Physiologic MR imaging of the tumor microenvironment revealed switching of metabolic phenotype upon recurrence of glioblastoma in humans

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Andreas Stadlbauer - , Friedrich-Alexander University Erlangen-Nürnberg, St. Pölten University Hospital (Author)
  • Stefan Oberndorfer - , St. Pölten University Hospital (Author)
  • Max Zimmermann - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Bertold Renner - , Institute of Clinical Pharmacology, Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Michael Buchfelder - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Gertraud Heinz - , St. Pölten University Hospital (Author)
  • Arnd Doerfler - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Andrea Kleindienst - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Karl Roessler - , Friedrich-Alexander University Erlangen-Nürnberg (Author)

Abstract

Treating recurrent glioblastoma (GB) is one of the challenges in modern neurooncology. Hypoxia, neovascularization, and energy metabolism are of crucial importance for therapy failure and recurrence. Twenty-one patients with initially untreated GB who developed recurrence were examined with a novel MRI approach for noninvasive visualization of the tumor microenvironment (TME). Imaging biomarker information about oxygen metabolism (mitochondrial oxygen tension) and neovascularization (microvascular density and type) were fused for classification of five different TME compartments: necrosis, hypoxia with/without neovascularization, oxidative phosphorylation, and glycolysis. Volume percentages of these TME compartments were compared between untreated and recurrent GB. At initial diagnosis, all 21 GB showed either the features of a glycolytic dominant phenotype with a high percentage of functional neovasculature (N = 12) or those of a necrotic/hypoxic dominant phenotype with a high percentage of defective tumor neovasculature (N = 9). At recurrence, all 21 GB revealed switching of the initial metabolic phenotype: either from the glycolytic to the necrotic/hypoxic dominant phenotype or vice-versa. A necrotic/hypoxic phenotype at recurrence was associated with a higher rate of multifocality of the recurrent lesions. Our MRI approach may be helpful for a better understanding of treatment-induced metabolic phenotype switching and for future studies developing targeted therapeutic strategies for recurrent GB.

Details

Original languageEnglish
Pages (from-to)528-538
Number of pages11
JournalJournal of cerebral blood flow and metabolism
Volume40
Issue number3
Publication statusPublished - 1 Mar 2020
Peer-reviewedYes

External IDs

PubMed 30732550
ORCID /0000-0003-0845-6793/work/139025267

Keywords

Keywords

  • angiogenesis, Glioblastoma, hypoxia, recurrence, treatment failure, tumor microenvironment