Shanshan Jiang¹, Xianlong Wang¹, Hao Yu¹, Jiandong Xi¹, Jingwen Wu¹, Lisong Liang¹, Shilong Lu¹, Tianyu Zou¹, Jinyuan Zhou², and Zhibo Wen^1
1Department of Radiology, Southern Medical University Zhujiang Hospital, Guangzhou, China, People's Republic of, ²Department of Radiology, Johns Hopkins University, Baltimore, MD, United States

The correlation between endogenous protein-based APT-weighted (APTw) imaging and gene expression in glioblastoma (GBM) was investigated. 16 patients with newly diagnosed GBM were studied. APTw/FLAIR hyperintensity area ratio (AFR), and APTw hyperintensity/gadolinium contrast-enhanced T1w enhancement area ratio (ATR) were calculated. Interoperative paired tumor and adjacent normal tissues were sampled for genomic analysis. BRCA1 and CDK4 were significantly downregulated in the high AFR group (adjusted P= 0.000953 and 0.025187), and SLAMF9 and MIA were significantly downregulated in the high ATR group (adjusted P= 1.08E-11 and 0.00997). APT imaging has great potential for unveiling some special genomic changes in GBM.

Philipp Kickingereder¹, Michael Götz², John Muschelli³, Antje Wick⁴, Ulf Neuberger⁵, Russell T Shinohara⁶, Alexander Radbruch⁷, Heinz-Peter Schlemmer⁷, Wolfgang Wick⁴, Martin Bendszus⁵, Klaus H Maier-Hein², and David Bonekamp^7
1Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany, ²Division Medical and Biological Informatics, DKFZ - German Cancer Research Center, Heidelberg, Germany, ³Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States, ⁴Department of Neurology, University of Heidelberg Medical Center, Heidelberg, Germany, ⁵Department of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany, ⁶Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States, ⁷Department of Radiology, DKFZ - German Cancer Research Center, Heidelberg, Germany

To analyze the potential of radiomics, an emerging field of research that aims to utilize the full potential of medical Imaging (1,2), for predicting and stratifying treatment response to antiangiogenic therapy in patients with recurrent glioblastoma.  

Cheng-Yu Chen^1,2,3, Fei-Ting Hsu¹, Hua-Shan Liu^1,4, Ping-Huei Tsai^1,3, Chia-Feng Lu^2,3,5, Yu-Chieh Kao^2,3, Li-Chun Hsieh¹, and Pen-Yuan Liao^1
1Department of Medical Image, Taipei Medical University Hospital, Taipei, Taiwan, ²Translational Imaging Research Center, College of Medicine, Taipei Medical University, Taipei, Taiwan, ³Department of Radiology, School of Medicine, Taipei Medical University, Taipei, Taiwan, ⁴Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, ⁵Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan

A new approach to unravel the genomic expression of glioblastoma by advanced MR imaging technique has recently been introduced to improve the prognostic and predictive efficacies of neuroimaging. This imaging method is potentially a valuable tool to link individual differences in the human genome to structure, function and physiology into brain disease, a method referred to as radiogenomics. In this study, we established locus specific radiogenomic map based on MR imaging and Microarray RNA analysis. Our results revealed that apparent diffusion coefficient (ADC) differences were correlated with several biological processes change, including cell proliferation, T cell immunity, immune response, and mitosis. The identification of tumor genotypes by imaging phenotypes will open a new era of therapeutic strategy in high grade gliomas.

Ahmad Algohary¹, Satish Viswanath¹, Sadhna Verma², and Anant Madabhushi^1
1Case Western Reserve University, Cleveland, OH, United States, ²University of Cincinnati, Cincinnati, OH, United States

Active Surveillance (AS) offers an important alternative to radical treatment as more men die with prostate cancer (PCA) than of the disease. In this study, we explore the role of radiomic texture features on a pre-biopsy screening 3 Tesla multi-parametric MRI that can predict which men with elevated PSA will have a cancer-positive or cancer-negative biopsy. The selected texture features correctly identified 14/15 biopsy-negative (compared to 10/15 cases correctly identified by PIRADS) and 23/30 biopsy-positive cases (compared to only 15/30 correctly identified by PIRADS). These features appear to enhance differentiation between biopsy-positive and biopsy-negative prostate cancer patients on Active Surveillance.

christopher lopez¹, Natalya Nagornaya², Nestor Parra², Deukwoo Kwon², Fazilat Ishkanian², Arnold Markoe², Andrew Maudsley², and Radka Stoyanova^2
1Radiation Oncology, University of Miami, Miami, FL, United States, ²University of Miami, Miami, FL, United States

To investigate the importance of metabolites of N-acetyl aspartate and choline derived from MRSI and the correlation of image features from localized radiation therapy volumes determined from MRI and CT defined tumor volumes. Also to replace subjective categorical image features with calculated objective features. Results suggest that radiation therapy planning can be more accurate by adding metabolic information.

