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The value of APTw CEST MRI in routine clinical assessment of human brain tumor patients at 3T

Background. With fast-growing evidence in literature for clinical applications of chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI), this prospective study aimed at applying amide proton transfer-weighted (APTw) CEST imaging in a clinical setting to assess its diagnostic...

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Main Authors: Lingl, Julia (Author) , Wunderlich, Arthur (Author) , Görke, Steffen (Author) , Paech, Daniel (Author) , Ladd, Mark E. (Author) , Liebig, Patrick (Author) , Pala, Andrej (Author) , Kim, Soung Yung (Author) , Braun, Michael (Author) , Schmitz, Bernd (Author) , Beer, Meinrad (Author) , Rosskopf, Johannes (Author)
Format: Article (Journal)
Language:English
Published: 14 February 2022
In: Diagnostics
Year: 2022, Volume: 12, Issue: 2, Pages: 1-11
ISSN:2075-4418
DOI:10.3390/diagnostics12020490
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/diagnostics12020490
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2075-4418/12/2/490
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Author Notes:Julia P. Lingl, Arthur Wunderlich, Steffen Goerke, Daniel Paech, Mark E. Ladd, Patrick Liebig, Andrej Pala, Soung Yung Kim, Michael Braun, Bernd L. Schmitz, Meinrad Beer and Johannes Rosskopf
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Summary:Background. With fast-growing evidence in literature for clinical applications of chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI), this prospective study aimed at applying amide proton transfer-weighted (APTw) CEST imaging in a clinical setting to assess its diagnostic potential in differentiation of intracranial tumors at 3 tesla (T). Methods. Using the asymmetry magnetization transfer ratio (MTRasym) analysis, CEST signals were quantitatively investigated in the tumor areas and in a similar sized region of the normal-appearing white matter (NAWM) on the contralateral hemisphere of 27 patients with intracranial tumors. Area under curve (AUC) analyses were used and results were compared to perfusion-weighted imaging (PWI). Results. Using APTw CEST, contrast-enhancing tumor areas showed significantly higher APTw CEST metrics than contralateral NAWM (AUC = 0.82; p < 0.01). In subgroup analyses of each tumor entity vs. NAWM, statistically significant effects were yielded for glioblastomas (AUC = 0.96; p < 0.01) and for meningiomas (AUC = 1.0; p < 0.01) but not for lymphomas as well as metastases (p > 0.05). PWI showed results comparable to APTw CEST in glioblastoma (p < 0.01). Conclusions. This prospective study confirmed the high diagnostic potential of APTw CEST imaging in a routine clinical setting to differentiate brain tumors.
Item Description:Gesehen am 05.05.2022
Physical Description:Online Resource
ISSN:2075-4418
DOI:10.3390/diagnostics12020490

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