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Zou T, Yu H, Jiang C, Wang X, Jiang S, Rui Q, Mei Y, Zhou J, Wen Z. Differentiating the histologic grades of gliomas preoperatively using amide proton transfer-weighted (APTW) and intravoxel incoherent motion MRI. NMR IN BIOMEDICINE 2018; 31:10.1002/nbm.3850. [PMID: 29098732 PMCID: PMC5757627 DOI: 10.1002/nbm.3850] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this work was to investigate the diagnostic performance of amide proton transfer-weighted (APTW) and intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the preoperative grading of gliomas. Fifty-one patients with suspected gliomas were recruited and underwent a preoperative MRI examination that included APTW and IVIM sequences. All cases were confirmed by postsurgical histopathology. APTW signal intensity, true diffusion coefficient (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) were applied to assess the solid tumor component and contralateral normal-appearing white matter. The relative APTW signal intensity (rAPTW) was also used. Independent-sample and paired-sample t-tests were used to compare differences in MRI parameters between low-grade glioma (LGG) and high-grade glioma (HGG) groups. The diagnostic performance was assessed with the receiver operating characteristic curve. Twenty-six patients were pathologically diagnosed with LGG and 25 were diagnosed with HGG. APTW, rAPTW and f values were significantly higher (all p < 0.001), whereas D values were significantly lower (p < 0.001) in the HGG group than in the LGG group. There was no significant difference between D* values for the two groups. rAPTW had an area under the curve (AUC) of 0.957, with a sensitivity of 100% and a specificity of 84.6%, followed by APTW, f, D and D*. The combined use of APTW and IVIM showed the best diagnostic performance, with an AUC of 0.986. In conclusion, APTW and IVIM, as two promising supplementary sequences for routine MRI, could be valuable in differentiating LGGs from HGGs.
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Affiliation(s)
- Tianyu Zou
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
| | - Hao Yu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
| | - Chunxiu Jiang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
| | - Xianlong Wang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
| | - Shanshan Jiang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, Baltimore, Maryland 21287, USA
| | - Qihong Rui
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
| | - Yingjie Mei
- Philips Healthcare, Guangzhou, Guangdong, P.R. China
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, Baltimore, Maryland 21287, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong, 510282, P.R. China
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Zhou IY, Wang E, Cheung JS, Lu D, Ji Y, Zhang X, Fulci G, Sun PZ. Direct saturation-corrected chemical exchange saturation transfer MRI of glioma: Simplified decoupling of amide proton transfer and nuclear overhauser effect contrasts. Magn Reson Med 2017; 78:2307-2314. [PMID: 29030880 PMCID: PMC5744877 DOI: 10.1002/mrm.26959] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 12/27/2022]
Abstract
PURPOSE Chemical exchange saturation transfer (CEST) MRI has shown promise in tissue characterization in diseases like stroke and tumor. However, in vivo CEST imaging such as amide proton transfer (APT) MRI is challenging because of concomitant factors such as direct water saturation, macromolecular magnetization transfer, and nuclear overhauser effect (NOE), which lead to a complex contrast in the commonly used asymmetry analysis (MTRasym). Here, we propose a direct saturation-corrected CEST (DISC-CEST) analysis for simplified decoupling and quantification of in vivo CEST effects. METHODS CEST MRI and relaxation measurements were carried out on a classical 2-pool creatine-gel CEST phantom and normal rat brains (N = 6) and a rat model of glioma (N = 8) at 4.7T. The proposed DISC-CEST quantification was carried out and compared with conventional MTRasym and the original three-offset method. RESULTS We demonstrated that the DISC-CEST contrast in the phantom had much stronger correlation with MTRasym than the three-offset method, which showed substantial underestimation. In normal rat brains, the DISC-CEST approach revealed significantly stronger APT effect in gray matter and higher NOE effect in white matter. Furthermore, the APT and NOE maps derived from DISC-CEST showed significantly higher APT effect in the tumors than contralateral normal tissue but no apparent difference in NOE. CONCLUSION The proposed DISC-CEST method, by correction of nonlinear direct water saturation effect, serves as a promising alternative to both the commonly used MTRasym and the simplistic three-offset analyses. It provides simple yet reliable in vivo CEST quantification such as APT and NOE mapping in brain tumor, which is promising for clinical translation. Magn Reson Med 78:2307-2314, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Iris Yuwen Zhou
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Enfeng Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
- Department of Radiology, 3 Affiliated Hospital, Zhengzhou University, Henan, China
| | - Jerry S Cheung
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Dongshuang Lu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Yang Ji
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Xiaoan Zhang
- Department of Radiology, 3 Affiliated Hospital, Zhengzhou University, Henan, China
| | - Giulia Fulci
- Molecular Neuro-oncology Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02124, USA
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
