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Cho NS, Hagiwara A, Yao J, Nathanson DA, Prins RM, Wang C, Raymond C, Desousa BR, Divakaruni A, Morrow DH, Nghiemphu PL, Lai A, Liau LM, Everson RG, Salamon N, Pope WB, Cloughesy TF, Ellingson BM. Amine-weighted chemical exchange saturation transfer magnetic resonance imaging in brain tumors. NMR IN BIOMEDICINE 2023; 36:e4785. [PMID: 35704275 DOI: 10.1002/nbm.4785] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 05/23/2023]
Abstract
Amine-weighted chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) is particularly valuable as an amine- and pH-sensitive imaging technique in brain tumors, targeting the intrinsically high concentration of amino acids with exchangeable amine protons and reduced extracellular pH in brain tumors. Amine-weighted CEST MRI contrast is dependent on the glioma genotype, likely related to differences in degree of malignancy and metabolic behavior. Amine-weighted CEST MRI may provide complementary value to anatomic imaging in conventional and exploratory therapies in brain tumors, including chemoradiation, antiangiogenic therapies, and immunotherapies. Continual improvement and clinical testing of amine-weighted CEST MRI has the potential to greatly impact patients with brain tumors by understanding vulnerabilities in the tumor microenvironment that may be therapeutically exploited.
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Affiliation(s)
- Nicholas S Cho
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, California, USA
- Medical Scientist Training Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Akifumi Hagiwara
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Jingwen Yao
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, California, USA
| | - David A Nathanson
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Robert M Prins
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Chencai Wang
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Brandon R Desousa
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Ajit Divakaruni
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Danielle H Morrow
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Phioanh L Nghiemphu
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- UCLA Brain Tumor Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Albert Lai
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- UCLA Brain Tumor Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Linda M Liau
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Richard G Everson
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Whitney B Pope
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Timothy F Cloughesy
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- UCLA Brain Tumor Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, California, USA
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- UCLA Brain Tumor Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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2
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Zhang HW, Liu XL, Zhang HB, Li YQ, Wang YL, Feng YN, Deng K, Lei Y, Huang B, Lin F. Differentiation of Meningiomas and Gliomas by Amide Proton Transfer Imaging: A Preliminary Study of Brain Tumour Infiltration. Front Oncol 2022; 12:886968. [PMID: 35646626 PMCID: PMC9132094 DOI: 10.3389/fonc.2022.886968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background Gliomas are more malignant and invasive than meningiomas. Objective To distinguish meningiomas from low-grade/high-grade gliomas (LGGs/HGGs) using amide proton transfer imaging (APT) combined with conventional magnetic resonance imaging (MRI) and to explore the application of APT in evaluating brain tumour invasiveness. Materials and Methods The imaging data of 50 brain tumors confirmed by pathology in patients who underwent APT scanning in our centre were retrospectively analysed. Of these tumors, 25 were meningiomas, 10 were LGGs, and 15 were HGGs. The extent of the tumour-induced range was measured on APT images, T2-weighted imaging (T2WI), and MRI enhancement; additionally, and the degree of enhancement was graded. Ratios (RAPT/T2 and RAPT/E) were obtained by dividing the range of changes observed by APT by the range of changes observed via T2WI and MR enhancement, respectively, and APTmean values were measured. The Mann–Whitney U test was used to compare the above measured values with the pathological results obtained for gliomas and meningiomas, the Kruskal-Wallis test was used to compare LGGs, HGGs and meningiomas, and Dunn’s test was used for pairwise comparisons. In addition, receiver operating characteristic (ROC) curves were drawn. Results The Mann–Whitney U test showed that APTmean (p=0.005), RAPT/T2 (p<0.001), and RAPT/E (p<0.001) values were statistically significant in the identification of meningioma and glioma. The Kruskal-Wallis test showed that the parameters APTmean, RAPT/T2, RAPT/E and the degree of enhancement are statistically significant. Dunn’s test revealed that RAPT/T2 (p=0.004) and RAPT/E (p=0.008) could be used for the identification of LGGs and meningiomas. APTmean (p<0.001), RAPT/T2 (p<0.001), and RAPT/E (p<0.001) could be used for the identification of HGGs and meningiomas. APTmean (p<0.001) was statistically significant in the comparison of LGGs and HGGs. ROC curves showed that RAPT/T2 (area under the curve (AUC)=0.947) and RAPT/E (AUC=0.919) could be used to distinguish gliomas from meningiomas. Conclusion APT can be used for the differential diagnosis of meningioma and glioma, but APTmean values can only be used for the differential diagnosis of HGGs and meningiomas or HGGs and LGGs. Gliomas exhibit more obvious changes than meningiomas in APT images of brain tissue; this outcome may be caused by brain infiltration.
