Ultra-High-Field MRI in the Diagnosis and Management of Gliomas: A Systematic Review

Annabelle Shaffer; Susanna S Kwok; Anant Naik; Aaron T Anderson; Fan Lam; Tracey Wszalek; Paul M Arnold; Wael Hassaneen

doi:10.3389/fneur.2022.857825

Ultra-High-Field MRI in the Diagnosis and Management of Gliomas: A Systematic Review

Front Neurol. 2022 Apr 5:13:857825. doi: 10.3389/fneur.2022.857825. eCollection 2022.

Authors

Annabelle Shaffer¹, Susanna S Kwok¹, Anant Naik¹, Aaron T Anderson^{2

3}, Fan Lam^{2

4

5}, Tracey Wszalek^{2

3}, Paul M Arnold^{1

6}, Wael Hassaneen^{1

6}

Affiliations

¹ Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
² Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
³ Carle Illinois Advanced Imaging Center, University of Illinois and Carle Health, Urbana, IL, United States.
⁴ Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
⁵ Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
⁶ Carle Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, United States.

Abstract

Importance: Gliomas, tumors of the central nervous system, are classically diagnosed through invasive surgical biopsy and subsequent histopathological study. Innovations in ultra-high field (UHF) imaging, namely 7-Tesla magnetic resonance imaging (7T MRI) are advancing preoperative tumor grading, visualization of intratumoral structures, and appreciation of small brain structures and lesions.

Objective: Summarize current innovative uses of UHF imaging techniques in glioma diagnostics and treatment.

Methods: A systematic review in accordance with PRISMA guidelines was performed utilizing PubMed. Case reports and series, observational clinical trials, and randomized clinical trials written in English were included. After removing unrelated studies and those with non-human subjects, only those related to 7T MRI were independently reviewed and summarized for data extraction. Some preclinical animal models are briefly described to demonstrate future usages of ultra-high-field imaging.

Results: We reviewed 46 studies (43 human and 3 animal models) which reported clinical usages of UHF MRI in the diagnosis and management of gliomas. Current literature generally supports greater resolution imaging from 7T compared to 1.5T or 3T MRI, improving visualization of cerebral microbleeds and white and gray matter, and providing more precise localization for radiotherapy targeting. Additionally, studies found that diffusion or susceptibility-weighted imaging techniques applied to 7T MRI, may be used to predict tumor grade, reveal intratumoral structures such as neovasculature and microstructures like axons, and indicate isocitrate dehydrogenase 1 mutation status in preoperative imaging. Similarly, newer imaging techniques such as magnetic resonance spectroscopy and chemical exchange saturation transfer imaging can be performed on 7T MRI to predict tumor grading and treatment efficacy. Geometrical distortion, a known challenge of 7T MRI, was at a tolerable level in all included studies.

Conclusion: UHF imaging has the potential to preoperatively and non-invasively grade gliomas, provide precise therapy target areas, and visualize lesions not seen on conventional MRI.

Keywords: 3-Tesla MRI; 7-Tesla MRI; brain tumors; glioblastoma; gliomas; ultra-high field MRI; ultra-high field imaging.

Publication types

Systematic Review