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Yu H, Lou H, Zou T, Wang X, Jiang S, Huang Z, Du Y, Jiang C, Ma L, Zhu J, He W, Rui Q, Zhou J, Wen Z. Applying protein-based amide proton transfer MR imaging to distinguish solitary brain metastases from glioblastoma. Eur Radiol 2017; 27:4516-4524. [PMID: 28534162 PMCID: PMC5744886 DOI: 10.1007/s00330-017-4867-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/26/2017] [Accepted: 04/26/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To determine the utility of amide proton transfer-weighted (APTw) MR imaging in distinguishing solitary brain metastases (SBMs) from glioblastomas (GBMs). METHODS Forty-five patients with SBMs and 43 patients with GBMs underwent conventional and APT-weighted sequences before clinical intervention. The APTw parameters and relative APTw (rAPTw) parameters in the tumour core and the peritumoral brain zone (PBZ) were obtained and compared between SBMs and GBMs. The receiver-operating characteristic (ROC) curve was used to assess the best parameter for distinguishing between the two groups. RESULTS The APTwmax, APTwmin, APTwmean, rAPTwmax, rAPTwmin or rAPTwmean values in the tumour core were not significantly different between the SBM and GBM groups (P = 0.141, 0.361, 0.221, 0.305, 0.578 and 0.448, respectively). However, the APTwmax, APTwmin, APTwmean, rAPTwmax, rAPTwmin or rAPTwmean values in the PBZ were significantly lower in the SBM group than in the GBM group (P < 0.001). The APTwmin values had the highest area under the ROC curve 0.905 and accuracy 85.2% in discriminating between the two neoplasms. CONCLUSION As a noninvasive imaging method, APT-weighted MR imaging can be used to distinguish SBMs from GBMs. KEY POINTS • APTw values in the tumour core were not different between SBMs and GBMs. • APTw values in peritumoral brain zone were lower in SBMs than in GBMs. • The APTw min was the best parameter to distinguish SBMs from GBMs.
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Affiliation(s)
- Hao Yu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Huiling Lou
- Department of Geriatrics, The First People' Hospital of Guangzhou, Guangzhou, Guangdong, 510180, China
| | - Tianyu Zou
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Xianlong Wang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Shanshan Jiang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, Park 336, Baltimore, MD, 21287, USA
| | - Zhongqing Huang
- Department of Medical Image Center, Yuebei People's Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yongxing Du
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Chunxiu Jiang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Ling Ma
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Jianbin Zhu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Wen He
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Qihong Rui
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China
| | - Jianyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, Park 336, Baltimore, MD, 21287, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No.253, Haizhu District, Guangzhou, Guangdong, 510282, China.
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Su C, Liu C, Zhao L, Jiang J, Zhang J, Li S, Zhu W, Wang J. Amide Proton Transfer Imaging Allows Detection of Glioma Grades and Tumor Proliferation: Comparison with Ki-67 Expression and Proton MR Spectroscopy Imaging. AJNR Am J Neuroradiol 2017; 38:1702-1709. [PMID: 28729292 DOI: 10.3174/ajnr.a5301] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 05/07/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Prognosis in glioma depends strongly on tumor grade and proliferation. In this prospective study of patients with untreated primary cerebral gliomas, we investigated whether amide proton transfer-weighted imaging could reveal tumor proliferation and reliably distinguish low-grade from high-grade gliomas compared with Ki-67 expression and proton MR spectroscopy imaging. MATERIALS AND METHODS This study included 42 patients with low-grade (n = 28) or high-grade (n = 14) glioma, all of whom underwent conventional MR imaging, proton MR spectroscopy imaging, and amide proton transfer-weighted imaging on the same 3T scanner within 2 weeks before surgery. We assessed metabolites of choline and N-acetylaspartate from proton MR spectroscopy imaging and the asymmetric magnetization transfer ratio at 3.5 ppm from amide proton transfer-weighted imaging and compared them with histopathologic grade and immunohistochemical expression of the proliferation marker Ki-67 in the resected specimens. RESULTS The asymmetric magnetization transfer ratio at 3.5 ppm values measured by different readers showed good concordance and were significantly higher in high-grade gliomas than in low-grade gliomas (3.61% ± 0.155 versus 2.64% ± 0.185, P = .0016), with sensitivity and specificity values of 92.9% and 71.4%, respectively, at a cutoff value of 2.93%. The asymmetric magnetization transfer ratio at 3.5 ppm values correlated with tumor grade (r = 0.506, P = .0006) and Ki-67 labeling index (r = 0.502, P = .002). For all patients, the asymmetric magnetization transfer ratio at 3.5 ppm correlated positively with choline (r = 0.43, P = .009) and choline/N-acetylaspartate ratio (r = 0.42, P = .01) and negatively with N-acetylaspartate (r = -0.455, P = .005). These correlations held for patients with low-grade gliomas versus those with high-grade gliomas, but the correlation coefficients were higher in high-grade gliomas (choline: r = 0.547, P = .053; N-acetylaspartate: r = -0.644, P = .017; choline/N-acetylaspartate: r = 0.583, P = .036). CONCLUSIONS The asymmetric magnetization transfer ratio at 3.5 ppm may serve as a potential biomarker not only for assessing proliferation, but also for predicting histopathologic grades in gliomas.
