Summary

The Institute for Neuroradiology closely collaborates with the departments of Neurooncology, Neuropathology and Neurosurgery to investigate tumor biology and therapy effects. Our focus is on non-invasive brain tumors characterization by means of special MRI methods such as metabolic imaging with MR spectroscopy and chemical exchange saturation transfer (CEST) imaging, perfusion methods, and quantitative MR relaxometry. CEST enables indirect detection of metabolites, pH and amides with exchangeable protons, MR spectroscopy allows in vivo quantification of the proliferation marker choline and its compounds, of the oncometabolites glycine and 2-hydroxyglutarate, of the neuronal substrates N-acetyl-aspartate, GABA and glutamate and high-energy metabolites.  Multimodal imaging that combines cerebral metabolic imaging with functional, dynamic (MR perfusion) and quantitative imaging (e.g. hypoxia imaging, measurement of blood brain barrier integrity) improves diagnostics, therapy planning, allows early detection of tumor progression and may predict the outcome. Our research activities cover all components necessary to bring new imaging methods from bench to bedside. This includes sequence development, preclinical testing on animal models and the clinical application of new imaging methods.

Apart for its own two clinical scanners (3 Tesla and 1.5 Tesla), the Institute for Neuroradiology has access to the two research-dedicated 3 Tesla MR scanners at the Brain Imaging Center Frankfurt. The patient centered infrastructure is supplemented by access to a 7 Tesla animal imaging scanner at the Georg Speyer Haus (also a DKTK Site), allowing for the preclinical evaluation of new sequences and imaging of treatment effects in rodent models. 

An important research focus is metabolic imaging using MR spectroscopy and CEST. Of relevance for clinical applications are the optimal sequence parameters at 3 Tesla and the diagnostic and preoperative prognostic values of these optimized measurements in glial tumors. We could implement choline metabolic imaging in the preoperative diagnostics by defining the best target for tumor biopsy and by predicting tumor malignancy. For instance, in addition to the known diagnostic significance of the metabolite choline, we demonstrated the importance of previously underestimated metabolites such as total creatine, glycine and myoinositol. 

Another research focus is on quantitative MR techniques in neuroradiology and MR perfusion. With quantitative T1 mapping we could show that T1-relaxation time prolongation is a sensitive marker of blood-brain-barrierdamage in gliomas and that the relative T1-shortening after intravenous application of contrast agent detects not only the MR visible tumor area, but also the infiltration zone. With quantitative T2 mapping we could uncover tumor progression under antiangiogenic therapy earlier than with conventional MR imaging. In its turn, MR perfusion has been shown to be a useful method to investigate the tumoral neuro-angiogenesis. 

Considering that the different MR methods measure different biological aspects and reflect the heterogeneity of the tumor regions, we focus our efforts in the development, optimization and implementation of multimodal assessment tumor protocols.

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