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Affiliation(s)
- Han-Wen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao-Lei Liu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Hong-Bo Zhang
- Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Ying-Qi Li
- Department of Radiology, Songgang People's Hospital, Shenzhen, China
| | - Yu-Li Wang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yu-Ning Feng
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Kan Deng
- Research Department, Philips Healthcare, Guangzhou, China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Biao Huang
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Fan Lin
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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3
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Shaffer A, Kwok SS, Naik A, Anderson AT, Lam F, Wszalek T, Arnold PM, Hassaneen W. Ultra-High-Field MRI in the Diagnosis and Management of Gliomas: A Systematic Review. Front Neurol 2022; 13:857825. [PMID: 35449515 PMCID: PMC9016277 DOI: 10.3389/fneur.2022.857825] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/02/2022] [Indexed: 12/03/2022] Open
Abstract
Importance: Gliomas, tumors of the central nervous system, are classically diagnosed through invasive surgical biopsy and subsequent histopathological study. Innovations in ultra-high field (UHF) imaging, namely 7-Tesla magnetic resonance imaging (7T MRI) are advancing preoperative tumor grading, visualization of intratumoral structures, and appreciation of small brain structures and lesions. Objective Summarize current innovative uses of UHF imaging techniques in glioma diagnostics and treatment. Methods A systematic review in accordance with PRISMA guidelines was performed utilizing PubMed. Case reports and series, observational clinical trials, and randomized clinical trials written in English were included. After removing unrelated studies and those with non-human subjects, only those related to 7T MRI were independently reviewed and summarized for data extraction. Some preclinical animal models are briefly described to demonstrate future usages of ultra-high-field imaging. Results We reviewed 46 studies (43 human and 3 animal models) which reported clinical usages of UHF MRI in the diagnosis and management of gliomas. Current literature generally supports greater resolution imaging from 7T compared to 1.5T or 3T MRI, improving visualization of cerebral microbleeds and white and gray matter, and providing more precise localization for radiotherapy targeting. Additionally, studies found that diffusion or susceptibility-weighted imaging techniques applied to 7T MRI, may be used to predict tumor grade, reveal intratumoral structures such as neovasculature and microstructures like axons, and indicate isocitrate dehydrogenase 1 mutation status in preoperative imaging. Similarly, newer imaging techniques such as magnetic resonance spectroscopy and chemical exchange saturation transfer imaging can be performed on 7T MRI to predict tumor grading and treatment efficacy. Geometrical distortion, a known challenge of 7T MRI, was at a tolerable level in all included studies. Conclusion UHF imaging has the potential to preoperatively and non-invasively grade gliomas, provide precise therapy target areas, and visualize lesions not seen on conventional MRI.
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Affiliation(s)
- Annabelle Shaffer
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Susanna S Kwok
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Anant Naik
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Aaron T Anderson
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Carle Illinois Advanced Imaging Center, University of Illinois and Carle Health, Urbana, IL, United States
| | - Fan Lam
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Tracey Wszalek
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Carle Illinois Advanced Imaging Center, University of Illinois and Carle Health, Urbana, IL, United States
| | - Paul M Arnold
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Carle Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, United States
| | - Wael Hassaneen
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Carle Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, United States
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4
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Platt T, Ladd ME, Paech D. 7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging. Invest Radiol 2021; 56:705-725. [PMID: 34510098 PMCID: PMC8505159 DOI: 10.1097/rli.0000000000000820] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 12/15/2022]
Abstract
ABSTRACT Ultrahigh magnetic fields offer significantly higher signal-to-noise ratio, and several magnetic resonance applications additionally benefit from a higher contrast-to-noise ratio, with static magnetic field strengths of B0 ≥ 7 T currently being referred to as ultrahigh fields (UHFs). The advantages of UHF can be used to resolve structures more precisely or to visualize physiological/pathophysiological effects that would be difficult or even impossible to detect at lower field strengths. However, with these advantages also come challenges, such as inhomogeneities applying standard radiofrequency excitation techniques, higher energy deposition in the human body, and enhanced B0 field inhomogeneities. The advantages but also the challenges of UHF as well as promising advanced methodological developments and clinical applications that particularly benefit from UHF are discussed in this review article.