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Affiliation(s)
- C Su
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - C Liu
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - L Zhao
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - J Jiang
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - J Zhang
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - S Li
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - W Zhu
- From the Department of Radiology (C.S., C.L., L.Z., J.J., J.Z., S.L., W.Z.), Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan, People's Republic of China
| | - J Wang
- Department of Radiation Physics (J.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas
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Jiang S, Zou T, Eberhart CG, Villalobos MAV, Heo HY, Zhang Y, Wang Y, Wang X, Yu H, Du Y, van Zijl PCM, Wen Z, Zhou J. Predicting IDH mutation status in grade II gliomas using amide proton transfer-weighted (APTw) MRI. Magn Reson Med 2017; 78:1100-1109. [PMID: 28714279 DOI: 10.1002/mrm.26820] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/31/2017] [Accepted: 06/11/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE To assess the amide proton transfer-weighted (APTw) MRI features of isocitrate dehydrogenase (IDH)-wildtype and IDH-mutant grade II gliomas and to test the hypothesis that the APTw signal is a surrogate imaging marker for identifying IDH mutation status preoperatively. METHODS Twenty-seven patients with pathologically confirmed low-grade glioma, who were previously scanned at 3T, were retrospectively analyzed. The Mann-Whitney test was used to evaluate relationships between APTw intensities for IDH-mutant and IDH-wildtype groups, and receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance of APTw. RESULTS Based on histopathology and molecular analysis, seven cases were diagnosed as IDH-wildtype grade II gliomas and 20 cases as IDH-mutant grade II gliomas. The maximum and minimum APTw values, based on multiple regions of interest, as well as the whole-tumor histogram-based mean and 50th percentile APTw values, were significantly higher in the IDH-wildtype gliomas than in the IDH-mutant groups. This corresponded to the areas under the ROC curves of 0.89, 0.76, 0.75, and 0.75, respectively, for the prediction of the IDH mutation status. CONCLUSION IDH-wildtype lesions typically were associated with relatively high APTw signal intensities as compared with IDH-mutant lesions. The APTw signal could be a valuable imaging biomarker by which to identify IDH1 mutation status in grade II gliomas. Magn Reson Med 78:1100-1109, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Department of Radiology, Futian Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Tianyu Zou
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Charles G Eberhart
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yi Zhang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yu Wang
- Department of Pathology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xianlong Wang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hao Yu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongxing Du
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Peter C M van Zijl
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Jiang S, Eberhart CG, Zhang Y, Heo HY, Wen Z, Blair L, Qin H, Lim M, Quinones-Hinojosa A, Weingart JD, Barker PB, Pomper MG, Laterra J, van Zijl PCM, Blakeley JO, Zhou J. Amide proton transfer-weighted magnetic resonance image-guided stereotactic biopsy in patients with newly diagnosed gliomas. Eur J Cancer 2017; 83:9-18. [PMID: 28704644 DOI: 10.1016/j.ejca.2017.06.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 05/31/2017] [Accepted: 06/11/2017] [Indexed: 01/03/2023]
Abstract
PURPOSE Pathological assessment using World Health Organization (WHO) criteria is the gold standard for diagnosis of gliomas. However, the accuracy of diagnosis is limited by tissue sampling, particularly for infiltrating, heterogeneous tumours. We assessed the accuracy of amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI)-guided tissue sampling to identify regions of high-grade glioma via radiographic-histopathologic correlation in patients with newly suspected glioma. PATIENTS AND METHODS Twenty-four patients with previously undiagnosed gliomas underwent a volumetric APTw MRI prior to their first neurosurgical procedure. A total of 70 specimens were collected via APTw image-directed stereotactic biopsy. Cellularity, necrosis, proliferation and glioma WHO grade were analysed for all specimens and correlated with corresponding APTw signal intensities. RESULTS Thirty-three specimens displayed grade-II pathology, 14 grade-III, 15 grade-IV, and eight specimens revealed only peritumoural oedema. Multiple glioma grades were found within a single lesion in six patients. APTw signal intensities of the biopsied sites and the maximum APTw values across all biopsied sites in each patient were significantly higher for high-grade versus low-grade specimens. APTw signal intensities were significantly positively correlated with cellularity (R = 0.757) and proliferation (R = 0.538). Multiple linear regression analysis showed that tumour cellularity and proliferation index were the best predictors of APTw signal intensities. CONCLUSION APTw imaging identified tumour areas of higher cellularity and proliferation, allowing identification of high-grade regions within heterogeneous gliomas. APTw imaging can be readily translated for more widespread use and can assist diagnostic neurosurgical procedures by increasing the accuracy of tumour sampling in patients with infiltrating gliomas.
