Laura Mancini1,2, Stefano Casagranda3, Francisco Torrealdea4, Marilena Rega4, Enrico De Vita1,5, Bruno Lopez3, Sebastian Brandner6,7, Benjamin Schmitt8, Patrick Liebig8, Eser Sanverdi1, Xavier Golay1,2, and Sotirios Bisdas1,2
1Lysholm Dept of Neuroradiology, National Hospital for Neurology & Neurosurgery, UCL Hospitals NHS Foundation Trust, London, United Kingdom, 2UCL Institute of Neurology, London, United Kingdom, 3Olea Medical, La Ciotat, France, 4University College of London Hospitals NHS Foundation Trust, London, United Kingdom, 5Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, 6Department of Neurodegenerative Disease, Institute of Neurology UCL, London, United Kingdom, 7National Hospital for Neurology & Neurosurgery, UCL Hospitals NHS Foundation Trust, London, United Kingdom, 8Siemens Healthcare Limited, Erlangen, Germany
1Lysholm Dept of Neuroradiology, National Hospital for Neurology & Neurosurgery, UCL Hospitals NHS Foundation Trust, London, United Kingdom, 2UCL Institute of Neurology, London, United Kingdom, 3Olea Medical, La Ciotat, France, 4University College of London Hospitals NHS Foundation Trust, London, United Kingdom, 5Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, 6Department of Neurodegenerative Disease, Institute of Neurology UCL, London, United Kingdom, 7National Hospital for Neurology & Neurosurgery, UCL Hospitals NHS Foundation Trust, London, United Kingdom, 8Siemens Healthcare Limited, Erlangen, Germany
Glioma staging depends on the IDH and 1p/19q
status. CEST is a higly sensitive MRI technique detecting amide- and amine-containing mobile proteins. We show that CEST amides/amines ratio is a powerful marker for differentiating gliomas with the best prognosis from those with the worst prognosis
Fig 1. Tumour CEST asymmetry curve normalised by subtracting the contralateral WM signal. a) IDH-wt gliomas (red) have proportionally higher amides than amines signal with respect to the IDH-mut subgroups. IDH-mut 1p/19q-ret gliomas (light-blue) has approximately 30% more signal than IDH-mut 1p/19q-codel gliomas (dark blue). b) IDH-wt gliomas (red) and IDH-mut 1p/19q-codel gliomas (dark-blue) are the same curves as in a). The IDH-mut 1p/19q-ret gliomas with T2/FLAIR mismatch (light blue) have 50% more signal than those without T2/FLAIR mismatch (green).
Fig 4. Violin plot of CESTamides (blue), CESTamines (red) and CESTamides/CESTamines (green). From left to right: IDH-wt, IDH-mut 1p/19q-ret with and without T2/FLAIR mismatch and IDH-mut 1p/19q-codel. CESTamines is lower in IDH-wt vs IDH-mut_1p/19q-ret (p=0.0005) and CESTamides/CESTamines is higher in IDH-wt vs both IDH-mut 1p/19q-ret (p=0.0029) and IDH-mut 1p/19q-codel (p=0.0018). In addition, CESTamides and CESTamines are higher in IDH-mut_1p/19q-ret vs IDH-mut_1p/19q-codel gliomas (p=0.0032 and p=0.0015).