Brain tumor

Diffuse gliomas are the most common malignant intracranial tumors. Besides challenges pertaining to their treatment – glioblastoma in particular presents a dismal prognosis and is virtually incurable – also pre-operative assessment by means of standard neuroimaging is characterized by a number of drawbacks including broad differential diagnosis, imprecise characterization of tumor subtype and of its infiltration in the surrounding brain parenchyma for accurate resection planning. As pathophysiological alterations of tumor tissue are tightly linked to an aberrant vascularization, advanced hemodynamic imaging has attracted considerable interest as a means to improve diffuse glioma characterization. At ASTRAN Lab we are currently investigating BOLD fMRI with standardized and precise CO2 and O2 modulation as an emerging physiologic MRI technique to detail specific glioblastoma characteristics. For clinical purposes, this technique potentially provides two important advantages, since standardized and precise gas application results in a high inter- and intra-subject agreement between follow-up studies, whereas BOLD MRI provides a high imaging contrast resolution covering the entire brain. The unique tissue response patterns generated from this technique can be further investigated to better detail glioblastoma lesions and gauge treatment response.