Amide proton transfer imaging for differentiation of benign and atypical meningiomas

Joo, Bio; Han, Kyunghwa; Choi, Yoon Seong; Lee, Seung Koo; Ahn, Sung Soo; Chang, Jong Hee; Kang, Seok‐Gu; Kim, Se Hoon; Zhou, Jinyuan

doi:10.1007/s00330-017-4962-1

Cited by 47 publications

(40 citation statements)

References 33 publications

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“…The mean APT of malignant tumors in head and neck was significantly higher than that of brain tissue, muscle tissue, and benign tumors . Atypical meningiomas exhibited significantly higher APT signal intensities than benign meningiomas . APTw imaging appears to be as useful as DWI and FDG‐PET/CT for the differentiation of malignant from benign lung nodules .…”

Section: Discussionmentioning

confidence: 93%

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Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study

Lin

et al. 2019

Magnetic Resonance Imaging

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Background Amide proton transfer‐weighted (APTw) imaging has shown great potential in the diagnosis of cancer, but has yet not been well studied in cervical cancer. Purpose To evaluate the image quality and clinical feasibility of APTw MRI for cervical cancer. Study Type Prospective. Population In all, 75 patients with cervical lesions and 49 healthy volunteers. Field Strength/Sequence 3.0 T, 3D turbo spin echo (TSE) APTw sequence. Assessment Three radiologists, blinded to the clinical data, independently evaluated APTw image quality with a 5‐point Likert scale on 64 patients with pathologically confirmed cervical cancer. APT values, calculated based on asymmetry of acquired Z‐spectrum with respect to water frequency, using 3D turbo spin echo volume acquisition with B0 correction, were independently measured by two radiologists, twice for each observer, on 52 cervical cancer lesions and 49 normal cervical stroma with a mean region of interest area of 638.6 mm2 and 557.5 mm2, respectively. Statistical Tests Interobserver agreement was evaluated by Kendall's W test. Intra‐ and interobserver interclass correlation coefficients (ICC) were computed. Student's t‐test was used to compare the differences of APT values between cervical cancer and normal cervix; receiver operating characteristic analysis was performed. Results Most cases revealed good APTw image quality with excellent agreement (Kendall's W = 0.850, P < 0.001). APT values of cervical cancer and normal cervical stroma were 2.745 ± 0.065 and 1.853 ± 0.059, respectively, with a significant difference (P < 0.0001). Intraobserver ICCs were 0.963 and 0.960 for two readers. Interobserver ICC was 0.993. Area under the curve (AUC) for differentiating cervical cancer from normal cervical stroma was 0.927. The feasible threshold value for AUC was determined as 2.221 with sensitivity of 84.62% and specificity of 83.66%. Data Conclusion 3D TSE APTw MRI is feasible in cervical cancer. Cervical cancer showed significantly higher APT values than normal cervix. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1318–1325.

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Section: Discussionmentioning

confidence: 93%

“…10 Atypical meningiomas exhibited significantly higher APT signal intensities than benign meningiomas. 33 APTw imaging appears to be as useful as DWI and FDG-PET/CT for the differentiation of malignant from benign lung nodules. 12 The APT ratio in prostate cancer was significantly higher than that in the peripheral zone benign regions.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study

Lin

et al. 2019

Magnetic Resonance Imaging

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“…[56][57][58] The unravelling of the different CEST signals and compensation for competing relaxation effects by the presented acquisition protocol can also enable obtaining more detailed information on the origin of CEST contrast in vivo. For general recommendations regarding acquisition parameters for CEST-MRI at 3 T, we refer to the APTweighted approach of Zhou and van Zijl et al, [59][60][61] as they have collected a sizeable amount of clinical evidence up until now. Note that the saturation power of 0.7 µT used in this study generates a different CEST contrast and cannot be directly compared with APT-weighted MRI using 2 µT.…”

Section: Discussionmentioning

confidence: 99%

Relaxation‐compensated APT and rNOE CEST‐MRI of human brain tumors at 3 T

Goerke

Soehngen

Deshmane

et al. 2019

Magnetic Resonance in Med

111

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Purpose Relaxation‐compensated CEST‐MRI (i.e., the inverse metrics magnetization transfer ratio and apparent exchange‐dependent relaxation) has already been shown to provide valuable information for brain tumor diagnosis at ultrahigh magnetic field strengths. This study aims at translating the established acquisition protocol at 7 T to a clinically relevant magnetic field strength of 3 T. Methods Protein model solutions were analyzed at multiple magnetic field strengths to assess the spectral widths of the amide proton transfer and relayed nuclear Overhauser effect (rNOE) signals at 3 T. This prior knowledge of the spectral range of CEST signals enabled a reliable and stable Lorentzian‐fitting also at 3 T where distinct peaks are no longer resolved in the Z‐spectrum. In comparison to the established acquisition protocol at 7 T, also the image readout was extended to three dimensions. Results The observed spectral range of CEST signals at 3 T was approximately ±15 ppm. Final relaxation‐compensated amide proton transfer and relayed nuclear Overhauser effect contrasts were in line with previous results at 7 T. Examination of a patient with glioblastoma demonstrated the applicability of this acquisition protocol in a clinical setting. Conclusion The presented acquisition protocol allows relaxation‐compensated CEST‐MRI at 3 T with a 3D coverage of the human brain. Translation to a clinically relevant magnetic field strength of 3 T opens the door to trials with a large number of participants, thus enabling a comprehensive assessment of the clinical relevance of relaxation compensation in CEST‐MRI.

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“…Actually, the hyperintense regions on APTw images are sometimes larger than the areas of contrast enhancement on Gd-T 1 w images, but smaller than the abnormal areas designated as tumor on T 2 w, T 1 w, and FLAIR. Numerous studies from different institutions [69][70][71][72][73][74] indicate that APTw imaging may add important value to brain cancer diagnosis.…”

Section: Current Applicationsmentioning

confidence: 99%

APT‐weighted MRI: Techniques, current neuro applications, and challenging issues

Zhou

Heo

Knutsson

et al. 2019

Magnetic Resonance Imaging

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242

329

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Amide proton transfer‐weighted (APTw) imaging is a molecular MRI technique that generates image contrast based predominantly on the amide protons in mobile cellular proteins and peptides that are endogenous in tissue. This technique, the most studied type of chemical exchange saturation transfer imaging, has been used successfully for imaging of protein content and pH, the latter being possible due to the strong dependence of the amide proton exchange rate on pH. In this article we briefly review the basic principles and recent technical advances of APTw imaging, which is showing promise clinically, especially for characterizing brain tumors and distinguishing recurrent tumor from treatment effects. Early applications of this approach to stroke, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and traumatic brain injury are also illustrated. Finally, we outline the technical challenges for clinical APT‐based imaging and discuss several controversies regarding the origin of APTw imaging signals in vivo. Level of Evidence: 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:347–364.

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Amide proton transfer imaging for differentiation of benign and atypical meningiomas

Abstract: • APT imaging is useful for differentiating between atypical and benign meningiomas. • Atypical meningiomas exhibited high APT-weighted signal intensity than benign meningiomas. • The diagnostic performance of MRI improved with nMTR for predicting atypical meningiomas.

Cited by 47 publications

References 33 publications

Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study

Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study

Relaxation‐compensated APT and rNOE CEST‐MRI of human brain tumors at 3 T

APT‐weighted MRI: Techniques, current neuro applications, and challenging issues

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