Abstract #0500

Fluid suppression in CEST imaging affects predominantly IDH-mutant 1p/19q retained gliomas with T2-FLAIR mismatch

Stefano Casagranda¹, Laura Mancini^2,3, Guillaume Gautier¹, Philippe Peter¹, Bruno Lopez¹, Sebastian Brandner^4,5, Enrico De Vita^2,6, Xavier Golay^2,3, and Sotirios Bisdas^2,3

¹Olea Medical, La Ciotat, France, ²Lysholm Dept of Neuroradiology, University College of London Hospitals NHS Foundation Trust, London, United Kingdom, ³Institute of Neurology UCL, London, United Kingdom, ⁴National Hospital for Neurology & Neurosurgery, University College of London Hospitals NHS Foundation Trust, London, United Kingdom, ⁵Department of Neurodegenerative Disease, Institute of Neurology UCL, London, United Kingdom, ⁶Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

CEST is a novel MR technique helpful for predicting IDH and 1p/19q status in gliomas. The asymmetry-based methods however are sensitive to fluid signal and recent studies have shown that a significant proportion of IDH-mutant 1p/19q retained gliomas have T2-FLAIR mismatch, indicating the presence of a more fluid microenvironment. This work shows how fluid-suppressed CEST imaging metrics have an impact on amide and amine signals in glioma, with highest effect on IDH-mutant 1p/19q retained with T2-FLAIR mismatch. The combined use of asymmetry-based and fluid-suppressed CEST metrics could be a valuable tool for glioma staging more robust than asymmetry-based metrics alone.

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