Abstract #0954

Tumor microenvironment (TME) mapping: MRI of intratumoral heterogeneity of oxygen metabolism and neovascularization uncovers two survival relevant subgroups of IDH1 wild-type glioblastoma

Andreas Stadlbauer^1,2, Max Zimmermann¹, Arnd Dörfler³, Roland Coras⁴, Stefan Oberndorfer⁵, Michael Buchfelder¹, and Karl Rössler¹

¹Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany, ²Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria, ³Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany, ⁴Department of Neuropathology, University of Erlangen-Nürnberg, Erlangen, Germany, ⁵Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria

The dismal prognosis of glioblastoma is largely attributed to hypoxic and perivascular niches in the tumor microenvironment (TME) which are essential for elucidation of pathophysiological mechanisms behind therapy resistance and recurrence. Here, we combined MRI biomarkers for oxygen metabolism and neovascularization with an automatic classification strategy for localization of hypoxic and vascular niches within the heterogeneously structured TME. Correlation with the metabolic pathway for energy production uncovered two different phenotypes for glioblastoma IDH1wt: A glycolytic phenotype with stable functional neovasculature, and a necrotic/hypoxic phenotype with defective neovasculature and a more aggressive tumor behavior. The glycolytic phenotype showed longer progression-free survival.

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