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Affiliation(s)
- Tanja Platt
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
| | - Mark E. Ladd
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
- Faculty of Physics and Astronomy
- Faculty of Medicine, University of Heidelberg, Heidelberg
- Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg
- Clinic for Neuroradiology, University of Bonn, Bonn, Germany
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Guo Z, Jiang Y, Qin X, Mu R, Meng Z, Zhuang Z, Liu F, Zhu X. Amide Proton Transfer-Weighted MRI Might Help Distinguish Amnestic Mild Cognitive Impairment From a Normal Elderly Population. Front Neurol 2021; 12:707030. [PMID: 34712196 PMCID: PMC8545995 DOI: 10.3389/fneur.2021.707030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate whether 3D amide proton transfer weighted (APTw) imaging based on magnetization transfer analysis can be used as a novel imaging marker to distinguish amnestic mild cognitive impairment (aMCI) patients from the normal elderly population by measuring changes in APTw signal intensity in the hippocampus and amygdala. Materials and Methods: Seventy patients with aMCI and 74 age- and sex-matched healthy volunteers were recruited for routine MRI and APT imaging examinations. Magnetic transfer ratio asymmetry (MTRasym) of the amide protons (at 3.5 ppm), or APTw values, were measured in the bilateral hippocampus and amygdala on three consecutive cross-sectional APT images and were compared between the aMCI and control groups. The independent sample t-test was used to evaluate the difference in APTw values of the bilateral hippocampus and amygdala between the aMCI and control groups. Receiver operator characteristic analysis was used to assess the diagnostic performance of the APTw. The paired t-test was used to assess the difference in APTw values between the left and right hippocampus and amygdala, in both the aMCI and control groups. Results: The APTw values of the bilateral hippocampus and amygdala in the aMCI group were significantly higher than those in the control group (left hippocampus 1.01 vs. 0.77% p < 0.001; right hippocampus 1.02 vs. 0.74%, p < 0.001; left amygdala 0.98 vs. 0.70% p < 0.001; right amygdala 0.94 vs. 0.71%, p < 0.001). The APTw values of the left amygdala had the largest AUC (0.875) at diagnosis of aMCI. There was no significant difference in APTw values between the left and right hippocampus and amygdala, in either group. (aMCI group left hippocampus 1.01 vs. right hippocampus 1.02%, p = 0.652; healthy control group left hippocampus 0.77 vs. right hippocampus 0.74%, p = 0.314; aMCI group left amygdala 0.98 vs. right amygdala 0.94%, p = 0.171; healthy control group left amygdala 0.70 vs. right amygdala 0.71%, p = 0.726). Conclusion: APTw can be used as a new imaging marker to distinguish aMCI patients from the normal elderly population by indirectly reflecting the changes in protein content in the hippocampus and amygdala.
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Affiliation(s)
- Zixuan Guo
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Yanchun Jiang
- Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiaoyan Qin
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ronghua Mu
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zhuoni Meng
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyu Zhuang
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Fuzhen Liu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiqi Zhu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
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Morrison MA, Lupo JM. 7-T Magnetic Resonance Imaging in the Management of Brain Tumors. Magn Reson Imaging Clin N Am 2021; 29:83-102. [PMID: 33237018 DOI: 10.1016/j.mric.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article provides an overview of the current status of ultrahigh-field 7-T magnetic resonance (MR) imaging in neuro-oncology, specifically for the management of patients with brain tumors. It includes a discussion of areas across the pretherapeutic, peritherapeutic, and posttherapeutic stages of patient care where 7-T MR imaging is currently being exploited and holds promise. This discussion includes existing technical challenges, barriers to clinical integration, as well as our impression of the future role of 7-T MR imaging as a clinical tool in neuro-oncology.
