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Liu C, Li Z, Chen Z, Zhao B, Zheng Z, Song X. Highly-accelerated CEST MRI using frequency-offset-dependent k-space sampling and deep-learning reconstruction. Magn Reson Med 2024; 92:688-701. [PMID: 38623899 DOI: 10.1002/mrm.30089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/31/2024] [Accepted: 03/02/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE To develop a highly accelerated CEST Z-spectral acquisition method using a specifically-designed k-space sampling pattern and corresponding deep-learning-based reconstruction. METHODS For k-space down-sampling, a customized pattern was proposed for CEST, with the randomized probability following a frequency-offset-dependent (FOD) function in the direction of saturation offset. For reconstruction, the convolution network (CNN) was enhanced with a Partially Separable (PS) function to optimize the spatial domain and frequency domain separately. Retrospective experiments on a self-acquired human brain dataset (13 healthy adults and 15 brain tumor patients) were conducted using k-space resampling. The prospective performance was also assessed on six healthy subjects. RESULTS In retrospective experiments, the combination of FOD sampling and PS network (FOD + PSN) showed the best quantitative metrics for reconstruction, outperforming three other combinations of conventional sampling with varying density and a regular CNN (nMSE and SSIM, p < 0.001 for healthy subjects). Across all acceleration factors from 4 to 14, the FOD + PSN approach consistently outperformed the comparative methods in four contrast maps including MTRasym, MTRrex, as well as the Lorentzian Difference maps of amide and nuclear Overhauser effect (NOE). In the subspace replacement experiment, the error distribution demonstrated the denoising benefits achieved in the spatial subspace. Finally, our prospective results obtained from healthy adults and brain tumor patients (14×) exhibited the initial feasibility of our method, albeit with less accurate reconstruction than retrospective ones. CONCLUSION The combination of FOD sampling and PSN reconstruction enabled highly accelerated CEST MRI acquisition, which may facilitate CEST metabolic MRI for brain tumor patients.
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Affiliation(s)
- Chuyu Liu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Zhongsen Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Benqi Zhao
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhuozhao Zheng
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaolei Song
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
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Kurmi Y, Viswanathan M, Zu Z. A Denoising Convolutional Autoencoder for SNR Enhancement in Chemical Exchange Saturation Transfer imaging: (DCAE-CEST). BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.07.597818. [PMID: 38895366 PMCID: PMC11185751 DOI: 10.1101/2024.06.07.597818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Purpose To develop a SNR enhancement method for chemical exchange saturation transfer (CEST) imaging using a denoising convolutional autoencoder (DCAE), and compare its performance with state-of-the-art denoising methods. Method The DCAE-CEST model encompasses an encoder and a decoder network. The encoder learns features from the input CEST Z-spectrum via a series of 1D convolutions, nonlinearity applications and pooling. Subsequently, the decoder reconstructs an output denoised Z-spectrum using a series of up-sampling and convolution layers. The DCAE-CEST model underwent multistage training in an environment constrained by Kullback-Leibler divergence, while ensuring data adaptability through context learning using Principal Component Analysis processed Z-spectrum as a reference. The model was trained using simulated Z-spectra, and its performance was evaluated using both simulated data and in-vivo data from an animal tumor model. Maps of amide proton transfer (APT) and nuclear Overhauser enhancement (NOE) effects were quantified using the multiple-pool Lorentzian fit, along with an apparent exchange-dependent relaxation metric. Results In digital phantom experiments, the DCAE-CEST method exhibited superior performance, surpassing existing denoising techniques, as indicated by the peak SNR and Structural Similarity Index. Additionally, in vivo data further confirms the effectiveness of the DCAE-CEST in denoising the APT and NOE maps when compared to other methods. While no significant difference was observed in APT between tumors and normal tissues, there was a significant difference in NOE, consistent with previous findings. Conclusion The DCAE-CEST can learn the most important features of the CEST Z-spectrum and provide the most effective denoising solution compared to other methods.
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Affiliation(s)
- Yashwant Kurmi
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, USA
| | - Malvika Viswanathan
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, USA
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, USA
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3
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Chen L, Huang L, Zhang J, Li S, Li Y, Tang L, Chen W, Wu M, Li T. Amide proton transfer-weighted and arterial spin labeling imaging may improve differentiation between high-grade glioma recurrence and radiation-induced brain injury. Heliyon 2024; 10:e32699. [PMID: 38961946 PMCID: PMC11219995 DOI: 10.1016/j.heliyon.2024.e32699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
Rationale and objectives The management of tumor recurrence (TR) and radiation-induced brain injury (RIBI) poses significant challenges, necessitating the development of effective differentiation strategies. In this study, we investigated the potential of amide proton transfer-weighted (APTw) and arterial spin labeling (ASL) imaging for discriminating between TR and RIBI in patients with high-grade glioma (HGG). Methods A total of 64 HGG patients receiving standard treatment were enrolled in this study. The patients were categorized based on secondary pathology or MRI follow-up results, and the demographic characteristics of each group were presented. The APTw, rAPTw, cerebral blood flow (CBF) and rCBF values were quantified. The differences in various parameters between TR and RIBI were assessed using the independent-samples t-test. The discriminative performance of these MRI parameters in distinguishing between the two conditions was assessed using receiver operating characteristic (ROC) curve analysis. Additionally, the Delong test was employed to further evaluate their discriminatory ability. Results The APTw and CBF values of TR were significantly higher compared to RIBI (P < 0.05). APTw MRI demonstrated superior diagnostic efficiency in distinguishing TR from RIBI (area under the curve [AUC]: 0.864; sensitivity: 75.0 %; specificity: 81.8 %) when compared to ASL imaging. The combined utilization of APTw and CBF value further enhanced the AUC to 0.922. The Delong test demonstrated that the combination of APTw and ASL exhibited superior performance in the identification of TR and RIBI, compared to ASL alone (P = 0.048). Conclusion APTw exhibited superior diagnostic efficacy compared to ASL in the evaluation of TR and RIBI. Furthermore, the combination of APTw and ASL exhibits greater discriminatory capability and diagnostic performance.
