Physiologic MR imaging of the tumor microenvironment revealed switching of metabolic phenotype upon recurrence of glioblastoma in humans

Stadlbauer A, Oberndorfer S, Zimmermann M, Renner B, Buchfelder M, Heinz G, Dörfler A, Kleindienst A, Roessler K (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Book Volume: 40

Pages Range: 528-538

Journal Issue: 3

DOI: 10.1177/0271678X19827885

Abstract

Treating recurrent glioblastoma (GB) is one of the challenges in modern neurooncology. Hypoxia, neovascularization, and energy metabolism are of crucial importance for therapy failure and recurrence. Twenty-one patients with initially untreated GB who developed recurrence were examined with a novel MRI approach for noninvasive visualization of the tumor microenvironment (TME). Imaging biomarker information about oxygen metabolism (mitochondrial oxygen tension) and neovascularization (microvascular density and type) were fused for classification of five different TME compartments: necrosis, hypoxia with/without neovascularization, oxidative phosphorylation, and glycolysis. Volume percentages of these TME compartments were compared between untreated and recurrent GB. At initial diagnosis, all 21 GB showed either the features of a glycolytic dominant phenotype with a high percentage of functional neovasculature (N = 12) or those of a necrotic/hypoxic dominant phenotype with a high percentage of defective tumor neovasculature (N = 9). At recurrence, all 21 GB revealed switching of the initial metabolic phenotype: either from the glycolytic to the necrotic/hypoxic dominant phenotype or vice-versa. A necrotic/hypoxic phenotype at recurrence was associated with a higher rate of multifocality of the recurrent lesions. Our MRI approach may be helpful for a better understanding of treatment-induced metabolic phenotype switching and for future studies developing targeted therapeutic strategies for recurrent GB.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum St. Pölten Austria (AT)

How to cite

APA:

Stadlbauer, A., Oberndorfer, S., Zimmermann, M., Renner, B., Buchfelder, M., Heinz, G.,... Roessler, K. (2020). Physiologic MR imaging of the tumor microenvironment revealed switching of metabolic phenotype upon recurrence of glioblastoma in humans. Journal of Cerebral Blood Flow and Metabolism, 40(3), 528-538. https://doi.org/10.1177/0271678X19827885

MLA:

Stadlbauer, Andreas, et al. "Physiologic MR imaging of the tumor microenvironment revealed switching of metabolic phenotype upon recurrence of glioblastoma in humans." Journal of Cerebral Blood Flow and Metabolism 40.3 (2020): 528-538.

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