Extension of T2 Hyperintense Areas in Patients with a Glioma: A Comparison Between High‐Quality 7 T MRI and Clinical Scans

ABSTRACT Gliomas are highly heterogeneous and often include a nonenhancing component that is hyperintense on T 2 weighted MRI. This can often not be distinguished from secondary gliosis and surrounding edema. We hypothesized that the extent of these T 2 hyperintense areas can more accurately be determined on high‐quality 7 T MRI scans. We investigated the extension, volume, and complexity (shape) of T 2 hyperintense areas in patients with glioma on high‐quality 7 T MRI scans compared to clinical MRI scans. T 2 hyperintense areas of 28 patients were visually compared and manually segmented on 7 T MRI and corresponding clinical (1.5 T/3 T) MRI scans, and the volume and shape markers were calculated and subsequently compared between scans. We showed extension of the T 2 hyperintense areas via the corpus callosum to the opposite hemisphere in four patients on the 7 T scans that was not visible on the clinical scan. Furthermore, we found a significantly larger volume of the T 2 hyperintense areas on the 7 T scans compared with the clinical scans (7 T scans: 28 mL [12.5–59.1]; clinical scans: 11.9 mL [11.8–56.6]; p = 0.01). We also found a higher complexity of the T 2 hyperintense areas on the 7 T scans compared with the clinical scans (convexity, solidity, concavity index and fractal dimension [ p < 0.001]). Our study suggests that high‐quality 7 T MRI scans may show more detail on the exact extension, size, and complexity of the T 2 hyperintense areas in patients with a glioma. This information could aid in more accurate planning of treatment, such as surgery and radiotherapy.