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Affiliation(s)
- Shanshan Jiang
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | | | - Yi Zhang
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Hye-Young Heo
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lindsay Blair
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Huamin Qin
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Lim
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jon D Weingart
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Peter B Barker
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Martin G Pomper
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - John Laterra
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Peter C M van Zijl
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | | | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
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Ji Y, Zhou IY, Qiu B, Sun PZ. Progress toward quantitative in vivo chemical exchange saturation transfer (CEST) MRI. Isr J Chem 2017. [DOI: 10.1002/ijch.201700025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Yang Ji
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital; Harvard Medical School; Rm 2301, 149 13 Street Charlestown MA 02129
- Center for Biomedical Engineering, Department of Electronic Science and Technology; University of Science and Technology of China; Hefei China
| | - Iris Yuwen Zhou
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital; Harvard Medical School; Rm 2301, 149 13 Street Charlestown MA 02129
| | - Bensheng Qiu
- Center for Biomedical Engineering, Department of Electronic Science and Technology; University of Science and Technology of China; Hefei China
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital; Harvard Medical School; Rm 2301, 149 13 Street Charlestown MA 02129
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The diagnostic value of high-frequency power-based diffusion-weighted imaging in prediction of neuroepithelial tumour grading. Eur Radiol 2017; 27:5056-5063. [PMID: 28608161 DOI: 10.1007/s00330-017-4899-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/23/2017] [Accepted: 05/16/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To retrospectively evaluate the diagnostic value of high-frequency power (HFP) compared with the minimum apparent diffusion coefficient (MinADC) in the prediction of neuroepithelial tumour grading. METHODS Diffusion-weighted imaging (DWI) data were acquired on 115 patients by a 3.0-T MRI system, which included b0 images and b1000 images over the whole brain in each patient. The HFP values and MinADC values were calculated by an in-house script written on the MATLAB platform. RESULTS There was a significant difference among each group excluding grade I (G1) vs. grade II (G2) (P = 0.309) for HFP and among each group for MinADC. ROC analysis showed a higher discriminative accuracy between low-grade glioma (LGG) and high-grade glioma (HGG) for HFP with area under the curve (AUC) value 1 compared with that for MinADC with AUC 0.83 ± 0.04 and also demonstrated a higher discriminative ability among the G1-grade IV (G4) group for HFP compared with that for MinADC except G1 vs. G2. CONCLUSIONS HFP could provide a simple and effective optimal tool for the prediction of neuroepithelial tumour grading based on diffusion-weighted images in routine clinical practice. KEY POINTS • HFP shows positive correlation with neuroepithelial tumour grading. • HFP presents a good diagnostic efficacy for LGG and HGG. • HFP is helpful in the selection of brain tumour boundary.
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Khlebnikov V, Windschuh J, Siero JC, Zaiss M, Luijten PR, Klomp DW, Hoogduin H. On the transmit field inhomogeneity correction of relaxation-compensated amide and NOE CEST effects at 7 T. NMR IN BIOMEDICINE 2017; 30:e3687. [PMID: 28111824 PMCID: PMC5412922 DOI: 10.1002/nbm.3687] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 05/08/2023]
Abstract
High field MRI is beneficial for chemical exchange saturation transfer (CEST) in terms of high SNR, CNR, and chemical shift dispersion. These advantages may, however, be counter-balanced by the increased transmit field inhomogeneity normally associated with high field MRI. The relatively high sensitivity of the CEST contrast to B1 inhomogeneity necessitates the development of correction methods, which is essential for the clinical translation of CEST. In this work, two B1 correction algorithms for the most studied CEST effects, amide-CEST and nuclear Overhauser enhancement (NOE), were analyzed. Both methods rely on fitting the multi-pool Bloch-McConnell equations to the densely sampled CEST spectra. In the first method, the correction is achieved by using a linear B1 correction of the calculated amide and NOE CEST effects. The second method uses the Bloch-McConnell fit parameters and the desired B1 amplitude to recalculate the CEST spectra, followed by the calculation of B1 -corrected amide and NOE CEST effects. Both algorithms were systematically studied in Bloch-McConnell equations and in human data, and compared with the earlier proposed ideal interpolation-based B1 correction method. In the low B1 regime of 0.15-0.50 μT (average power), a simple linear model was sufficient to mitigate B1 inhomogeneity effects on a par with the interpolation B1 correction, as demonstrated by a reduced correlation of the CEST contrast with B1 in both the simulations and the experiments.
