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Cancers
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Advances in Neuro-Oncological Imaging
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Advances in Neuro-Oncological Imaging

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (1 October 2023) | Viewed by 8864

Special Issue Editors

Dr. Julia Furtner

E-Mail Website
Guest Editor
Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
Interests: neuroimaging; radiomics/radiogenomics in context of brain tumors; MRI; PET; PET/MRI
Special Issues, Collections and Topics in MDPI journals
Dr. Anna Sophie Berghoff

E-Mail Website
Guest Editor
Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Interests: neuro-oncology; biomarkers; clinical studies; immunotherapy
Special Issues, Collections and Topics in MDPI journals
Dr. Barbara Kiesel

E-Mail Website
Guest Editor
Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria
Interests: neuro-oncological neurosurgery; fluorescence guided resection; epigenetic in brain tumors

Special Issue Information

Dear Colleagues,

Central nervous system tumors have a significant impact on patient quality of life as well as the healthcare system due to the profound level of impairment that is already evident in the early stage of the disease, posing a tremendous medical and socioeconomic burden. The most widely used method for identifying and monitoring brain and spinal cord tumors is non-invasive imaging techniques on a qualitative or quantitative basis.

This Special Issue of Cancers aims to highlight imaging techniques that can provide new insights into tumor detection, diagnosis, molecular profiling, prognosis, or prediction of response to treatment in primary and secondary CNS tumors.

We are pleased to invite you to submit original research articles and reviews with a focus on novel aspects of diverse neuro-oncological imaging research fields such as advanced MRI (including, e.g., hyperpolarized MRI, CEST imaging, MR fingerprinting, quantitative MRI), PET, neuro-oncological imaging biomarkers, radiomics or multi-omic approaches, as well as functional MRI or intraoperative MRI.

We look forward to receiving your contributions.

Dr. Julia Furtner
Dr. Anna Sophie Berghoff
Dr. Barbara Kiesel
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • central nervous system (CNS) tumors
  • brain tumors
  • spinal cord tumors
  • magnetic resonance imaging (MRI)
  • positron emission tomography (PET)
  • intraoperative MRI
  • imaging biomarkers
  • metabolic imaging
  • radiomics
  • machine learning

Published Papers (7 papers)

