Physiological MRI Biomarkers in the Differentiation Between Glioblastomas and Solitary Brain Metastases

Elisabeth Heynold, Max Zimmermann, Nirjhar Hore, Michael Buchfelder, Arnd Doerfler, Andreas Stadlbauer, Natalia Kremenevski

Research output: Journal article (peer-reviewed)Journal article

9 Citations (Scopus)


PURPOSE: Glioblastomas (GB) and solitary brain metastases (BM) are the most common brain tumors in adults. GB and BM may appear similar in conventional magnetic resonance imaging (cMRI). Their management strategies, however, are quite different with significant consequences on clinical outcome. The aim of this study was to evaluate the usefulness of a previously presented physiological MRI approach scoping to obtain quantitative information about microvascular architecture and perfusion, neovascularization activity, and oxygen metabolism to differentiate GB from BM.

PROCEDURES: Thirty-three consecutive patients with newly diagnosed, untreated, and histopathologically confirmed GB or BM were preoperatively examined with our physiological MRI approach as part of the cMRI protocol.

RESULTS: Physiological MRI biomarker maps revealed several significant differences in the pathophysiology of GB and BM: Central necrosis was more hypoxic in GB than in BM (30 %; P = 0.036), which was associated with higher neovascularization activity (65 %; P = 0.043) and metabolic rate of oxygen (48 %; P = 0.004) in the adjacent contrast-enhancing viable tumor parts of GB. In peritumoral edema, GB infiltration caused neovascularization activity (93 %; P = 0.018) and higher microvascular perfusion (30 %; P = 0.022) associated with higher tissue oxygen tension (33 %; P = 0.020) and lower oxygen extraction from vasculature (32 %; P = 0.040).

CONCLUSION: Our physiological MRI approach, which requires only 7 min of extra data acquisition time, might be helpful to noninvasively distinguish GB and BM based on pathophysiological differences. However, further studies including more patients are required.

Original languageEnglish
Pages (from-to)787-795
Number of pages9
JournalMolecular Imaging and Biology
Issue number5
Publication statusPublished - Oct 2021


  • Aged
  • Aged, 80 and over
  • Brain Neoplasms/diagnostic imaging
  • Cell Hypoxia/physiology
  • Diagnosis, Differential
  • Female
  • Glioblastoma/diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging/methods
  • Male
  • Middle Aged
  • Neovascularization, Pathologic/diagnostic imaging
  • Retrospective Studies


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