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Affiliation(s)
- Vitaliy Khlebnikov
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Johannes Windschuh
- Division of Medical Physics in RadiologyDeutsches Krebsforschungszentrum (DKFZ) [German Cancer Research Center]HeidelbergGermany
| | - Jeroen C.W. Siero
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
- Spinoza Centre for NeuroimagingAmsterdamThe Netherlands
| | - Moritz Zaiss
- Division of Medical Physics in RadiologyDeutsches Krebsforschungszentrum (DKFZ) [German Cancer Research Center]HeidelbergGermany
| | - Peter R. Luijten
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Dennis W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Hans Hoogduin
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
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van Zijl PCM, Lam WW, Xu J, Knutsson L, Stanisz GJ. Magnetization Transfer Contrast and Chemical Exchange Saturation Transfer MRI. Features and analysis of the field-dependent saturation spectrum. Neuroimage 2017; 168:222-241. [PMID: 28435103 DOI: 10.1016/j.neuroimage.2017.04.045] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022] Open
Abstract
Magnetization Transfer Contrast (MTC) and Chemical Exchange Saturation Transfer (CEST) experiments measure the transfer of magnetization from molecular protons to the solvent water protons, an effect that becomes apparent as an MRI signal loss ("saturation"). This allows molecular information to be accessed with the enhanced sensitivity of MRI. In analogy to Magnetic Resonance Spectroscopy (MRS), these saturation data are presented as a function of the chemical shift of participating proton groups, e.g. OH, NH, NH2, which is called a Z-spectrum. In tissue, these Z-spectra contain the convolution of multiple saturation transfer effects, including nuclear Overhauser enhancements (NOEs) and chemical exchange contributions from protons in semi-solid and mobile macromolecules or tissue metabolites. As a consequence, their appearance depends on the magnetic field strength (B0) and pulse sequence parameters such as B1 strength, pulse shape and length, and interpulse delay, which presents a major problem for quantification and reproducibility of MTC and CEST effects. The use of higher B0 can bring several advantages. In addition to higher detection sensitivity (signal-to-noise ratio, SNR), both MTC and CEST studies benefit from longer water T1 allowing the saturation transferred to water to be retained longer. While MTC studies are non-specific at any field strength, CEST specificity is expected to increase at higher field because of a larger chemical shift dispersion of the resonances of interest (similar to MRS). In addition, shifting to a slower exchange regime at higher B0 facilitates improved detection of the guanidinium protons of creatine and the inherently broad resonances of the amine protons in glutamate and the hydroxyl protons in myoinositol, glycogen, and glucosaminoglycans. Finally, due to the higher mobility of the contributing protons in CEST versus MTC, many new pulse sequences can be designed to more specifically edit for CEST signals and to remove MTC contributions.
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Affiliation(s)
- Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Wilfred W Lam
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Jiadi Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Linda Knutsson
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Greg J Stanisz
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland.
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61
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Sakata A, Fushimi Y, Okada T, Arakawa Y, Kunieda T, Minamiguchi S, Kido A, Sakashita N, Miyamoto S, Togashi K. Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors. J Magn Reson Imaging 2017; 46:732-739. [PMID: 28252822 DOI: 10.1002/jmri.25597] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/28/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative grading in patients with brain tumor. MATERIALS AND METHODS Institutional Review Board approval and written informed consent were obtained. Forty-one patients with suspected brain tumors were enrolled in the study. Single-voxel MRS and 2D APT imaging of the same slice level were conducted using a 3T MRI scanner. Positive or negative contrast enhancement on T1 -weighted images was assessed by two neuroradiologists. Correlations among metabolite concentrations, metabolite ratios, and calculated histogram parameters, including mean APT (APTmean ) and the 90th percentile of APT (APT90 ) were assessed using Spearman's correlation coefficient. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis for contrast enhancement and MRS and APT imaging. Values of P < 0.05 were considered statistically significant. RESULTS Positive correlations with statistical significance were found between total concentration of choline (Cho) and APT90 (r = 0.49), and between Cho/creatine (Cr) and APTmean (r = 0.65) as well as APT90 (r = 0.49). A negative correlation with statistical significance was observed between NAA/Cr and APTmean (r = -0.52). According to ROC curves, Cho/Cr, APTmean , APT90 , demonstrated higher area under the curve (AUC) values than that of contrast enhancement in grading gliomas. CONCLUSION Significant correlations were observed between metabolite concentrations and ratios on MRS and APT values. MRS and APT imaging showed comparable diagnostic capability for grading brain tumors, suggesting that both MRS and APT imaging offer potential for quantitatively assessing similar biological characteristics in brain tumors on noncontrast MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:732-739.
