Exploring intracellular environment in low-grade gliomas by diffusion-weighted MRS and APTw imaging at 3T

Motivation: Characterization of advanced biomarkers of glioma intracellular environment will benefit understanding of disease pathophysiology. Goal(s): To measure metabolite diffusion and protein accumulation in gliomas and explore their interdependence. Approach: We combined diffusion-weighted MRS and amide proton transfer weighted (APTw) imaging at 3T in a cohort of 33 patients with an IDH-mutated glioma. Results: Diffusion of the glial metabolites tCho and tCr, as well as amide concentration, were significantly higher in glioma than contralateral tissue. Diffusion of tNAA was decreased in astrocytomas compared to contralateral tissue. Metabolite diffusion was not significantly influenced by increased protein accumulation. Impact: Developing noninvasive biomarkers that are specific to the intracellular environment may help improving our understanding of glioma pathophysiology and mechanisms of progression, which ultimately will benefit diagnostic precision and adoption of optimal therapeutic strategies.