Jorn Fierstra1, Christiaan van Niftrik2, Marco Piccirelli3, Oliver Bozinov2, Athina Pangalu3, Niklaus Krayenbühl2, Antonios Valavanis3, Michael Weller4, Luca Regli2. 1. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: jorn.fierstra@usz.ch. 2. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. 3. Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. 4. Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland.
Abstract
PURPOSE: Cerebral diffuse gliomas exhibit perilesional impaired cerebrovascular reactivity (CVR), yet the degree of impairment as well as its full spatial extent in the brain remains unknown. With quantitative fMRI, we studied twelve subjects with untreated brain diffuse glioma and twelve healthy controls to assess CVR impairment and determine its distribution throughout the brain. METHODS: In a prospective case-control study, quantitative CVR measurements were derived from BOLD fMRI volumes during standardized iso-oxic changes in carbon dioxide. Whole brain CVR was assessed with additional detailed analyses using specific tumor and tissue masks and compared to datasets of healthy controls. RESULTS: Whole brain CVR was significantly impaired compared to healthy controls (0.11±0.10 versus 0.28±0.8, p<0.01). All diffuse glioma patients exhibited even more severely impaired intralesional CVR (mean 0.01±0.06). Increasing tumor volume significantly correlated with severity of intralesional CVR impairment (p<0.05, R2=0.38), and whole brain CVR impairment (p<0.05, R2=0.55). CONCLUSION: Patients with brain diffuse glioma exhibit intralesional and whole brain impaired CVR with severity correlating to tumor volume. Quantitative fMRI may be entertained to study antitumor therapy efficacy by tracking CVR changes and may have a complementary role to better interpret BOLD associated neurovascular uncoupling.
PURPOSE: Cerebral diffuse gliomas exhibit perilesional impaired cerebrovascular reactivity (CVR), yet the degree of impairment as well as its full spatial extent in the brain remains unknown. With quantitative fMRI, we studied twelve subjects with untreated brain diffuse glioma and twelve healthy controls to assess CVR impairment and determine its distribution throughout the brain. METHODS: In a prospective case-control study, quantitative CVR measurements were derived from BOLD fMRI volumes during standardized iso-oxic changes in carbon dioxide. Whole brain CVR was assessed with additional detailed analyses using specific tumor and tissue masks and compared to datasets of healthy controls. RESULTS: Whole brain CVR was significantly impaired compared to healthy controls (0.11±0.10 versus 0.28±0.8, p<0.01). All diffuse gliomapatients exhibited even more severely impaired intralesional CVR (mean 0.01±0.06). Increasing tumor volume significantly correlated with severity of intralesional CVR impairment (p<0.05, R2=0.38), and whole brain CVR impairment (p<0.05, R2=0.55). CONCLUSION:Patients with brain diffuse glioma exhibit intralesional and whole brain impaired CVR with severity correlating to tumor volume. Quantitative fMRI may be entertained to study antitumor therapy efficacy by tracking CVR changes and may have a complementary role to better interpret BOLD associated neurovascular uncoupling.
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Authors: Emilie Sleight; Michael S Stringer; Ian Marshall; Joanna M Wardlaw; Michael J Thrippleton Journal: Front Physiol Date: 2021-02-25 Impact factor: 4.566
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Authors: Martina Sebök; Christiaan Hendrik Bas van Niftrik; Giovanni Muscas; Athina Pangalu; Katharina Seystahl; Michael Weller; Luca Regli; Jorn Fierstra Journal: Neurooncol Adv Date: 2021-03-30
Authors: Christiaan Hendrik Bas van Niftrik; Marco Piccirelli; Giovanni Muscas; Martina Sebök; Joseph Arnold Fisher; Oliver Bozinov; Christoph Stippich; Antonios Valavanis; Luca Regli; Jorn Fierstra Journal: PLoS One Date: 2019-05-06 Impact factor: 3.240
Authors: Martina Sebök; Christiaan Hendrik Bas van Niftrik; Matthias Halter; Aimee Hiller; Katharina Seystahl; Athina Pangalu; Michael Weller; Christoph Stippich; Luca Regli; Jorn Fierstra Journal: Cerebellum Date: 2020-12 Impact factor: 3.847