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Affiliation(s)
- Akihiko Sakata
- Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto, Japan
| | - Yasutaka Fushimi
- Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Kyoto University Graduate School of Medicine, Human Brain Research Center, Kyoto, Japan
| | - Yoshiki Arakawa
- Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto, Japan
| | - Takeharu Kunieda
- Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto, Japan
| | - Sachiko Minamiguchi
- Kyoto University Graduate School of Medicine, Department of Diagnostic Pathology, Kyoto, Japan
| | - Aki Kido
- Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto, Japan
| | - Naotaka Sakashita
- Toshiba Medical Systems Corporations, MRI Systems Development Department, Otawara, Japan
| | - Susumu Miyamoto
- Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto, Japan
| | - Kaori Togashi
- Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto, Japan
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62
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Tse DH, da Silva NA, Poser BA, Shah NJ. B1+ inhomogeneity mitigation in CEST using parallel transmission. Magn Reson Med 2017; 78:2216-2225. [DOI: 10.1002/mrm.26624] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/05/2016] [Accepted: 01/07/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Desmond H.Y. Tse
- Faculty of Psychology and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - Nuno Andre da Silva
- Institute of Neuroscience and Medicine-4, Forschungszentrum Juelich GmbH, Wilhelm-Johnen-Strasse; Juelich Germany
| | - Benedikt A. Poser
- Faculty of Psychology and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - N. Jon Shah
- Institute of Neuroscience and Medicine-4, Forschungszentrum Juelich GmbH, Wilhelm-Johnen-Strasse; Juelich Germany
- Department of Neurology; Faculty of Medicine, RWTH Aachen University, JARA; Aachen Germany
- Department of Electrical and Computer Systems Engineering; and Monash Biomedical Imaging, School of Psychological Sciences, Monash University; Melbourne Victoria Australia
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63
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Choi YS, Ahn SS, Lee SK, Chang JH, Kang SG, Kim SH, Zhou J. Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume. Eur Radiol 2017; 27:3181-3189. [PMID: 28116517 DOI: 10.1007/s00330-017-4732-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/22/2016] [Accepted: 01/02/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To evaluate the added value of amide proton transfer (APT) imaging to the apparent diffusion coefficient (ADC) from diffusion tensor imaging (DTI) and the relative cerebral blood volume (rCBV) from perfusion magnetic resonance imaging (MRI) for discriminating between high- and low-grade gliomas. METHODS Forty-six consecutive adult patients with diffuse gliomas who underwent preoperative APT imaging, DTI and perfusion MRI were enrolled. APT signals were compared according to the World Health Organization grade. The diagnostic ability and added value of the APT signal to the ADC and rCBV for discriminating between low- and high-grade gliomas were evaluated using receiver operating characteristic (ROC) analyses and integrated discrimination improvement. RESULTS The APT signal increased as the glioma grade increased. The discrimination abilities of the APT, ADC and rCBV values were not significantly different. Using both the APT signal and ADC significantly improved discrimination vs. the ADC alone (area under the ROC curve [AUC], 0.888 vs. 0.910; P = 0.007), whereas using both the APT signal and rCBV did not improve discrimination vs. the rCBV alone (AUC, 0.927 vs. 0.923; P = 0.222). CONCLUSIONS APT imaging may be a useful imaging biomarker that adds value to the ADC for discriminating between low- and high-grade gliomas. KEY POINTS • Higher APT values were correlated with higher glioma grades. • Adding the APT signal to the ADC improved glioma grading. • Adding the APT signal to rCBV did not improve glioma grading. • APT is a useful adjunct to the ADC for glioma grading.
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Affiliation(s)
- Yoon Seong Choi
- Department of Radiology and Research Institute of Radiological Science, College of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, College of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science, College of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seok-Gu Kang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyuan Zhou
- Division of MRI Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Magnetization Transfer and Amide Proton Transfer MRI of Neonatal Brain Development. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3052723. [PMID: 27885356 PMCID: PMC5112326 DOI: 10.1155/2016/3052723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/10/2016] [Indexed: 11/18/2022]
Abstract
Purpose. This study aims to evaluate the process of brain development in neonates using combined amide proton transfer (APT) imaging and conventional magnetization transfer (MT) imaging. Materials and Methods. Case data were reviewed for all patients hospitalized in our institution's neonatal ward. Patients underwent APT and MT imaging (a single protocol) immediately following the routine MR examination. Single-slice APT/MT axial imaging was performed at the level of the basal ganglia. APT and MT ratio (MTR) measurements were performed in multiple brain regions of interest (ROIs). Data was statistically analyzed in order to assess for significant differences between the different regions of the brain or correlation with patient gestational age. Results. A total of 38 neonates were included in the study, with ages ranging from 27 to 41 weeks' corrected gestational age. There were statistically significant differences in both APT and MTR measurements between the frontal lobes, basal ganglia, and occipital lobes (APT: frontal lobe versus occipital lobe P = 0.031 and other groups P = 0.00; MTR: frontal lobe versus occipital lobe P = 0.034 and other groups P = 0.00). Furthermore, APT and MTR in above brain regions exhibited positive linear correlations with patient gestational age. Conclusions. APT/MT imaging can provide valuable information about the process of the neonatal brain development at the molecular level.
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Khlebnikov V, Siero JCW, Wijnen J, Visser F, Luijten PR, Klomp DWJ, Hoogduin H. Is there any difference in Amide and NOE CEST effects between white and gray matter at 7T? JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2016; 272:82-86. [PMID: 27662404 DOI: 10.1016/j.jmr.2016.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Abstract
Measurement of Chemical Exchange Saturation Transfer (CEST) is providing tissue physiology dependent contrast, e.g. by looking at Amide and NOE (Nuclear Overhauser Enhancement) effects. CEST is unique in providing quantitative metabolite information at high imaging resolution. However, direct comparison of Amide and NOE effects between different tissues may result in wrong conclusions on the metabolite concentration due to the additional contributors to the observed CEST contrast, such as water content (WC) and water T1 relaxation (T1w). For instance, there are multiple contradictory reports in the literature on Amide and NOE effects in white matter (WM) and gray matter (GM) at 7T. This study shows that at 7T, tissue water T1 relaxation is a stronger contributor to CEST contrasts than WC. After water T1 correction, there was no difference in Amide effects between WM and GM, whereas WM/GM contrast was enhanced for NOE effects.