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Research

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21 pages, 21359 KiB  
Article
Advanced Hyperpolarized 13C Metabolic Imaging Protocol for Patients with Gliomas: A Comprehensive Multimodal MRI Approach
by Adam W. Autry, Sana Vaziri, Jeremy W. Gordon, Hsin-Yu Chen, Yaewon Kim, Duy Dang, Marisa LaFontaine, Ralph Noeske, Robert Bok, Javier E. Villanueva-Meyer, Jennifer L. Clarke, Nancy Ann Oberheim Bush, Susan M. Chang, Duan Xu, Janine M. Lupo, Peder E. Z. Larson, Daniel B. Vigneron and Yan Li
Cancers 2024, 16(2), 354; https://doi.org/10.3390/cancers16020354 - 13 Jan 2024
Viewed by 969
Abstract
This study aimed to implement a multimodal 1H/HP-13C imaging protocol to augment the serial monitoring of patients with glioma, while simultaneously pursuing methods for improving the robustness of HP-13C metabolic data. A total of 100 1H/HP [1- [...] Read more.
This study aimed to implement a multimodal 1H/HP-13C imaging protocol to augment the serial monitoring of patients with glioma, while simultaneously pursuing methods for improving the robustness of HP-13C metabolic data. A total of 100 1H/HP [1-13C]-pyruvate MR examinations (104 HP-13C datasets) were acquired from 42 patients according to the comprehensive multimodal glioma imaging protocol. Serial data coverage, accuracy of frequency reference, and acquisition delay were evaluated using a mixed-effects model to account for multiple exams per patient. Serial atlas-based HP-13C MRI demonstrated consistency in volumetric coverage measured by inter-exam dice coefficients (0.977 ± 0.008, mean ± SD; four patients/11 exams). The atlas-derived prescription provided significantly improved data quality compared to manually prescribed acquisitions (n = 26/78; p = 0.04). The water-based method for referencing [1-13C]-pyruvate center frequency significantly reduced off-resonance excitation relative to the coil-embedded [13C]-urea phantom (4.1 ± 3.7 Hz vs. 9.9 ± 10.7 Hz; p = 0.0007). Significantly improved capture of tracer inflow was achieved with the 2-s versus 5-s HP-13C MRI acquisition delay (p = 0.007). This study demonstrated the implementation of a comprehensive multimodal 1H/HP-13C MR protocol emphasizing the monitoring of steady-state/dynamic metabolism in patients with glioma. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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20 pages, 13405 KiB  
Article
MRI-Based Assessment of Brain Tumor Hypoxia: Correlation with Histology
by Fatemeh Arzanforoosh, Maaike Van der Velden, Avery J. L. Berman, Sebastian R. Van der Voort, Eelke M. Bos, Joost W. Schouten, Arnaud J. P. E. Vincent, Johan M. Kros, Marion Smits and Esther A. H. Warnert
Cancers 2024, 16(1), 138; https://doi.org/10.3390/cancers16010138 - 27 Dec 2023
Viewed by 882
Abstract
Cerebral hypoxia significantly impacts the progression of brain tumors and their resistance to radiotherapy. This study employed streamlined quantitative blood-oxygen-level-dependent (sqBOLD) MRI to assess the oxygen extraction fraction (OEF)—a measure of how much oxygen is being extracted from vessels, with higher OEF values [...] Read more.
Cerebral hypoxia significantly impacts the progression of brain tumors and their resistance to radiotherapy. This study employed streamlined quantitative blood-oxygen-level-dependent (sqBOLD) MRI to assess the oxygen extraction fraction (OEF)—a measure of how much oxygen is being extracted from vessels, with higher OEF values indicating hypoxia. Simultaneously, we utilized vessel size imaging (VSI) to evaluate microvascular dimensions and blood volume. A cohort of ten patients, divided between those with glioma and those with brain metastases, underwent a 3 Tesla MRI scan. We generated OEF, cerebral blood volume (CBV), and vessel size maps, which guided 3–4 targeted biopsies per patient. Subsequent histological analyses of these biopsies used hypoxia-inducible factor 1-alpha (HIF-1α) for hypoxia and CD31 for microvasculature assessment, followed by a correlation analysis between MRI and histological data. The results showed that while the sqBOLD model was generally applicable to brain tumors, it demonstrated discrepancies in some metastatic tumors, highlighting the need for model adjustments in these cases. The OEF, CBV, and vessel size maps provided insights into the tumor’s hypoxic condition, showing intertumoral and intratumoral heterogeneity. A significant relationship between MRI-derived measurements and histological data was only evident in the vessel size measurements (r = 0.68, p < 0.001). Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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25 pages, 4240 KiB  
Article
Prediction of Rapid Early Progression and Survival Risk with Pre-Radiation MRI in WHO Grade 4 Glioma Patients
by Walia Farzana, Mustafa M. Basree, Norou Diawara, Zeina A. Shboul, Sagel Dubey, Marie M. Lockhart, Mohamed Hamza, Joshua D. Palmer and Khan M. Iftekharuddin
Cancers 2023, 15(18), 4636; https://doi.org/10.3390/cancers15184636 - 19 Sep 2023
Viewed by 1179
Abstract
Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to the start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of [...] Read more.
Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to the start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of conventional radiomics, sophisticated multi-resolution fractal texture features, and different molecular features (MGMT, IDH mutations) as a diagnostic and prognostic tool for prediction of REP from non-REP cases using computational and statistical modeling methods. The radiation-planning T1 post-contrast (T1C) MRI sequences of 70 patients are analyzed. An ensemble method with 5-fold cross-validation over 1000 iterations offers an AUC of 0.793 ± 0.082 for REP versus non-REP classification. In addition, copula-based modeling under dependent censoring (where a subset of the patients may not be followed up with until death) identifies significant features (p-value < 0.05) for survival probability and prognostic grouping of patient cases. The prediction of survival for the patients’ cohort produces a precision of 0.881 ± 0.056. The prognostic index (PI) calculated using the fused features shows that 84.62% of REP cases fall under the bad prognostic group, suggesting the potential of fused features for predicting a higher percentage of REP cases. The experimental results further show that multi-resolution fractal texture features perform better than conventional radiomics features for prediction of REP and survival outcomes. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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14 pages, 5720 KiB  
Article
MR Vascular Fingerprinting with Hybrid Gradient–Spin Echo Dynamic Susceptibility Contrast MRI for Characterization of Microvasculature in Gliomas
by Krishnapriya Venugopal, Fatemeh Arzanforoosh, Daniëlle van Dorth, Marion Smits, Matthias J. P. van Osch, Juan A. Hernandez-Tamames, Esther A. H. Warnert and Dirk H. J. Poot
Cancers 2023, 15(7), 2180; https://doi.org/10.3390/cancers15072180 - 06 Apr 2023
Cited by 1 | Viewed by 1480
Abstract
Characterization of tumor microvasculature is important in tumor assessment and studying treatment response. This is possible by acquiring vascular biomarkers with magnetic resonance imaging (MRI) based on dynamic susceptibility contrast (DSC). We propose magnetic resonance vascular fingerprinting (MRVF) for hybrid echo planar imaging [...] Read more.
Characterization of tumor microvasculature is important in tumor assessment and studying treatment response. This is possible by acquiring vascular biomarkers with magnetic resonance imaging (MRI) based on dynamic susceptibility contrast (DSC). We propose magnetic resonance vascular fingerprinting (MRVF) for hybrid echo planar imaging (HEPI) acquired during the first passage of the contrast agent (CA). The proposed approach was evaluated in patients with gliomas, and we simultaneously estimated vessel radius and relative cerebral blood volume. These parameters were also compared to the respective values estimated using the previously introduced vessel size imaging (VSI) technique. The results of both methods were found to be consistent. MRVF was also found to be robust to noise in the estimation of the parameters. DSC-HEPI-based MRVF provides characterization of microvasculature in gliomas with a short acquisition time and can be further improved in several ways to increase our understanding of tumor physiology. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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14 pages, 4102 KiB  
Article
Microvasculature Features Derived from Hybrid EPI MRI in Non-Enhancing Adult-Type Diffuse Glioma Subtypes
by Fatemeh Arzanforoosh, Sebastian R. van der Voort, Fatih Incekara, Arnaud Vincent, Martin Van den Bent, Johan M. Kros, Marion Smits and Esther A. H. Warnert
Cancers 2023, 15(7), 2135; https://doi.org/10.3390/cancers15072135 - 04 Apr 2023
Cited by 4 | Viewed by 1254
Abstract
In this study, we used the vessel size imaging (VSI) MRI technique to characterize the microvasculature features of three subtypes of adult-type diffuse glioma lacking enhancement. Thirty-eight patients with confirmed non-enhancing glioma were categorized into three subtypes: Oligo (IDH-mut&1p/19q-codeleted), Astro (IDH-mut), and GBM [...] Read more.
In this study, we used the vessel size imaging (VSI) MRI technique to characterize the microvasculature features of three subtypes of adult-type diffuse glioma lacking enhancement. Thirty-eight patients with confirmed non-enhancing glioma were categorized into three subtypes: Oligo (IDH-mut&1p/19q-codeleted), Astro (IDH-mut), and GBM (IDH-wt). The VSI technique provided quantitative maps of cerebral blood volume (CBV), microvasculature (µCBV), and vessel size for each patient. Additionally, tissue samples of 21 patients were histopathologically analyzed, and microvasculature features were quantified. Both MRI- and histology-derived features were compared across the three glioma subtypes with ANOVA or Kruskal–Wallis tests. Group averages of CBV, μCBV, and vessel size were significantly different between the three glioma subtypes (p < 0.01). Astro (IDH-mut) had a significantly lower CBV and µCBV compared to Oligo (IDH-mut&1p/19q-codeleted) (p = 0.004 and p = 0.001, respectively), and a higher average vessel size compared to GBM (IDH-wt) (p = 0.01). The histopathological analysis showed that GBM (IDH-wt) possessed vessels with more irregular shapes than the two other subtypes (p < 0.05). VSI provides a good insight into the microvasculature characteristics of the three adult-type glioma subtypes even when lacking enhancement. Further investigations into the specificity of VSI to differentiate glioma subtypes are thus warranted. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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Review