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Affiliation(s)
- Melanie A Morrison
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
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Vachha B, Huang SY. MRI with ultrahigh field strength and high-performance gradients: challenges and opportunities for clinical neuroimaging at 7 T and beyond. Eur Radiol Exp 2021; 5:35. [PMID: 34435246 PMCID: PMC8387544 DOI: 10.1186/s41747-021-00216-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
Research in ultrahigh magnetic field strength combined with ultrahigh and ultrafast gradient technology has provided enormous gains in sensitivity, resolution, and contrast for neuroimaging. This article provides an overview of the technical advantages and challenges of performing clinical neuroimaging studies at ultrahigh magnetic field strength combined with ultrahigh and ultrafast gradient technology. Emerging clinical applications of 7-T MRI and state-of-the-art gradient systems equipped with up to 300 mT/m gradient strength are reviewed, and the impact and benefits of such advances to anatomical, structural and functional MRI are discussed in a variety of neurological conditions. Finally, an outlook and future directions for ultrahigh field MRI combined with ultrahigh and ultrafast gradient technology in neuroimaging are examined.
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Affiliation(s)
- Behroze Vachha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Susie Y Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 13th Street, Room 2301, Charlestown, MA, 02129, USA.
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8
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Chen Y, Wang X, Su T, Xu Z, Wang Y, Zhang Z, Xue H, Zhuo Z, Zhu Y, Jin Z, Zhang T. Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value. Quant Imaging Med Surg 2021; 11:2279-2291. [PMID: 34079701 DOI: 10.21037/qims-20-675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The feasibility and image quality of three-dimensional (3D) amide proton transfer (APT)-weighted (APTw) in parotid tumor lesions have not been well established in previous studies. This study aimed to evaluate the utility of APT imaging in parotid lesions and glands. Methods Patients with parotid lesions received 3D turbo spin echo (TSE) APTw on a 3.0T scanner. Two radiologists, who were blinded to the clinical data, independently evaluated the APTw image quality using 4-point Likert scales (1= poor, 4= excellent) in terms of integrity and hyperintensity artifacts. An image quality selection protocol was built based on the two scores. Evaluable images (integrity score >1) and trustable images (integrity score >3 and hyperintensity artifacts score >2) were then enrolled for APTw value comparison between parotid lesions and glands. Results Forty consecutive patients were included in this study. Four patients were excluded due to severe motion (n=3) or dental (n=1) artifacts, and 36 patients received the APT sequence. Among these, more parotid tumor lesions (34/36, 94.4%) than normal parotid glands (23/31, 74.2%) revealed excellent integrity scores (score =4) (P=0.034). Most parotid tumor lesions (24/34, 70.6%) and glands (16/28, 57.1%) revealed no or little hyperintensity artifacts for diagnosis (scores 3 and 4). APT values of parotid lesions and glands in the evaluable groups were 2.11%±1.15% and 1.60%±1.56%, respectively, and the difference was not significant (P=0.197). APT values of parotid lesions and glands in the trustable groups were 1.99%±1.18% and 1.03%±1.09%, respectively, and the difference was statistically significant (P=0.018). Conclusions 3D APTw could be used to differentiate parotid tumors and normal parotid glands; however, the technology still needs to be improved to remove artifacts. In our study, most APTw images of tumor lesions in parotid glands had acceptable image quality, and these APTw images are feasible for diagnostic use.
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Affiliation(s)
- Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Yuanli Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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9
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von Knebel Doeberitz N, Maksimovic S, Loi L, Paech D. [Chemical exchange saturation transfer (CEST) : Magnetic resonance imaging in diagnostic oncology]. Radiologe 2021; 61:43-51. [PMID: 33337509 DOI: 10.1007/s00117-020-00786-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Contrast generation by chemical exchange saturation transfer (CEST) is a recently emerging magnetic resonance imaging (MRI) research field with high clinical potential. METHODS This review covers the methodological principles and summarizes the clinical experience of CEST imaging studies in diagnostic oncology performed to date. RESULTS AND CONCLUSION CEST enables the detection of lowly concentrated metabolites, such as peptides and glucose, through selective saturation of metabolite-bound protons and subsequent magnetization transfer to free water. This technology yields additional information about metabolic activity and the tissue microenvironment without the need for conventional contrast agents or radioactive tracers. Various studies, mainly conducted in patients with neuro-oncolgic diseases, suggest that this technology may aid to assess tumor malignancy as well as therapeutic response prior to and in the first follow-up after intervention. KEY POINTS CEST-MRI enables the indirect detection of metabolites without radioactive tracers or contrast agents. Clinical experience exists especially in the setting of neuro-oncologic imaging. In oncologic imaging, CEST-MRI may improve assessment of prognosis and therapy response.