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Affiliation(s)
- Vitaliy Khlebnikov
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Jeroen C W Siero
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jannie Wijnen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Peter R Luijten
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dennis W J Klomp
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans Hoogduin
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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66
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Togao O, Keupp J, Hiwatashi A, Yamashita K, Kikuchi K, Yoneyama M, Honda H. Amide proton transfer imaging of brain tumors using a self-corrected 3D fast spin-echo dixon method: Comparison With separate B 0 correction. Magn Reson Med 2016; 77:2272-2279. [PMID: 27385636 DOI: 10.1002/mrm.26322] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/19/2016] [Accepted: 06/02/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE To assess the quantitative performance of three-dimensional (3D) fast spin-echo (FSE) Dixon amide proton transfer (APT) imaging of brain tumors compared with B0 correction with separate mapping methods. METHODS Twenty-two patients with brain tumors (54.2 ± 18.7 years old, 12 males and 10 females) were scanned at 3 Tesla (T). Z-spectra were obtained at seven different frequency offsets at ±3.1 ppm, ± 3.5 ppm, ± 3.9 ppm, and -1560 ppm. The scan was repeated three times at +3.5 ppm with echo shifts for Dixon B0 mapping. The APT image corrected by a three-point Dixon-type B0 map from the same scan (3D-Dixon) or a separate B0 map (2D-separate and 3D-separate), and an uncorrected APT image (3D-uncorrected) were generated. We compared the APT-weighted signals within a tumor obtained with each 3D method with those obtained with 2D-separate as a reference standard. RESULTS Excellent agreements and correlations with the 2D-separate were obtained by the 3D-Dixon method for both mean (ICC = 0.964, r = 0.93, P < 0.0001) and 90th-percentile (ICC = 0.972, r = 0.95, P < 0.0001) APT-weighted signals. These agreements and correlations for 3D-Dixon were better than those obtained by the 3D-uncorrected and 3D-separate methods. CONCLUSION The 3D FSE Dixon APT method with intrinsic B0 correction offers a quantitative performance that is similar to that of established two-dimensional (2D) methods. Magn Reson Med 77:2272-2279, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Jochen Keupp
- Philips Research Europe, Röntgenstrasse 24-26, Hamburg, 22335, Germany
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masami Yoneyama
- Philips Electronics Japan, 2-13-37 Konan, Minato-ku, Tokyo, 108-8507, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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67
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Khlebnikov V, Polders D, Hendrikse J, Robe PA, Voormolen EH, Luijten PR, Klomp DWJ, Hoogduin H. Amide proton transfer (APT) imaging of brain tumors at 7 T: The role of tissue water T1-Relaxation properties. Magn Reson Med 2016; 77:1525-1532. [DOI: 10.1002/mrm.26232] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Vitaliy Khlebnikov
- Department of Radiology, Image Sciences Institute; University Medical Center Utrecht; Utrecht the Netherlands
| | | | - Jeroen Hendrikse
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | - Pierre A. Robe
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eduard H. Voormolen
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | - Peter R. Luijten
- Department of Radiology, Image Sciences Institute; University Medical Center Utrecht; Utrecht the Netherlands
| | - Dennis W. J. Klomp
- Department of Radiology, Image Sciences Institute; University Medical Center Utrecht; Utrecht the Netherlands
| | - Hans Hoogduin
- Department of Radiology, Image Sciences Institute; University Medical Center Utrecht; Utrecht the Netherlands
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68
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Togao O, Hiwatashi A, Yamashita K, Kikuchi K, Keupp J, Yoshimoto K, Kuga D, Yoneyama M, Suzuki SO, Iwaki T, Takahashi M, Iihara K, Honda H. Grading diffuse gliomas without intense contrast enhancement by amide proton transfer MR imaging: comparisons with diffusion- and perfusion-weighted imaging. Eur Radiol 2016; 27:578-588. [PMID: 27003139 DOI: 10.1007/s00330-016-4328-0] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/19/2016] [Accepted: 03/09/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate whether amide proton transfer (APT) MR imaging can differentiate high-grade gliomas (HGGs) from low-grade gliomas (LGGs) among gliomas without intense contrast enhancement (CE). METHODS This retrospective study evaluated 34 patients (22 males, 12 females; age 36.0 ± 11.3 years) including 20 with LGGs and 14 with HGGs, all scanned on a 3T MR scanner. Only tumours without intense CE were included. Two neuroradiologists independently performed histogram analyses to measure the 90th-percentile (APT90) and mean (APTmean) of the tumours' APT signals. The apparent diffusion coefficient (ADC) and relative cerebral blood volume (rCBV) were also measured. The parameters were compared between the groups with Student's t-test. Diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis. RESULTS The APT90 (2.80 ± 0.59 % in LGGs, 3.72 ± 0.89 in HGGs, P = 0.001) and APTmean (1.87 ± 0.49 % in LGGs, 2.70 ± 0.58 in HGGs, P = 0.0001) were significantly larger in the HGGs compared to the LGGs. The ADC and rCBV values were not significantly different between the groups. Both the APT90 and APTmean showed medium diagnostic performance in this discrimination. CONCLUSIONS APT imaging is useful in discriminating HGGs from LGGs among diffuse gliomas without intense CE. KEY POINTS • Amide proton transfer (APT) imaging helps in grading non-enhancing gliomas • High-grade gliomas showed higher APT signal than low-grade gliomas • APT imaging showed better diagnostic performance than diffusion- and perfusion-weighted imaging.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Jochen Keupp
