CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI
Infectious brain lesions caused by the pathogenic fungi Cryptococcus neoformans and C. gattii, also referred to as cryptococcomas, could be diagnosed incorrectly as cystic brain tumors if only based on conventional magnetic resonance (MR) images. Previous MR spectroscopy (MRS) studies showed high lo...
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doaj-0108716ede63425b9d0bea7346ef08a62021-08-28T04:45:08ZengElsevierNeuroImage: Clinical2213-15822021-01-0131102737CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRILiesbeth Vanherp0Kristof Govaerts1Matteo Riva2Jennifer Poelmans3An Coosemans4Katrien Lagrou5Willy Gsell6Greetje Vande Velde7Uwe Himmelreich8Biomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, BelgiumBiomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, BelgiumLaboratory of Tumor Immunology and Immunotherapy, Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Neurosurgery, Mont-Godinne Hospital, UCL Namur, Yvoir, BelgiumBiomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, BelgiumLaboratory of Tumor Immunology and Immunotherapy, Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, BelgiumLaboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; National Reference Centre for Mycosis, Department of Laboratory Medicine, University Hospitals Leuven, Leuven, BelgiumBiomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, BelgiumBiomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, BelgiumBiomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Corresponding author at: Biomedical MRI, Department Imaging and Pathology, KU Leuven, Herestraat 49, O&N1, box 505, 3000 Leuven, Belgium.Infectious brain lesions caused by the pathogenic fungi Cryptococcus neoformans and C. gattii, also referred to as cryptococcomas, could be diagnosed incorrectly as cystic brain tumors if only based on conventional magnetic resonance (MR) images. Previous MR spectroscopy (MRS) studies showed high local concentrations of the fungal disaccharide trehalose in cryptococcomas. The aim of this study was to detect and localize fungal brain lesions caused by Cryptococcus species based on Chemical Exchange Saturation Transfer (CEST) MR imaging of endogenous trehalose, and hereby to distinguish cryptococcomas from gliomas. In phantoms, trehalose and cryptococcal cells generated a concentration-dependent CEST contrast in the 0.2 – 2 ppm chemical shift range, similar to glucose, but approximately twice as strong. In vivo single voxel MRS of a murine cryptococcoma model confirmed the presence of trehalose in cryptococcomas, but mainly for lesions that were large enough compared to the size of the MRS voxel. With CEST MRI, combining the more specific CEST signal at 0.7 ppm with the higher signal-to-noise ratio signal at 4 ppm in the CryptoCEST contrast enabled localization and distinction of cryptococcomas from the normal brain and from gliomas, even for lesions smaller than 1 mm3. Thanks to the high endogenous concentration of the fungal biomarker trehalose in cryptococcal cells, the CryptoCEST contrast allowed identification of cryptococcomas with high spatial resolution and differentiation from gliomas in mice. Furthermore, the CryptoCEST contrast was tested to follow up antifungal treatment of cryptococcomas. Translation of this non-invasive method to the clinic holds potential for improving the differential diagnosis and follow-up of cryptococcal infections in the brain.http://www.sciencedirect.com/science/article/pii/S2213158221001819CEST MR imagingMR spectroscopyFungal infectionCryptococcosisTrehaloseBiomarker |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Liesbeth Vanherp Kristof Govaerts Matteo Riva Jennifer Poelmans An Coosemans Katrien Lagrou Willy Gsell Greetje Vande Velde Uwe Himmelreich |
spellingShingle |
Liesbeth Vanherp Kristof Govaerts Matteo Riva Jennifer Poelmans An Coosemans Katrien Lagrou Willy Gsell Greetje Vande Velde Uwe Himmelreich CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI NeuroImage: Clinical CEST MR imaging MR spectroscopy Fungal infection Cryptococcosis Trehalose Biomarker |
author_facet |
Liesbeth Vanherp Kristof Govaerts Matteo Riva Jennifer Poelmans An Coosemans Katrien Lagrou Willy Gsell Greetje Vande Velde Uwe Himmelreich |
author_sort |
Liesbeth Vanherp |
title |
CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI |
title_short |
CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI |
title_full |
CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI |
title_fullStr |
CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI |
title_full_unstemmed |
CryptoCEST: A promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with MRI |
title_sort |
cryptocest: a promising tool for spatially resolved identification of fungal brain lesions and their differentiation from brain tumors with mri |
publisher |
Elsevier |
series |
NeuroImage: Clinical |
issn |
2213-1582 |
publishDate |
2021-01-01 |
description |
Infectious brain lesions caused by the pathogenic fungi Cryptococcus neoformans and C. gattii, also referred to as cryptococcomas, could be diagnosed incorrectly as cystic brain tumors if only based on conventional magnetic resonance (MR) images. Previous MR spectroscopy (MRS) studies showed high local concentrations of the fungal disaccharide trehalose in cryptococcomas. The aim of this study was to detect and localize fungal brain lesions caused by Cryptococcus species based on Chemical Exchange Saturation Transfer (CEST) MR imaging of endogenous trehalose, and hereby to distinguish cryptococcomas from gliomas. In phantoms, trehalose and cryptococcal cells generated a concentration-dependent CEST contrast in the 0.2 – 2 ppm chemical shift range, similar to glucose, but approximately twice as strong. In vivo single voxel MRS of a murine cryptococcoma model confirmed the presence of trehalose in cryptococcomas, but mainly for lesions that were large enough compared to the size of the MRS voxel. With CEST MRI, combining the more specific CEST signal at 0.7 ppm with the higher signal-to-noise ratio signal at 4 ppm in the CryptoCEST contrast enabled localization and distinction of cryptococcomas from the normal brain and from gliomas, even for lesions smaller than 1 mm3. Thanks to the high endogenous concentration of the fungal biomarker trehalose in cryptococcal cells, the CryptoCEST contrast allowed identification of cryptococcomas with high spatial resolution and differentiation from gliomas in mice. Furthermore, the CryptoCEST contrast was tested to follow up antifungal treatment of cryptococcomas. Translation of this non-invasive method to the clinic holds potential for improving the differential diagnosis and follow-up of cryptococcal infections in the brain. |
topic |
CEST MR imaging MR spectroscopy Fungal infection Cryptococcosis Trehalose Biomarker |
url |
http://www.sciencedirect.com/science/article/pii/S2213158221001819 |
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