31P MRSI in Pediatric Low Grade Gliomas During Treatment at 7T

Motivation: Treatment monitoring in pediatric brain tumors is often challenging. Non-invasive tools are needed to assess tumor activity accurately. Goal(s): To monitor changes in phospholipid metabolism (i.e., phosphomonoesters/phosphodiesters [PME/PDE]) in pediatric low grade gliomas. Approach: Eleven pediatric brain tumor patients underwent 31P-MRSI at 7T. PME/PDE in the tumor was compared to a normal-appearing brain voxel. Clinical outcomes were assessed, and results were compared between treatment and wait-and-scan groups. Results: Tumors selected for treatment showed higher PME/PDE ratios at baseline, hinting at potential aggressiveness. These ratios decreased during treatment but remained stable in the wait-and-scan group. Impact: Treatment monitoring in pediatric brain tumors is often challenging. Using 31P-MRSI we showed that tumors selected for treatment exhibited higher PME/PDE, signifying potential tumor aggressiveness. PME/PDE levels decreased during treatment, indicating potential for non-invasive assessment of treatment effects.