Combined diffusion-weighted MRI and diffusion-weighted MR spectroscopy for interrogating the glioma tumour microenvironment: a preliminary study
Abstract
Background and purpose: Gliomas are characterised by a complex tumour microenvironment (TME) that contributes to treatment resistance and tumour heterogeneity. Therefore, the non-invasive interrogation of both the intracellular and extracellular compartments of gliomas remains a key unmet need. We investigated the feasibility and complementarity of combining diffusion-weighted MRI (DW-MRI) with biophysical modelling Vascular, Extracellular, and Restricted Diffusion for Cytometry in Tumours (VERDICT) and diffusion-weighted MR spectroscopy (DW-MRS) for simultaneous characterisation of glioma tumour cells and the glioma TME.
Methods: 14 patients with newly diagnosed glioma (WHO grades 2–4: 4 IDH-wildtype and 10 IDH-mutant) underwent DW-MRI at 3 T; DW-MRS was additionally acquired in 10 patients. Tumours were automatically segmented into enhancing, non-enhancing, and oedema regions using a validated pipeline. VERDICT models were fitted to multi-shell DW-MRI data to estimate intracellular volume fraction (f IC ), cell radius, extracellular diffusivities (D and D), and free-water fraction (f FW ). Single voxel DW-MRS (20×20×20 mm³) provided metabolite-specific apparent diffusion coefficients (ADCs) for total N-acetylaspartate (tNAA), Creatine (tCr), and choline (tCho). T-tests assessed DW-MRI and descriptive statistics assessed DW-MRS parameters in tumour regions compared to normal appearing white matter (NAWM) and IDH mutation status. Pearson’s correlations assessed associations…
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