High-resolution metabolic mapping of gliomas via patch-based super-resolution magnetic resonance spectroscopic imaging at 7T

Objectives: To demonstrate the feasibility of 7 T magnetic resonance spectroscopic imaging (MRSI), combined with patch-based super-resolution (PBSR) reconstruction, for high-resolution multi-metabolite mapping of gliomas. Materials and methods: Ten patients with WHO grade II, III and IV gliomas (6/4, male/female; 45 +/- 9 years old) were prospectively measured between 2014 and 2018 on a 7 T whole-body MR imager after routine 3 T magnetic resonance imaging (MRI) and positron emission tomography (PET). Free induction decay MRSI with a 64 x 64matrix and a nominal voxel size of 3.4 x 3.4 x 8 mm(3 )was acquired in six minutes, along with standard T1/T2weighted MRI. Metabolic maps were obtained via spectral LCmodel processing and reconstructed to 0.9 x 0.9 x 8 mm(3 )resolutions via PBSR. Results: Metabolite maps obtained from combined 7 T MRSI and PBSR resolved the density of metabolic activity in the gliomas in unprecedented detail. Particularly in the more heterogeneous cases (e.g. post resection), metabolite maps enabled the identification of complex metabolic activities, which were in topographic agreement with PET enhancement. Conclusions: PBSR-MRSI combines the benefits of ultra-high-field MR systems, cuffing-edge MRSI, and advanced postprocessing to allow millimetric resolution molecular imaging of glioma tissue beyond standard methods. An ideal example is the accurate imaging of glutamine, which is a prime target of modern therapeutic approaches, made possible due to the higher spectral resolution of 7 T systems.