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...

Full description

Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: MDPI AG 2022-02-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/2/490
_version_ 1827655652334370816
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.
first_indexed 2024-03-09T22:10:39Z
format Article
id doaj.art-ae144aab5fe942598601ae51451aabd5
institution Directory Open Access Journal
issn 2075-4418
language English
last_indexed 2024-03-09T22:10:39Z
publishDate 2022-02-01
publisher MDPI AG
record_format Article
series Diagnostics
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
work_keys_str_mv AT juliaplingl thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT arthurwunderlich thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT steffengoerke thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT danielpaech thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT markeladd thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT patrickliebig thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT andrejpala thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT soungyungkim thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT michaelbraun thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT berndlschmitz thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT meinradbeer thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT johannesrosskopf thevalueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT juliaplingl valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT arthurwunderlich valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT steffengoerke valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT danielpaech valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT markeladd valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT patrickliebig valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT andrejpala valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT soungyungkim valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT michaelbraun valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT berndlschmitz valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT meinradbeer valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t
AT johannesrosskopf valueofaptwcestmriinroutineclinicalassessmentofhumanbraintumorpatientsat3t