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Affiliation(s)
- N von Knebel Doeberitz
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - S Maksimovic
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - L Loi
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - D Paech
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
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Abstract
Magnetic resonance imaging (MRI) has been the cornerstone of imaging of brain tumors in the past 4 decades. Conventional MRI remains the workhorse for neuro-oncologic imaging, not only for basic information such as location, extent, and navigation but also able to provide information regarding proliferation and infiltration, angiogenesis, hemorrhage, and more. More sophisticated MRI sequences have extended the ability to assess and quantify these features; for example, permeability and perfusion acquisitions can assess blood-brain barrier disruption and angiogenesis, diffusion techniques can assess cellularity and infiltration, and spectroscopy can address metabolism. Techniques such as fMRI and diffusion fiber tracking can be helpful in diagnostic planning for resection and radiation therapy, and more sophisticated iterations of these techniques can extend our understanding of neurocognitive effects of these tumors and associated treatment responses and effects. More recently, MRI has been used to go beyond such morphological, physiological, and functional characteristics to assess the tumor microenvironment. The current review highlights multiple recent and emerging approaches in MRI to characterize the tumor microenvironment.
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Sartoretti T, Sartoretti E, Wyss M, Schwenk Á, Najafi A, Binkert C, Reischauer C, Zhou J, Jiang S, Becker AS, Sartoretti-Schefer S. Amide Proton Transfer Contrast Distribution in Different Brain Regions in Young Healthy Subjects. Front Neurosci 2019; 13:520. [PMID: 31178687 PMCID: PMC6538817 DOI: 10.3389/fnins.2019.00520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/06/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives To define normal signal intensity values of amide proton transfer-weighted (APTw) magnetic resonance (MR) imaging in different brain regions. Materials and Methods Twenty healthy subjects (9 females, mean age 29 years, range 19 - 37 years) underwent MR imaging at 3 Tesla. 3D APTw (RF saturation B1,rms = 2 μT, duration 2 s, 100% duty cycle) and 2D T2-weighted turbo spin echo (TSE) images were acquired. Postprocessing (image fusion, ROI measurements of APTw intensity values in 22 different brain regions) was performed and controlled by two independent neuroradiologists. Values were measured separately for each brain hemisphere. A subject was scanned both in prone and supine position to investigate differences between hemispheres. A mixed model on a 5% significance level was used to assess the effect of gender, brain region and side on APTw intensity values. Results Mean APTw intensity values in the hippocampus and amygdala varied between 1.13 and 1.57%, in the deep subcortical nuclei (putamen, globus pallidus, head of caudate nucleus, thalamus, red nucleus, substantia nigra) between 0.73 and 1.84%, in the frontal, occipital and parietal cortex between 0.56 and 1.03%; in the insular cortex between 1.11 and 1.15%, in the temporal cortex between 1.22 and 1.37%, in the frontal, occipital and parietal white matter between 0.32 and 0.54% and in the temporal white matter between 0.83 and 0.89%. APTw intensity values were significantly impacted both by brain region (p < 0.001) and by side (p < 0.001), whereby overall values on the left side were higher than on the right side (1.13 vs. 0.9%). Gender did not significantly impact APTw intensity values (p = 0.24). APTw intensity values between the left and the right side were partially reversed after changing the position of one subject from supine to prone. Conclusion We determined normal baseline APTw intensity values in different anatomical localizations in healthy subjects. APTw intensity values differed both between anatomical regions and between left and right brain hemisphere.
