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Zhou J, Zaiss M, Knutsson L, Sun PZ, Ahn SS, Aime S, Bachert P, Blakeley JO, Cai K, Chappell MA, Chen M, Gochberg DF, Goerke S, Heo HY, Jiang S, Jin T, Kim SG, Laterra J, Paech D, Pagel MD, Park JE, Reddy R, Sakata A, Sartoretti-Schefer S, Sherry AD, Smith SA, Stanisz GJ, Sundgren PC, Togao O, Vandsburger M, Wen Z, Wu Y, Zhang Y, Zhu W, Zu Z, van Zijl PCM. Review and consensus recommendations on clinical APT-weighted imaging approaches at 3T: Application to brain tumors. Magn Reson Med 2022; 88:546-574. [PMID: 35452155 PMCID: PMC9321891 DOI: 10.1002/mrm.29241] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 12/16/2022]
Abstract
Amide proton transfer-weighted (APTw) MR imaging shows promise as a biomarker of brain tumor status. Currently used APTw MRI pulse sequences and protocols vary substantially among different institutes, and there are no agreed-on standards in the imaging community. Therefore, the results acquired from different research centers are difficult to compare, which hampers uniform clinical application and interpretation. This paper reviews current clinical APTw imaging approaches and provides a rationale for optimized APTw brain tumor imaging at 3 T, including specific recommendations for pulse sequences, acquisition protocols, and data processing methods. We expect that these consensus recommendations will become the first broadly accepted guidelines for APTw imaging of brain tumors on 3 T MRI systems from different vendors. This will allow more medical centers to use the same or comparable APTw MRI techniques for the detection, characterization, and monitoring of brain tumors, enabling multi-center trials in larger patient cohorts and, ultimately, routine clinical use.
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Affiliation(s)
- Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Moritz Zaiss
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Institute of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Linda Knutsson
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medical Radiation Physics, Lund University, Lund, Sweden.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Silvio Aime
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Peter Bachert
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Jaishri O Blakeley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kejia Cai
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael A Chappell
- Mental Health and Clinical Neurosciences and Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Daniel F Gochberg
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Physics, Vanderbilt University, Nashville, Tennessee, USA
| | - Steffen Goerke
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tao Jin
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science and Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - John Laterra
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Mark D Pagel
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ravinder Reddy
- Center for Advance Metabolic Imaging in Precision Medicine, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - A Dean Sherry
- Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Chemistry and Biochemistry, University of Texas at Dallas, Richardson, Texas, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Greg J Stanisz
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Pia C Sundgren
- Department of Diagnostic Radiology/Clinical Sciences Lund, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Osamu Togao
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter C M van Zijl
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
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Tamrazi B, Liu CSJ, Cen SY, Nelson MB, Dhall G, Nelson MD. Brain Irradiation and Gadobutrol Administration in Pediatric Patients with Brain Tumors: Effect on MRI Brain Signal Intensity. Radiology 2018; 289:188-194. [PMID: 29989524 DOI: 10.1148/radiol.2018173057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose To determine whether treatment affects MRI signal intensity in pediatric patients with primary brain tumors independent of the administration of macrocyclic gadolinium-based contrast agents (GBCAs). Materials and Methods This retrospective, single-center study included 78 patients (mean age, 7.7 years ± 5.4) with primary brain tumors who underwent macrocyclic GBCA-enhanced MRI from 2015 to 2018. Three groups were compared: (a) patients who had undergone radiation therapy (37 patients, 26 of whom had undergone concurrent chemotherapy), (b) patients who had undergone chemotherapy only (17 patients), and (c) patients who had received no treatment ("no-treatment group," 24 patients). The signal intensity in the globus pallidus (GP), thalamus, dentate nucleus (DN), and pons was measured on unenhanced T1-weighted images. GP-to-thalamus and DN-to-pons signal intensity ratios were compared among groups with analysis of variance by using the Kruskal-Wallis test, followed by post hoc pairwise tests with Tukey adjustment, and were analyzed relative to group, total cumulative doses of GBCA, age, and sex with multivariable linear models. Results The mean number of GBCA-enhanced MRI examinations in the radiation therapy, chemotherapy-only, and no-treatment groups was 7.11, 7.29, and 4.96, respectively (P < .01 for the radiation therapy and chemotherapy groups compared with the no-treatment group). The DN-to-pons ratio in the radiation therapy group was higher than that in both the no-treatment group and the chemotherapy-only group (P < .01 for both). There was no significant difference in the DN-to-pons ratios between the chemotherapy-only group and the no-treatment group (P = .99). The GP-to-thalamus ratios did not differ among all three groups (P = .09). There was no dose-dependent effect of GBCA on the DN-to-pons and GP-to-thalamus ratios when adjusting for the effects of treatment (P = .21 and P = .38, respectively). Conclusion Brain irradiation contributes to a higher dentate nucleus signal intensity in pediatric patients with brain tumor independent of the administration of macrocyclic gadolinium-based contrast agents. © RSNA, 2018.
