ArticleNeuro-oncology2016
Whole-brain spectroscopic MRI biomarkers identify infiltrating margins in glioblastoma patients.
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Article in Neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers.
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77citing papers in PubMed
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Who cites it
77 citing papers in PubMed.
- The STEMRI trial: Magnetic resonance spectroscopy imaging can define tumor areas enriched in glioblastoma stem-like cells.Science advances · 2023Trial
- Applying a Radiation Therapy Volume Analysis Pipeline to Determine the Utility of Spectroscopic MRI-Guided Adaptive Radiation Therapy for Glioblastoma.Tomography (Ann Arbor, Mich.) · 2023Trial
- A Novel Approach to Determining Tumor Progression Using a Three-Site Pilot Clinical Trial of Spectroscopic MRI-Guided Radiation Dose Escalation in Glioblastoma.Tomography (Ann Arbor, Mich.) · 2023Trial
- A Phase 2 Study of Dose-intensified Chemoradiation Using Biologically Based Target Volume Definition in Patients With Newly Diagnosed Glioblastoma.International journal of radiation oncology, biology, physics · 2021Trial
- The Brain Imaging Collaboration Suite (BrICS): A Cloud Platform for Integrating Whole-Brain Spectroscopic MRI into the Radiation Therapy Planning Workflow.Tomography (Ann Arbor, Mich.) · 2019Trial
- Radiation Effects on Normal Brain in Subjects With Recurrent Glioblastoma by Spectroscopic MRI.NMR in biomedicine · 2026Article
- Glioblastoma in adults: A Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions.Neuro-oncology · 2025Review
- Longitudinal Overlap and Metabolite Analysis in Spectroscopic MRI-Guided Proton Beam Therapy in Pediatric High-Grade Glioma.Tomography (Ann Arbor, Mich.) · 2025Article
- Autoimmune Encephalitis-like Presentation of Glioblastoma: Get to Know This Rare Occurrence.Journal of clinical medicine · 2025Article
- Defining occult disease in glioblastoma using spectroscopic MRI: implications for clinical target volume delineation.Radiation oncology (London, England) · 2025Article
- NNFit: A Self-Supervised Deep Learning Method for Accelerated Quantification of High-Resolution Short-Echo-Time MR Spectroscopy Datasets.Radiology. Artificial intelligence · 2025Article
- Article
- Conference Report: Review of Clinical Implementation of Advanced Quantitative Imaging Techniques for Personalized Radiotherapy.Tomography (Ann Arbor, Mich.) · 2024Article
- Long term follow-up of patients with newly diagnosed glioblastoma treated by intraoperative photodynamic therapy: an update from the INDYGO trial (NCT03048240).Journal of neuro-oncology · 2024Article
- An Update on MR Spectroscopy in Cancer Management: Advances in Instrumentation, Acquisition, and Analysis.Radiology. Imaging cancer · 2024Review
- A Biopsy-Controlled Prospective Study of Contrast-Enhancing Diffuse Glioma Infiltration Based on FET-PET and FLAIR.Cancers · 2024Article
- Article
- The Utility of Spectroscopic MRI in Stereotactic Biopsy and Radiotherapy Guidance in Newly Diagnosed Glioblastoma.Tomography (Ann Arbor, Mich.) · 2024Article
- Integrating multi-modal imaging in radiation treatments for glioblastoma.Neuro-oncology · 2024Review
- SPECTRO GLIO trial aftermath: Where do we go from here?Neuro-oncology · 2024Article
17 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors.
James S CordovaDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Hui-Kuo G ShuDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Zhongxing LiangDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Saumya S GurbaniDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Lee A D CooperDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Chad A HolderDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Jeffrey J OlsonDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Brad KairdolfDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Eduard SchreibmannDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Stewart G NeillDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Constantinos G HadjipanayisDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Hyunsuk ShimDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia (J.S.C., Z.L., S.S.G., C.A.H., H.S.); Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia(H.G.S., E.S.); Winship Cancer Institute of Emory University, Atlanta, Georgia(H.G.S., Z.L., J.J.O., C.G.H., H.S.); Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia(S.S.G., L.A.D.C., B.K., H.S.); Department of Biomedical informatics, Emory University School of Medicine, Atlanta, Georgia(L.A.D.C.); Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia(J.J.O., C.G.H.); Department of Pathology, Emory University School of Medicine, Atlanta, Georgia(S.G.N.); Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York (C.G.H.).
