Relaxation-compensated amide proton transfer (APT) MRI signal intensity is associated with survival and progression in high-grade glioma patients

Paech, Daniel; Dreher, Constantin; Regnery, Sebastian; Meißner, Jan; Goerke, Steffen; Windschuh, Johannes; Oberhollenzer, Johanna; Schultheiss, Miriam N; Deike-Hofmann, Katerina; Bickelhaupt, Sebastian; Radbruch, Alexander; Zaiß, Moritz; Unterberg, Andreas; Wick, Wolfgang; Bendszus, Martin; Bachert, Peter; Ladd, Mark E.; Schlemmer, Heinz–Peter

doi:10.1007/s00330-019-06066-2

Cited by 72 publications

(63 citation statements)

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“…However, the existing acquisition protocols for APT imaging of the human brain cannot be directly translated to examinations of the human breast due to the presence of adipose tissue. The ubiquitous fat signal leads to an incorrect normalization of the Z ‐spectrum, and therefore to an intrinsic dependence of all CEST signals on the fat content in each voxel.…”

Section: Introductionmentioning

confidence: 99%

A novel normalization for amide proton transfer CEST MRI to correct for fat signal–induced artifacts: application to human breast cancer imaging

Zimmermann

Korzowski

Breitling

et al. 2019

Magnetic Resonance in Med

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Purpose: The application of amide proton transfer (APT) CEST MRI for diagnosis of breast cancer is of emerging interest. However, APT imaging in the human breast is affected by the ubiquitous fat signal preventing a straightforward application of existing acquisition protocols. Although the spectral region of the APT signal does not coincide with fat resonances, the fat signal leads to an incorrect normalization of the Z-spectrum, and therefore to distorted APT effects. In this study, we propose a novel normalization for APT-CEST MRI that corrects for fat signal-induced artifacts in the postprocessing without the need for application of fat saturation schemes or water-fat separation approaches. Methods: The novel normalization uses the residual signal at the spectral position of the direct water saturation to estimate the fat contribution. A comprehensive theoretical description of the normalization for an arbitrary phase relation of the water and fat signal is provided. Functionality and applicability of the proposed normalization was demonstrated by in vitro and in vivo experiments. Results: In vitro, an underestimation of the conventional APT contrast of approximately −1.2% per 1% fat fraction was observed. The novel normalization yielded an APT contrast independent of the fat contribution, which was also independent of the | 921 ZIMMERMANN Et Al.

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Section: Introductionmentioning

confidence: 99%

A novel normalization for amide proton transfer CEST MRI to correct for fat signal–induced artifacts: application to human breast cancer imaging

Zimmermann

Korzowski

Breitling

et al. 2019

Magnetic Resonance in Med

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“…Our analyses of univariate Cox regression indicated that, except for the VSI values and IDH mutation status, several clinical features were correlated with LGG patient outcomes, including older age, postoperative adjuvant chemoradiotherapy, and multiple lesions or lobes, and a large number of studies support our findings. [24][25][26] For multivariate Cox regression, we established four models based on different risk factors obtained from the results of univariate analysis. Each model contains three factors at most, due to the limit on the number of our cases.…”

Section: It Is Well Known That Patients With Idh-mutantmentioning

confidence: 99%

<p>Vessel Size Imaging is Associated with IDH Mutation and Patient Survival in Diffuse Lower-Grade Glioma</p>

Kang¹,

Chen²,

Guo³

et al. 2020

CMAR

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Background: Patients with isocitrate dehydrogenase (IDH) mutant gliomas have better survival and appear to be more sensitive to chemotherapy than their IDH wild-type counterparts. We attempted to assess the correlations of vessel size imaging (VSI) values with IDH mutation status and patient survival in diffuse lower-grade glioma (LGG). Methods: We enrolled 60 patients with diffuse LGGs, among which 43 had IDH-mutant tumors. All patients underwent VSI examination and VSI values for active tumors were calculated. Receiver operating characteristic (ROC) curves were established to evaluate the detection efficiency. Logistic regression was employed to determine the ability of variables to discriminate IDH mutational status. Kaplan-Meier survival analysis and Cox proportional hazards models were utilized to estimate the correlations of VSI values and other risk factors with patient survival. Results: We observed that VSI values were lower in IDH-mutant LGGs than IDH wild-type LGGs. The VSImax and VSImean values had AUC values of 0.7305 and 0.7401, respectively, in distinguishing IDH-mutant LGGs from IDH wild-type LGGs. Logistic regression showed that VSImean values, age and tumor location were associated with IDH-mutant status, and the formula integrating the three factors had an AUC value of 0.7798 when distinguishing IDH-mutant LGGs from IDH wild-type LGGs. Moreover, LGG patients with high VSI values exhibited worse survival rates than those with low VSI values for both progression-free survival (PFS) and overall survival (OS). Multivariate Cox proportional hazards regression analysis suggested that IDH mutation status, VSImean values and multiple lesions or lobes were risk factors for PFS of LGG patients. Conclusion: VSI value is associated with IDH genotype and maybe an independent predictor of the survival of patients with LGGs.

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“…3 with recent studies reporting the use of CEST to distinguish between therapy responders and non-responders during [131] or directly after [132] therapy. Recently, an association between CEST and long-term outcome by means of patient overall survival and progression-free survival could be shown [136].…”

Section: Cestmentioning

confidence: 99%

Beyond T2 and 3T: New MRI techniques for clinicians

Knowles

Friedrich

Fischer

et al. 2019

Clinical and Translational Radiation Oncology

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Relaxation-compensated amide proton transfer (APT) MRI signal intensity is associated with survival and progression in high-grade glioma patients

Cited by 72 publications

References 50 publications

A novel normalization for amide proton transfer CEST MRI to correct for fat signal–induced artifacts: application to human breast cancer imaging

A novel normalization for amide proton transfer CEST MRI to correct for fat signal–induced artifacts: application to human breast cancer imaging

<p>Vessel Size Imaging is Associated with IDH Mutation and Patient Survival in Diffuse Lower-Grade Glioma</p>

Beyond T2 and 3T: New MRI techniques for clinicians

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