Quantitative Susceptibility Mapping Differentiates between Blood Depositions and Calcifications in Patients with Glioblastoma
Open Access
- 21 March 2013
- journal article
- clinical trial
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (3), e57924
- https://doi.org/10.1371/journal.pone.0057924
Abstract
The application of susceptibility weighted imaging (SWI) in brain tumor imaging is mainly used to assess tumor-related “susceptibility based signals” (SBS). The origin of SBS in glioblastoma is still unknown, potentially representing calcifications or blood depositions. Reliable differentiation between both entities may be important to evaluate treatment response and to identify glioblastoma with oligodendroglial components that are supposed to present calcifications. Since calcifications and blood deposits are difficult to differentiate using conventional MRI, we investigated whether a new post-processing approach, quantitative susceptibility mapping (QSM), is able to distinguish between both entities reliably. SWI, FLAIR, and T1-w images were acquired from 46 patients with glioblastoma (14 newly diagnosed, 24 treated with radiochemotherapy, 8 treated with radiochemotherapy and additional anti-angiogenic medication). Susceptibility maps were calculated from SWI data. All glioblastoma were evaluated for the appearance of hypointense or hyperintense correlates of SBS on the susceptibility maps. 43 of 46 glioblastoma presented only hyperintense intratumoral SBS on susceptibility maps, indicating blood deposits. Additional hypointense correlates of tumor-related SBS on susceptibility maps, indicating calcification, were identified in 2 patients being treated with radiochemotherapy and in one patient being treated with additional anti-angiogenic medication. Histopathologic reports revealed an oligodendroglial component in one patient that presented calcifications on susceptibility maps. QSM provides a quantitative, local MRI contrast, which reliably differentiates between blood deposits and calcifications. Thus, quantitative susceptibility mapping appears promising to identify rare variants of glioblastoma with oligodendroglial components non-invasively and may allow monitoring the role of calcification in the context of different therapy regimes.Keywords
This publication has 45 references indexed in Scilit:
- Differentiation between diamagnetic and paramagnetic cerebral lesions based on magnetic susceptibility mappingMedical Physics, 2010
- Combination of high-resolution susceptibility-weighted imaging and the apparent diffusion coefficient: added value to brain tumour imaging and clinical feasibility of non-contrast MRI at 3 TThe British Journal of Radiology, 2010
- Added Value and Diagnostic Performance of Intratumoral Susceptibility Signals in the Differential Diagnosis of Solitary Enhancing Brain Lesions: Preliminary StudyAmerican Journal of Neuroradiology, 2009
- Investigation of the influence of carbon dioxide concentrations on cerebral physiology by susceptibility-weighted magnetic resonance imaging (SWI)NeuroImage, 2008
- Development of a robust method for generating 7.0 T multichannel phase images of the brain with application to normal volunteers and patients with neurological diseasesNeuroImage, 2008
- Susceptibility‐weighted imaging to visualize blood products and improve tumor contrast in the study of brain massesJournal of Magnetic Resonance Imaging, 2006
- Fast phase unwrapping algorithm for interferometric applicationsOptics Letters, 2003
- Glioblastomas with an Oligodendroglial Component: A Pathological and Molecular StudyJournal of Neuropathology and Experimental Neurology, 2001
- MRI appearances of calcified regions within intracranial tumoursNeuroradiology, 1993
- The detection of intracranial calcifications by MR.1986