Tracy L Luks¹, Tracy Richmond McKnight¹, Aurelia Williams¹, Evan Neill¹, Khadjia Lobo¹, Anders Persson², Arie Perry³, Joanna Phillips³, Annette Molinaro⁴, Susan Chang⁴, and Sarah J Nelson^1
1Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ²Neurology, University of California San Francisco, San Francisco, CA, United States, ³Pathology, University of California San Francisco, San Francisco, CA, United States, ⁴Neurosurgery, University of California San Francisco, San Francisco, CA, United States

Invivo MR anatomy, diffusion, perfusion, and spectroscopy profiles from non-enhancing grade 2 and grade 3 gliomas were examined by histologic and molecular characteristics associated with clinical outcome. Patients underwent a pre-surgical 3T MR exam including IRSPGR, FSE, FLAIR, DWI, MRSI and DSC. For surgical biopsies, histological sub-type, grade, cleaved caspase-3, MIB-1, Ki67, IDH1R132H, ATRX, p53, and co-deletion of 1p19q were determined. Overall, molecular characteristics associated with worse clinical outcome were associated with higher ADC and lower FA, lower nCBV and nPH, and higher Recov, and higher nLAC.

Prateek Prasanna¹, Raymond Huang², Andrew Rose¹, Gagandeep Singh¹, Anant Madabhushi¹, and Pallavi Tiwari^1
1Case Western Reserve University, Cleveland, OH, United States, ²Brigham and Women's Hospital, Boston, MA, United States

Pseudoprogression is an early-delayed inflammatory response to chemoradiotherapy typically appearing up to 3 months post-treatment in brain tumors. On routine MRI, pseudoprogression closely mimics the appearance of true progression, thereby making their visual identification challenging. Early diagnosis of pseudoprogression has implications in management of treatment effects and subsequently survival. We present initial results of using a newly developed radiomic descriptor, CoLlAGE, in distinguishing the two pathologies. We report that CoLlAGe measurements when captured from the necrotic region as opposed to just the enhancing region on MRI can reliably distinguish psuedo-progression from true progression with 100% accuracy (n=17)

Andreas Stadlbauer¹, Max Zimmermann¹, Karl Rössler¹, Stefan Oberndorfer², Arnd Dörfler³, Michael Buchfelder¹, and Gertraud Heinz^4
1Department of Neurosurgery, University of Erlangen, Erlangen, Germany, ²Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria, ³Department of Neuroradiology, University of Erlangen, Erlangen, Germany, ⁴Department of Radiology, University Clinic of St. Pölten, St. Pölten, Austria

Reprogramming energy metabolism and inducing angiogenesis are part of the hallmarks of cancer. Thirty-five patients with untreated or recurrent glioma were examined using vascular architecture mapping (VAM) and the multiparametric quantitative BOLD (mp-qBOLD) technique for combined exanimation of oxygen metabolism and angiogenesis in gliomas. Maps of oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO₂) as well as of the vascular architecture MRI biomarkers microvessel radius (R_U), density (N_U), and type indicator (MTI) were calculated. Low-grade glioma showed increased OEF. Glioblastomas showed significantly increased CMRO₂ and N_U. MTI demonstrated widespread areas draining venous microvasculature in high-grade gliomas.

Dieter Henrik Heiland¹, Thomas Lange², Ralf Schwarzwald³, Dietmar Pfeifer⁴, Karl Egger³, Horst Urbach³, Astrid Weyerbrock¹, and Irina Mader^3
1Dept. of Neurosurgery, University Medical Center Freiburg, Freiburg, Germany, ²Dept. MR Physics, Dept. of Radiology, University Medical Center Freiburg, Freiburg, Germany, ³Dept. of Neuroradiology, University Medical Center Freiburg, Freiburg, Germany, ⁴Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany

The purpose of this work was to search for a connection between metabolites observed by proton magnetic resonance spectroscopy of glioblastomas and tumor genetics. Two specific pathways could be identified, one belonging to NAA and discriminating an astroglial versus oligo/neural subgroup. Another one was related to Cr also distinguishing between two subgroups, one attributed to apoptosis and another one to the PI3K-AKT-mTOR signaling cascade.