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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Resting-state fMRI uncovers differences in functional connectivity within tumour and peritumoral areas in patients with glioblastoma and brain metastasis

Ruhezustand fMRI deckt Unterschiede in der funktionellen Konnektivität zwischen tumoralen und peritumoralen Bereichen bei Patienten mit Glioblastomen und Gehirnmetastasen auf

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  • presenting/speaker Kerstin Jütten - Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Julius Maximilian Kernbach - Universitätsklinikum RWTH Aachen, Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), Aachen, Deutschland; Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Jonas Ort - Universitätsklinikum RWTH Aachen, Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), Aachen, Deutschland; Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Karlijn Hakvoort - Universitätsklinikum RWTH Aachen, Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), Aachen, Deutschland; Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Hans Clusmann - Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen,Bonn,Cologne,Düsseldorf, Deutschland; Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Daniel Delev - Universitätsklinikum RWTH Aachen, Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), Aachen, Deutschland; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen,Bonn,Cologne,Düsseldorf, Deutschland; Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV250

doi: 10.3205/22dgnc242, urn:nbn:de:0183-22dgnc2429

Published: May 25, 2022

© 2022 Jütten et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The recently discovered neuron-to-glioma and paracrine neuron-to-metastasis communications suggest that a tumor lesion may induce alterations in resting-state functional connectivity (FC). Since a proper distinction of healthy and infiltrated tissue remains elusive and glioma is increasingly recognized as a systemic brain disorder, differences within FC may help to define the tumor burden more precisely. Our aim was to investigate the functional link between tumor lesion and the remaining brain in both patients with glioblastoma and brain metastasis.

Methods: Preliminary analyses included 16 treatment-naîve patients, eight glioblastoma patients (mean age: 65±4 years) and eight patients with metastases (mean age: 58±4 years), who underwent resting-state fMRI. Tumor lesions were segmented, and a peritumoral mask was created by dilating the tumor mask by 10mm and subtracting the tumor area. While controlling for tumor volume, tumor to whole-brain FC, tumor to peritumoral FC, and peritumoral to whole-brain FC were determined and differences between patient groups were analyzed.

Results: Tumoral and peritumoral volume was comparable in both patient groups (p>.05). Tumor to peritumoral FC was significantly lower compared to both tumor to whole-brain and peritumoral to whole-brain FC. Furthermore, tumor to whole-brain FC was lower in glioblastoma patients as compared to patients with metastases (MedianGBM=.60, MedianMET=.63). Regarding tumor to peritumoral FC, not only did glioblastoma patients reveal lower median values, within-group FC varied more than in patients with metastases (MedianGBM=.25, SDGBM=.26; MedianMET=.29, SDMET=.18), implying differences in their infiltrative growth patterns. In contrast, both patient groups revealed equally high peritumoral to whole-brain FC (both Median=.60).

Conclusion: Resting-state fMRI suggested differences in the functional coupling of tumor and adjacent as well as distant non-lesioned brain regions between patients with glioblastomas and metastases. The peritumoral area was functionally connected to non-lesional regions rather than to the tumor itself, underlining the importance of looking beyond the tumor margin particularly with regard to neurosurgical resection. Larger patient studies may allow to not only identify biological and histological markers responsible for the FC diversity within and between different tumor entities, but may also help to improve individualized treatment.