, z-maps were created and further processed into BOLD asynchrony maps. Metric and visual analyses were used to evaluate the spatial correlation between the lesions as depicted in the BOLD asynchrony maps and the other imaging modalities.RESULTSHealthy controls had no false positive BOLD asynchrony signal. Spatial overlap with all modalities was only minor to moderate (mean surface Dice similarity coefficient (DSC), 0.26-0.45; mean volumetric DSC, 0.18-0.32; mean visual overlap, 31-44%). Compared to IDH-mutant gliomas, an insignificant trend towards a higher spatial congruency of BOLD asynchrony and FET PET tumor volume was observed for IDH-wildtype gliomas in the visual analysis (p=0.092). In the metric analysis, higher spatial congruence of IDH-wildtype gliomas was also observed for BOLD asynchrony and contrast enhancement (p=0.027), and for FLAIR signal abnormalities (p=0.048). Around 80% of patients exhibited elevated BOLD asynchrony signals in areas that showed no pathological changes in both FET PET and MRI. This is likely due to methodological rather than pathophysiological causes and is currently being investigated further.CONCLUSIONAlthough BOLD asynchrony maps seem to be an interesting approach to delineate glioma extent, methodological uncertainties should be considered and warrant further investigation before possible clinical translation.
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