The use of multiparametric brain tumor segmentation for investigating 1H MRSI-detected, fasting-induced ketone body accumulation in glioma

Motivation: The evaluation of MR spectroscopy imaging findings with multiparametric brain tumor segmentation might facilitate the understanding of altered tumor metabolism induced by intervention on an individual patient/tumor level. Goal(s): In this study, we used this approach to elucidate the glioma metabolism under nutritional intervention. Approach: The concentrations of ketone bodies in brain tumor after 72-hour-fasting were correlated with the volume of glioma sub-regions for 13 brain tumor patients. Results: The outcome indicates that the accumulation of ketone bodies in solid tumors and necrotic areas after fasting might be a result of neovascularization and the blood-brain barrier compromise. Impact: Here, we report on the validation of a dedicated, multi-voxel MRSI protocol with fully automated multiparametric segmentation of glioma sub-regions for monitoring fasting-induced changes.