The Value of CEST MRI of Peritumoral Regions in Post-Therapy Malignant Glioma Assessment

Motivation: Monitoring post-chemoradiotherapy malignant gliomas is a persistent challenge in neuro-oncology. The peritumoral region, closely related to tumor recurrence, has been infrequently examined in the imaging pattens and the potential mechanism. Goal(s): Our objective was to explore whether CEST MRI could distinguish tumor recurrence from treatment effects and uncover potential mechanisms behind high-grade gliomas' invasive behavior. Approach: We investigated the CEST effects at 3.5ppm and 2.0ppm, as well as T1 and T2 values from the peritumoral regions of malignant gliomas with histogram analysis. Results: Significant higher CEST effects across chemical shift offsets were presented in peritumoral regions in recurrent tumor compared with treatment effects. Impact: The different progressive patterns in peritumoral regions between treatment effects and tumor recurrence are assessable by CEST MRI. It provides a potential imaging maker matrix to unveil the mechanism of invasive behavior of malignant gliomas.