Non-invasive characterization of intracranial tumors by magnetic resonance elastography

Presurgical, non-invasive methods of differentiating brain tumors have remained unsatisfactory even for specialized academic hospitals. Despite major advances in clinical and neuroradiological diagnostic techniques, the majority of neurooncology patients still need to undergo a brain biopsy for diagnosis. Recent single cell experiments suggested that biomechanical cell properties might be very sensitive in detecting cellular malignancy. Accordingly, we investigated magnetic resonance elastography (MRE) as an investigative tool for the clinical routine diagnostic work-up of intracranial neoplasm. In order to obtain sufficient spatial resolution for the biomechanical characterization of intracranial tumors, we modified a recently introduced least-squares solution of the stationary wave equation, facilitating stable solutions of the magnitude |G*| and the phase angle α of the complex shear modulus G*. MRE was added to a routine diagnostic or presurgical neuroradiological magnetic resonance imaging work-up in 16 prospective patients and it was well tolerated in all cases. Our preliminary tumor MRE data revealed alterations in viscoelastic constants, e.g. a loss of stiffness in malignancies compared to healthy reference tissue, or benign variants. Based on larger studies on selected tumor entities to establish threshold and reference values for future diagnostic purposes, MRE may thus provide a predictive marker for tumor malignancy and thereby contribute to an early non-invasive clinical assessment of suspicious cerebral lesions.