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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MDPI AG
2022-02-01
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Online Access: | https://www.mdpi.com/2075-4418/12/2/490 |
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author | 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 Johannes Rosskopf |
author_facet | 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 Johannes Rosskopf |
author_sort | Julia P. Lingl |
collection | DOAJ |
description | 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; <i>p</i> < 0.01). In subgroup analyses of each tumor entity vs. NAWM, statistically significant effects were yielded for glioblastomas (AUC = 0.96; <i>p</i> < 0.01) and for meningiomas (AUC = 1.0; <i>p</i> < 0.01) but not for lymphomas as well as metastases (<i>p</i> > 0.05). PWI showed results comparable to APTw CEST in glioblastoma (<i>p</i> < 0.01). Conclusions. This prospective study confirmed the high diagnostic potential of APTw CEST imaging in a routine clinical setting to differentiate brain tumors. |
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last_indexed | 2024-03-09T22:10:39Z |
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spelling | doaj.art-ae144aab5fe942598601ae51451aabd52023-11-23T19:33:02ZengMDPI AGDiagnostics2075-44182022-02-0112249010.3390/diagnostics12020490The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3TJulia P. Lingl0Arthur Wunderlich1Steffen Goerke2Daniel Paech3Mark E. Ladd4Patrick Liebig5Andrej Pala6Soung Yung Kim7Michael Braun8Bernd L. Schmitz9Meinrad Beer10Johannes Rosskopf11Department of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyGerman Cancer Research Center (DKFZ), Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, GermanyGerman Cancer Research Center (DKFZ), Division of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, GermanyGerman Cancer Research Center (DKFZ), Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, GermanySiemens Healthcare GmbH, Henkestraße 127, 91052 Erlangen, GermanyDepartment of Neurosurgery, Bezirkskrankenhaus Guenzburg, Lindenallee 2, 89312 Guenzburg, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyDepartment of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, GermanyBackground. 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; <i>p</i> < 0.01). In subgroup analyses of each tumor entity vs. NAWM, statistically significant effects were yielded for glioblastomas (AUC = 0.96; <i>p</i> < 0.01) and for meningiomas (AUC = 1.0; <i>p</i> < 0.01) but not for lymphomas as well as metastases (<i>p</i> > 0.05). PWI showed results comparable to APTw CEST in glioblastoma (<i>p</i> < 0.01). Conclusions. This prospective study confirmed the high diagnostic potential of APTw CEST imaging in a routine clinical setting to differentiate brain tumors.https://www.mdpi.com/2075-4418/12/2/490CESTAPTwbrain tumorMRI |
spellingShingle | 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 Johannes Rosskopf The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T Diagnostics CEST APTw brain tumor MRI |
title | The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T |
title_full | The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T |
title_fullStr | The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T |
title_full_unstemmed | The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T |
title_short | The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T |
title_sort | value of aptw cest mri in routine clinical assessment of human brain tumor patients at 3t |
topic | CEST APTw brain tumor MRI |
url | https://www.mdpi.com/2075-4418/12/2/490 |
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