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September 17, 2025

7T MRSI ratios can predict the presence of 5-ALA fluorescence in gliomas comparable to T1w-CE and PET

Key Points

The study found that 7T MRSI ratios can effectively predict 5-ALA fluorescence in gliomas, improving clinical decision-making.
ROC curves showed that Gln/tCr, Gly/tCr, Ser/tCr, and GSH/tCr ratios have predictive power comparable to CE MRI and PET.
Retrospective evaluation involved 30 glioma patients, analyzing the predictive ability of various imaging modalities for 5-ALA fluorescence.
The results advocate for 7T MRSI integration in therapy planning, highlighting its importance in glioma management.

Abstract

Motivation: The role of MRSI in predicting 5-ALA fluorescence in gliomas has not yet been explored. Goal(s): Our goal was to test if 7T MRSI is able to predict the presence of 5-ALA fluorescence and to compare it to CE MRI and PET. Approach: We retrospectively evaluated 5-ALA fluorescence, 7T MRSI ratio levels, PET TNRs and T1w-CE in 30 glioma patients. Further, we tested their abilities to predict 5-ALA fluorescence using ROC curves. Results: ROC curves indicate that Gln/tCr, Gly/tCr, Ser/tCr and GSH/tCr have the potential to predict 5-ALA fluorescence, with performance comparable to CE and PET. Impact: Our results show that 7T MRSI is a powerful tool for predicting 5-ALA fluorescence in gliomas and can be useful in therapy planning. It would be valuable to investigate the spatial correlation between 7T MRSI and areas of 5-ALA fluorescence.

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