Katharina Johanna Wenger-Alakmeh, Marlies Wagner, Patrick Nikolaus Harter, Kea Franz, Jörg Bojunga, Emmanouil Fokas, Detlef Imhoff, Claus Rödel, Johannes Rieger, Elke Hattingen, Joachim Peter Steinbach, Ulrich Pilatus, Martin Vos
- Background: The ERGO2 (Ernaehrungsumstellung bei Patienten mit Rezidiv eines Glioblastoms) MR-spectroscopic imaging (MRSI) subtrial investigated metabolism in patients randomized to calorically restricted ketogenic diet/intermittent fasting (crKD-IF) versus standard diet (SD) in addition to re-irradiation (RT) for recurrent malignant glioma. Intracerebral concentrations of ketone bodies (KB), intracellular pH (pHi), and adenosine triphosphate (ATP) were non-invasively determined. Methods: 50 patients were randomized (1:1): Group A keeping a crKD-IF for nine days, and Group B a SD. RT was performed on day 4-8. Twenty-three patients received an extended MRSI-protocol (1H decoupled 31P MRSI with 3D chemical shift imaging (CSI) and 2D 1H point-resolved spectroscopy (PRESS)) at a 3T scanner at baseline and on day 6. Voxels were selected from the area of recurrent tumor and contralateral hemisphere. Spectra were analyzed with LCModel, adding simulated signals of 3-hydroxybutyrate (βOHB), acetone (Acn) and acetoacetate (AcAc) to the standard basis set. Results: Acn was the only reliably MRSI-detectable KB within tumor tissue and/or normal appearing white matter (NAWM). It was detected in 4/11 patients in Group A and in 0/8 patients in Group B. MRSI results showed no significant depletion of ATP in tumor tissue of patients at day 6 during crKD-IF, even though there were a significant difference in ketone serum levels between Group A and B at day 6 and a decline in fasting glucose in Group A from baseline to day 6. The tumor specific alkaline pHi was maintained. Conclusions: Our metabolic findings suggest that tumor cells maintain energy homeostasis even with reduced serum glucose levels and may generate additional ATP through other sources.r sources.
MetadatenVerfasserangaben: | Katharina Johanna Wenger-AlakmehORCiDGND, Marlies WagnerORCiDGND, Patrick Nikolaus HarterORCiDGND, Kea Franz, Jörg BojungaGND, Emmanouil FokasORCiDGND, Detlef Imhoff, Claus RödelORCiDGND, Johannes RiegerGND, Elke HattingenORCiDGND, Joachim Peter SteinbachORCiDGND, Ulrich PilatusORCiD, Martin VosORCiD |
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URN: | urn:nbn:de:hebis:30:3-575627 |
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DOI: | https://doi.org/10.3390/cancers12123549 |
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ISSN: | 2072-6694 |
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Pubmed-Id: | https://pubmed.ncbi.nlm.nih.gov/33261052 |
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Titel des übergeordneten Werkes (Englisch): | Cancers |
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Verlag: | MDPI |
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Verlagsort: | Basel |
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Dokumentart: | Wissenschaftlicher Artikel |
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Sprache: | Englisch |
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Datum der Veröffentlichung (online): | 27.11.2020 |
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Datum der Erstveröffentlichung: | 27.11.2020 |
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Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Datum der Freischaltung: | 22.12.2020 |
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Freies Schlagwort / Tag: | ATP; MR-spectroscopy; diet; fasting; glioblastoma; ketogenic; ketone body |
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Jahrgang: | 12 |
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Ausgabe / Heft: | Article 3549 |
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Seitenzahl: | 16 |
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HeBIS-PPN: | 477016928 |
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Institute: | Medizin / Medizin |
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DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Lizenz (Deutsch): | Creative Commons - Namensnennung 4.0 |
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