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Affiliation(s)
- Thomas Sartoretti
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Elisabeth Sartoretti
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Wyss
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Philips Health Systems, Zurich, Switzerland
| | - Árpád Schwenk
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Arash Najafi
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Christoph Binkert
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carolin Reischauer
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Jinyuan Zhou
- Department of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Shanshan Jiang
- Department of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sabine Sartoretti-Schefer
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Liebert A, Zaiss M, Gumbrecht R, Tkotz K, Linz P, Schmitt B, Laun FB, Doerfler A, Uder M, Nagel AM. Multiple interleaved mode saturation (MIMOSA) for B
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inhomogeneity mitigation in chemical exchange saturation transfer. Magn Reson Med 2019; 82:693-705. [DOI: 10.1002/mrm.27762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/25/2019] [Accepted: 03/13/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Andrzej Liebert
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | - Moritz Zaiss
- High‐Field Magnetic Resonance Center Max Planck Institute for Biological Cybernetics Tuebingen Germany
| | | | - Katharina Tkotz
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | - Peter Linz
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | | | - Frederik B. Laun
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | - Arnd Doerfler
- Department of Neuroradiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | - Michael Uder
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
| | - Armin M. Nagel
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
- Institute of Medical Physics University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Germany
- Division of Medical Physics in Radiology German Cancer Research Centre (DKFZ) Heidelberg Germany
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13
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Zhao J, Huang S, Xie H, Li W. An evidence-based approach to evaluate the accuracy of amide proton transfer-weighted MRI in characterization of gliomas. Medicine (Baltimore) 2019; 98:e14768. [PMID: 30855481 PMCID: PMC6417527 DOI: 10.1097/md.0000000000014768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUD To perform a meta-analysis to evaluate the diagnostic accuracy of the amide proton transfer (APT) technique in differentiating high-grade gliomas (HGGs) from low grade gliomas (LGGs). METHODS Medical literature databases were searched for studies that evaluated the diagnostic accuracy of APT in patients suspected of brain tumor who underwent APT MRI and surgery. Only English language studies and published before September 2018 were considered to be included in this project. Homogeneity was assessed by the inconsistency index. Mean difference (MD) at 95% confidence interval (CI) of all parameters derived from APT was calculated. Publication bias was explored by Egger's funnel plot. RESULTS Six eligible studies were included in the meta-analysis, comprising 144 HGGs and 122 LGGs. The APT-related parameter signal intensity (SI) was significantly higher in the HGG than the LGG (WMD = 0.86 (0.61-1.1), P < .0001); A significant difference was also found between grade II and grade III (WMD = 0.6 (0.4-0.8), P < .0001), and between grade II and grade IV (WMD = 1.07 (0.65-1.49), P < .0001). CONCLUSIONS APT imaging may be a useful imaging biomarker for discriminating between LGGs and HGGs. However, large randomized control trials (RCT) were necessary to evaluate its clinical value.
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Affiliation(s)
| | - Songtao Huang
- Department of Radiology, Guang’an People's Hospital, Sichuan
| | - Huan Xie
- Department of Radiology, Guang’an People's Hospital, Sichuan
| | - Wenfei Li
- Department of Radiology, First Hospital of Qinhuangdao, Hebei, China
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14
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Lohmann P, Werner JM, Shah NJ, Fink GR, Langen KJ, Galldiks N. Combined Amino Acid Positron Emission Tomography and Advanced Magnetic Resonance Imaging in Glioma Patients. Cancers (Basel) 2019; 11:cancers11020153. [PMID: 30699942 PMCID: PMC6406895 DOI: 10.3390/cancers11020153] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 02/07/2023] Open
Abstract
Imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging (MRI) provide valuable information about brain tumor patients. Particularly amino acid PET, advanced MRI techniques, and combinations thereof are of great interest for the non-invasive assessment of biological characteristics in patients with primary or secondary brain cancer. A methodological innovation that potentially advances research in patients with brain tumors is the increasing availability of hybrid PET/MRI systems, which enables the simultaneous acquisition of both imaging modalities. Furthermore, the advent of ultra-high field MRI scanners operating at magnetic field strengths of 7 T or more will allow further development of metabolic MR imaging at higher resolution. This review focuses on the combination of amino acid PET with MR spectroscopic imaging, perfusion- and diffusion-weighted imaging, as well as chemical exchange saturation transfer in patients with high-grade gliomas, especially glioblastomas.
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Affiliation(s)
- Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-3, -4, -5, -11), Forschungszentrum Juelich, 52425 Juelich, Germany.
| | - Jan-Michael Werner
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
| | - N Jon Shah
- Institute of Neuroscience and Medicine (INM-3, -4, -5, -11), Forschungszentrum Juelich, 52425 Juelich, Germany.
- JARA-BRAIN-Translational Medicine, 52074 Aachen, Germany.
- Department of Neurology, RWTH Aachen University, 52074 Aachen, Germany.
| | - Gereon R Fink
- Institute of Neuroscience and Medicine (INM-3, -4, -5, -11), Forschungszentrum Juelich, 52425 Juelich, Germany.
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4, -5, -11), Forschungszentrum Juelich, 52425 Juelich, Germany.
- Department of Nuclear Medicine, RWTH Aachen University, 52074 Aachen, Germany.
| | - Norbert Galldiks
- Institute of Neuroscience and Medicine (INM-3, -4, -5, -11), Forschungszentrum Juelich, 52425 Juelich, Germany.
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
- Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, 50937 Cologne, Germany.
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