Funding
MEDICAL SCIENTIST TRAINING PROGRAMT32GM008169 · NIGMS · EMORY UNIVERSITY · PI GROSS, ROBERT E · 1987 to 2021
$20.3MGraduate Training in the Pharmacological StudiesT32GM008602 · NIGMS · EMORY UNIVERSITY · PI HALL, RANDY A. · 1996 to 2021
$5.1MQuantitative MRSI to predict early response to SAHA therapy in new GBM managementU01CA172027 · NCI · EMORY UNIVERSITY · PI BARKER, PETER B, HU, XIAOPING P · 2013 to 2017
$3.2MUsing Proton MRS to Predict Response of SAHA treatment in GlioblastomaR21CA141836 · NCI · EMORY UNIVERSITY · PI HU, XIAOPING P, OLSON, JEFFREY J · 2010 to 2011
$664kImproving extent of glioblastoma resection by combining volumetric MRSI and 5-ALAR21CA186169 · NCI · EMORY UNIVERSITY · PI HADJIPANAYIS, CONSTANTINOS GEORGE, HOLDER, CHAD A. · 2014 to 2015
$660kQuantitative MRSI for the prediction of response to chemoradiation therapy in GBMF31CA180319 · NCI · EMORY UNIVERSITY · PI CORDOVA, JAMES SCOTT · 2013 to 2016
$98kNCI NIH HHS F31 CA180319NCI NIH HHS R21 CA141836NCI NIH HHS R21 CA186169NCI NIH HHS U01 CA172027NIGMS NIH HHS T32 GM008169NIGMS NIH HHS T32 GM008602
Abstract
backgroundThe standard of care for glioblastoma (GBM) is maximal safe resection followed by radiation therapy with chemotherapy. Currently, contrast-enhanced MRI is used to define primary treatment volumes for surgery and radiation therapy. However, enhancement does not identify the tumor entirely, resulting in limited local control. Proton spectroscopic MRI (sMRI), a method reporting endogenous metabolism, may better define the tumor margin. Here, we develop a whole-brain sMRI pipeline and validate sMRI metrics with quantitative measures of tumor infiltration.
methodsWhole-brain sMRI metabolite maps were coregistered with surgical planning MRI and imported into a neuronavigation system to guide tissue sampling in GBM patients receiving 5-aminolevulinic acid fluorescence-guided surgery. Samples were collected from regions with metabolic abnormalities in a biopsy-like fashion before bulk resection. Tissue fluorescence was measured ex vivo using a hand-held spectrometer. Tissue samples were immunostained for Sox2 and analyzed to quantify the density of staining cells using a novel digital pathology image analysis tool. Correlations among sMRI markers, Sox2 density, and ex vivo fluorescence were evaluated.
resultsSpectroscopic MRI biomarkers exhibit significant correlations with Sox2-positive cell density and ex vivo fluorescence. The choline to N-acetylaspartate ratio showed significant associations with each quantitative marker (Pearson's ρ = 0.82, P < .001 and ρ = 0.36, P < .0001, respectively). Clinically, sMRI metabolic abnormalities predated contrast enhancement at sites of tumor recurrence and exhibited an inverse relationship with progression-free survival.
conclusionsAs it identifies tumor infiltration and regions at high risk for recurrence, sMRI could complement conventional MRI to improve local control in GBM patients.
Indexed as
Aminolevulinic AcidAspartic AcidBiomarkersBrainBrain NeoplasmsCell CountCholineDisease-Free SurvivalGlioblastomaHumansImage Interpretation, Computer-AssistedMagnetic Resonance ImagingNeuronavigationOptical ImagingPhotosensitizing AgentsProton Magnetic Resonance SpectroscopyAminolevulinic AcidAspartic AcidBiomarkersCholineN-acetylaspartatePhotosensitizing AgentsSOX2 protein, humanSOXB1 Transcription Factors5-aminolevulinic acidglioblastomaquantitative histological image analysisspectroscopic MRIsurgical and radiation therapy planning
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