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AJNR Am J Neuroradiol. 2016 Jan;37(1):66-73. doi: 10.3174/ajnr.A4493. Epub 2015 Oct 22.

Improved Brain Tumor Classification by Sodium MR Imaging: Prediction of IDH Mutation Status and Tumor Progression.

Author information

1
From the Departments of Neuroradiology (A.B., M.B., J.K.) Departments of Radiology (A.B., J.K.) armin.biller@med.uni-heidelberg.de.
2
Department of Biological Psychology and Neuropsychology (S.B.), University of Hamburg, Hamburg, Germany.
3
Medical Physics in Radiology (A.N., N.B.), German Cancer Research Centre (DKFZ), Heidelberg, Germany.
4
Neurosurgery (J.-O.N.).
5
Neuro-Oncology (W.W., A.H.).
6
From the Departments of Neuroradiology (A.B., M.B., J.K.).
7
Neuropathology (F.S.).
8
From the Departments of Neuroradiology (A.B., M.B., J.K.) Multidimensional Image Processing Group (J.K.), HCI/IWR, University of Heidelberg, Heidelberg, Germany Departments of Radiology (A.B., J.K.).

Abstract

BACKGROUND AND PURPOSE:

MR imaging in neuro-oncology is challenging due to inherent ambiguities in proton signal behavior. Sodium-MR imaging may substantially contribute to the characterization of tumors because it reflects the functional status of the sodium-potassium pump and sodium channels.

MATERIALS AND METHODS:

Sodium-MR imaging data of patients with treatment-naïve glioma WHO grades I-IV (n = 34; mean age, 51.29 ± 17.77 years) were acquired by using a 7T MR system. For acquisition of sodium-MR images, we applied density-adapted 3D radial projection reconstruction pulse sequences. Proton-MR imaging data were acquired by using a 3T whole-body system.

RESULTS:

We demonstrated that the initial sodium signal of a treatment-naïve brain tumor is a significant predictor of isocitrate dehydrogenase (IDH) mutation status (P < .001). Moreover, independent of this correlation, the Cox proportional hazards model confirmed the sodium signal of treatment-naïve brain tumors as a predictor of progression (P = .003). Compared with the molecular signature of IDH mutation status, information criteria of model comparison revealed that the sodium signal is even superior to IDH in progression prediction. In addition, sodium-MR imaging provides a new approach to noninvasive tumor classification. The sodium signal of contrast-enhancing tumor portions facilitates differentiation among most glioma types (P < .001).

CONCLUSIONS:

The information of sodium-MR imaging may help to classify neoplasias at an early stage, to reduce invasive tissue characterization such as stereotactic biopsy specimens, and overall to promote improved and individualized patient management in neuro-oncology by novel imaging signatures of brain tumors.

PMID:
26494691
DOI:
10.3174/ajnr.A4493
[Indexed for MEDLINE]
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