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24 pages, 11880 KiB  
Review
Advances in Neuro-Oncological Imaging: An Update on Diagnostic Approach to Brain Tumors
by Paniz Sabeghi, Paniz Zarand, Sina Zargham, Batis Golestany, Arya Shariat, Myles Chang, Evan Yang, Priya Rajagopalan, Daniel Chang Phung and Ali Gholamrezanezhad
Cancers 2024, 16(3), 576; https://doi.org/10.3390/cancers16030576 - 30 Jan 2024
Viewed by 1253
Abstract
This study delineates the pivotal role of imaging within the field of neurology, emphasizing its significance in the diagnosis, prognostication, and evaluation of treatment responses for central nervous system (CNS) tumors. A comprehensive understanding of both the capabilities and limitations inherent in emerging [...] Read more.
This study delineates the pivotal role of imaging within the field of neurology, emphasizing its significance in the diagnosis, prognostication, and evaluation of treatment responses for central nervous system (CNS) tumors. A comprehensive understanding of both the capabilities and limitations inherent in emerging imaging technologies is imperative for delivering a heightened level of personalized care to individuals with neuro-oncological conditions. Ongoing research in neuro-oncological imaging endeavors to rectify some limitations of radiological modalities, aiming to augment accuracy and efficacy in the management of brain tumors. This review is dedicated to the comparison and critical examination of the latest advancements in diverse imaging modalities employed in neuro-oncology. The objective is to investigate their respective impacts on diagnosis, cancer staging, prognosis, and post-treatment monitoring. By providing a comprehensive analysis of these modalities, this review aims to contribute to the collective knowledge in the field, fostering an informed approach to neuro-oncological care. In conclusion, the outlook for neuro-oncological imaging appears promising, and sustained exploration in this domain is anticipated to yield further breakthroughs, ultimately enhancing outcomes for individuals grappling with CNS tumors. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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13 pages, 6084 KiB  
Review
Advances in the Radiological Evaluation of and Theranostics for Glioblastoma
by Grayson W. Hooper, Shehbaz Ansari, Jason M. Johnson and Daniel T. Ginat
Cancers 2023, 15(16), 4162; https://doi.org/10.3390/cancers15164162 - 18 Aug 2023
Cited by 2 | Viewed by 1155
Abstract
Imaging is essential for evaluating patients with glioblastoma. Traditionally a multimodality undertaking, CT, including CT cerebral blood profusion, PET/CT with traditional fluorine-18 fluorodeoxyglucose (18F-FDG), and MRI have been the mainstays for diagnosis and post-therapeutic assessment. However, recent advances in these modalities, [...] Read more.
Imaging is essential for evaluating patients with glioblastoma. Traditionally a multimodality undertaking, CT, including CT cerebral blood profusion, PET/CT with traditional fluorine-18 fluorodeoxyglucose (18F-FDG), and MRI have been the mainstays for diagnosis and post-therapeutic assessment. However, recent advances in these modalities, in league with the emerging fields of radiomics and theranostics, may prove helpful in improving diagnostic accuracy and treating the disease. Full article
(This article belongs to the Special Issue Advances in Neuro-Oncological Imaging)
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