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Affiliation(s)
- Benita Tamrazi
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Chia-Shang J Liu
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Steven Y Cen
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Mary B Nelson
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Girish Dhall
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Marvin D Nelson
- From the Departments of Radiology (B.T., M.D.N.) and Pediatrics (M.B.N., G.D.), Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027; and Departments of Radiology (C.S.J.L.), Neurology and Radiology (S.Y.C.), and Pediatrics (M.B.N.), Keck School of Medicine of the University of Southern California, Los Angeles, Calif
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Tamrazi B, Nguyen B, Liu CSJ, Azen CG, Nelson MB, Dhall G, Nelson MD. Changes in Signal Intensity of the Dentate Nucleus and Globus Pallidus in Pediatric Patients: Impact of Brain Irradiation and Presence of Primary Brain Tumors Independent of Linear Gadolinium-based Contrast Agent Administration. Radiology 2018; 287:452-460. [PMID: 29189102 PMCID: PMC5929364 DOI: 10.1148/radiol.2017171850] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose To determine whether whole-brain irradiation, chemotherapy, and primary brain pathologic conditions affect magnetic resonance (MR) imaging signal changes in pediatric patients independent of the administration of gadolinium-based contrast agents (GBCAs). Materials and Methods This institutional review board-approved, HIPAA-compliant study included 144 pediatric patients who underwent intravenous GBCA-enhanced MR imaging examinations (55 patients with primary brain tumors and whole-brain irradiation, 19 with primary brain tumors and chemotherapy only, 52 with primary brain tumors without any treatment, and 18 with neuroblastoma without brain metastatic disease). The signal intensities (SIs) in the globus pallidus (GP), thalamus (T), dentate nucleus (DN), and pons (P) were measured on unenhanced T1-weighted images. GP:T and DN:P SI ratios were compared between groups by using the analysis of variance and were analyzed relative to group, total cumulative number of doses of GBCA, age, and sex by using multivariable linear models. Results DN:P ratio for the radiation therapy group was greater than that for the other groups except for the group of brain tumors treated with chemotherapy (P < .05). The number of GBCA doses was correlated with the DN:P ratio for the nontreated brain tumor group (P < .0001). The radiation therapy-treated brain tumor group demonstrated higher DN:P ratios than the nontreated brain tumor group for number of doses less than or equal to 10 (P < .0001), whereas ratios in the nontreated brain tumor group were higher than those in the radiation therapy-treated brain tumor group for doses greater than 20 (P = .05). The GP:T ratios for the brain tumor groups were greater than that for the neuroblastoma group (P = .01). Conclusion Changes in SI of the DN and GP that are independent of the administration of GBCA occur in patients with brain tumors undergoing brain irradiation, as well as in patients with untreated primary brain tumors. © RSNA, 2017.
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Affiliation(s)
- Benita Tamrazi
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Binh Nguyen
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Chia-Shang J. Liu
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Colleen G. Azen
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Mary B. Nelson
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Girish Dhall
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
| | - Marvin D. Nelson
- From the Departments of Radiology (B.T., B.N., C.S.J.L., C.G.A., M.D.N.) and Hematology (M.B.N., G.D.), Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027
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Wang G, Zhang Y, Hegde SS, Bottomley PA. High-resolution and accelerated multi-parametric mapping with automated characterization of vessel disease using intravascular MRI. J Cardiovasc Magn Reson 2017; 19:89. [PMID: 29157260 PMCID: PMC5694914 DOI: 10.1186/s12968-017-0399-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Atherosclerosis is prevalent in cardiovascular disease, but present imaging modalities have limited capabilities for characterizing lesion stage, progression and response to intervention. This study tests whether intravascular magnetic resonance imaging (IVMRI) measures of relaxation times (T1, T2) and proton density (PD) in a clinical 3 Tesla scanner could characterize vessel disease, and evaluates a practical strategy for accelerated quantification. METHODS IVMRI was performed in fresh human artery segments and swine vessels in vivo, using fast multi-parametric sequences, 1-2 mm diameter loopless antennae and 200-300 μm resolution. T1, T2 and PD data were used to train a machine learning classifier (support vector machine, SVM) to automatically classify normal vessel, and early or advanced disease, using histology for validation. Disease identification using the SVM was tested with receiver operating characteristic curves. To expedite acquisition of T1, T2 and PD data for vessel characterization, the linear algebraic method ('SLAM') was modified to accommodate the antenna's highly-nonuniform sensitivity, and used to provide average T1, T2 and PD measurements from compartments of normal and pathological tissue segmented from high-resolution images at acceleration factors of R ≤ 18-fold. The results were validated using compartment-average measures derived from the high-resolution scans. RESULTS The SVM accurately classified ~80% of samples into the three disease classes. The 'area-under-the-curve' was 0.96 for detecting disease in 248 samples, with T1 providing the best discrimination. SLAM T1, T2 and PD measures for R ≤ 10 were indistinguishable from the true means of segmented tissue compartments. CONCLUSION High-resolution IVMRI measures of T1, T2 and PD with a trained SVM can automatically classify normal, early and advanced atherosclerosis with high sensitivity and specificity. Replacing relaxometric MRI with SLAM yields good estimates of T1, T2 and PD an order-of-magnitude faster to facilitate IVMRI-based characterization of vessel disease.
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Affiliation(s)
- Guan Wang
- Department of Electrical & Computer Engineering, Johns Hopkins University, Baltimore, MD USA
- Division of MR Research, Department of Radiology and Radiological Sciences, Johns Hopkins University, Park building 310, 600 N Wolfe Street, Baltimore, MD 21287 USA
| | - Yi Zhang
- Division of MR Research, Department of Radiology and Radiological Sciences, Johns Hopkins University, Park building 310, 600 N Wolfe Street, Baltimore, MD 21287 USA
| | - Shashank Sathyanarayana Hegde
- Division of MR Research, Department of Radiology and Radiological Sciences, Johns Hopkins University, Park building 310, 600 N Wolfe Street, Baltimore, MD 21287 USA
| | - Paul A. Bottomley
- Department of Electrical & Computer Engineering, Johns Hopkins University, Baltimore, MD USA
- Division of MR Research, Department of Radiology and Radiological Sciences, Johns Hopkins University, Park building 310, 600 N Wolfe Street, Baltimore, MD 21287 USA
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