- Philips Research, Röntgenstrasse 24-26, Hamburg, 22335, Germany
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daisuke Kuga
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masami Yoneyama
- Philips Electronics Japan, 2-13-37 Konan Minato-ku, Tokyo, 108-8507, Japan
| | - Satoshi O Suzuki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toru Iwaki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masaya Takahashi
- Advanced Imaging Research Center, UT Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX, 75235, USA
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
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69
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Ma B, Blakeley JO, Hong X, Zhang H, Jiang S, Blair L, Zhang Y, Heo HY, Zhang M, van Zijl PCM, Zhou J. Applying amide proton transfer-weighted MRI to distinguish pseudoprogression from true progression in malignant gliomas. J Magn Reson Imaging 2016; 44:456-62. [PMID: 26788865 DOI: 10.1002/jmri.25159] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 01/04/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To assess amide proton transfer-weighted (APTW) imaging features in patients with malignant gliomas after chemoradiation and the diagnostic performance of APT imaging for distinguishing true progression from pseudoprogression. MATERIALS AND METHODS After approval by the Institutional Review Board, 32 patients with clinically suspected tumor progression in the first 3 months after chemoradiation were enrolled and scanned at 3T. Longitudinal routine magnetic resonance imaging (MRI) changes and medical records were assessed to confirm true progression versus pseudoprogression. True progression was defined as lesions progressing on serial imaging over 6 months, and pseudoprogression was defined as lesions stabilizing or regressing without intervention. The APTWmean and APTWmax signals were obtained from three to five regions of interests for each patient and compared between the true progression and pseudoprogression groups. The diagnostic performance was assessed with receiver operating characteristic curve analysis. RESULTS The true progression was associated with APTW hyperintensity (APTWmean = 2.75% ± 0.42%), while pseudoprogression was associated with APTW isointensity to mild hyperintensity (APTWmean = 1.56% ± 0.42%). The APTW signal intensities were significantly higher in the true progression group (n = 20) than in the pseudoprogression group (P < 0.001; n = 12). The cutoff APTWmean and APTWmax intensity values to distinguish between true progression and pseudoprogression were 2.42% (with a sensitivity of 85.0% and a specificity of 100%) and 2.54% (with a sensitivity of 95.0% and a specificity of 91.7%), respectively. CONCLUSION The APTW-MRI signal is a valuable imaging biomarker for distinguishing pseudoprogression from true progression in glioma patients. J. Magn. Reson. Imaging 2016;44:456-462.
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Affiliation(s)
- Bo Ma
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan, PR China
| | - Jaishri O Blakeley
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xiaohua Hong
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hongyan Zhang
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shanshan Jiang
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lindsay Blair
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yi Zhang
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hye-Young Heo
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mingzhi Zhang
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Peter C M van Zijl
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Zhang Y, Heo HY, Lee DH, Zhao X, Jiang S, Zhang K, Li H, Zhou J. Selecting the reference image for registration of CEST series. J Magn Reson Imaging 2015; 43:756-61. [PMID: 26268435 DOI: 10.1002/jmri.25027] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/22/2015] [Accepted: 07/23/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To compare different reference images selected for registration among chemical exchange saturation transfer (CEST) series. MATERIALS AND METHODS Five normal volunteers and eight brain tumor patients were studied on a 3 Tesla scanner. Image registration was performed by choosing each of the acquired CEST saturation or unsaturation dynamic images as the reference. CEST images at 3.5 ppm (amide proton transfer, APT) were computed for each motion-corrected data set after main magnetic field inhomogeneity correction. A uniformity index was defined to quantify the efficacy of image registration using different reference images. Joint histograms and the structural similarity index (SSIM) were used to analyze the intrinsic image similarity between various dynamic images. RESULTS Image registration increased the average uniformity index by 18% if the 3.5 ppm saturated image was selected as the reference image. However, registering to the unsaturated dynamic image reduced the uniformity index by 13% on average. The joint histogram analysis showed that the saturated dynamic images were highly similar (SSIM = 0.89 ± 0.01), and were considerably different from the unsaturated dynamic image (SSIM = 0.58 ± 0.03). CONCLUSION The selection of the 3.5 ppm dynamic image as the reference image generated the highest uniformity index for APT imaging though other saturated images were equally suited as reference images.
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Affiliation(s)
- Yi Zhang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dong-Hoon Lee
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xuna Zhao
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kai Zhang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Haiyun Li
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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