Physio-Metabolic MRI–derived tumor microenvironment mapping for differentiating glioblastomas from large brain metastases

Motivation: Distinguishing glioblastoma (GBM) from solitary large brain metastases (LBM) is pivotal for tailoring therapeutic strategy and optimizing clinical outcome. Goal(s): To differentiate GBM from LBM employing MRI-derived tumor microenvironment (TME) mapping. Approach: Patients with solitary brain tumors who underwent physio-metabolic MRI were included. Physio-metabolic MRI parameters were compared and integrated to classify tumor into five TME types. Results: GBM showed lower hypoxia, higher aerobic glycolysis, and vital tumor percentage than LBM. GBM displayed lower OEF, higher PO2 and MVD value in enhancing area. Vital tumor percentage and PO2 in enhancing region respectively performed best for differentiation GBM from LBM. Impact: The physio-metabolic MRI-derived biomarkers of oxygen metabolism and neovascularization offer valuable insights into the heterogeneity of TME, enabling more precise and personalized identification of solitary brain tumors. This approach paves the way for developing novel, tailored therapeutic strategies forthose patients.