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Affiliation(s)
- Ling Chen
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Lizhao Huang
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Jinhuan Zhang
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Shuanghong Li
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Yao Li
- Department of Neurosurgery, Liuzhou Workers Hospital, Guangxi, China
| | - Lifang Tang
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Weijiao Chen
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Min Wu
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
| | - Tao Li
- Department of Radiology, Liuzhou Workers Hospital, Guangxi, China
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Kersch CN, Kim M, Stoller J, Barajas RF, Park JE. Imaging Genomics of Glioma Revisited: Analytic Methods to Understand Spatial and Temporal Heterogeneity. AJNR Am J Neuroradiol 2024; 45:537-548. [PMID: 38548303 DOI: 10.3174/ajnr.a8148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/09/2023] [Indexed: 04/12/2024]
Abstract
An improved understanding of the cellular and molecular biologic processes responsible for brain tumor development, growth, and resistance to therapy is fundamental to improving clinical outcomes. Imaging genomics is the study of the relationships between microscopic, genetic, and molecular biologic features and macroscopic imaging features. Imaging genomics is beginning to shift clinical paradigms for diagnosing and treating brain tumors. This article provides an overview of imaging genomics in gliomas, in which imaging data including hallmarks such as IDH-mutation, MGMT methylation, and EGFR-mutation status can provide critical insights into the pretreatment and posttreatment stages. This article will accomplish the following: 1) review the methods used in imaging genomics, including visual analysis, quantitative analysis, and radiomics analysis; 2) recommend suitable analytic methods for imaging genomics according to biologic characteristics; 3) discuss the clinical applicability of imaging genomics; and 4) introduce subregional tumor habitat analysis with the goal of guiding future radiogenetics research endeavors toward translation into critically needed clinical applications.
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Affiliation(s)
- Cymon N Kersch
- From the Department of Radiation Medicine (C.N.K.), Oregon Health and Science University, Portland, Oregon
| | - Minjae Kim
- Department of Radiology and Research Institute of Radiology (M.K., J.E.P.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jared Stoller
- Department of Diagnostic Radiology (J.S., R.F.B.), Oregon Health and Science University, Portland, Oregon
| | - Ramon F Barajas
- Department of Diagnostic Radiology (J.S., R.F.B.), Oregon Health and Science University, Portland, Oregon
- Knight Cancer Institute (R.F.B.), Oregon Health and Science University, Portland, Oregon
- Advanced Imaging Research Center (R.F.B.), Oregon Health and Science University, Portland, Oregon
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology (M.K., J.E.P.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Viswanathan M, Yin L, Kurmi Y, Zu Z. Machine learning-based amide proton transfer imaging using partially synthetic training data. Magn Reson Med 2024; 91:1908-1922. [PMID: 38098340 PMCID: PMC10955622 DOI: 10.1002/mrm.29970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/30/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE Machine learning (ML) has been increasingly used to quantify CEST effect. ML models are typically trained using either measured data or fully simulated data. However, training with measured data often lacks sufficient training data, whereas training with fully simulated data may introduce bias because of limited simulations pools. This study introduces a new platform that combines simulated and measured components to generate partially synthetic CEST data, and to evaluate its feasibility for training ML models to predict amide proton transfer (APT) effect. METHODS Partially synthetic CEST signals were created using an inverse summation of APT effects from simulations and the other components from measurements. Training data were generated by varying APT simulation parameters and applying scaling factors to adjust the measured components, achieving a balance between simulation flexibility and fidelity. First, tissue-mimicking CEST signals along with ground truth information were created using multiple-pool model simulations to validate this method. Second, an ML model was trained individually on partially synthetic data, in vivo data, and fully simulated data, to predict APT effect in rat brains bearing 9 L tumors. RESULTS Experiments on tissue-mimicking data suggest that the ML method using the partially synthetic data is accurate in predicting APT. In vivo experiments suggest that our method provides more accurate and robust prediction than the training using in vivo data and fully synthetic data. CONCLUSION Partially synthetic CEST data can address the challenges in conventional ML methods.
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Affiliation(s)
- Malvika Viswanathan
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
| | - Leqi Yin
- School of Engineering, Vanderbilt University, Nashville, US
| | - Yashwant Kurmi
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
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6
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Sun C, Zhao Y, Zu Z. Evaluation of the molecular origin of amide proton transfer-weighted imaging. Magn Reson Med 2024; 91:716-734. [PMID: 37749854 PMCID: PMC10841347 DOI: 10.1002/mrm.29878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/15/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To evaluate the assumption in amide proton transfer weighted (APTw) imaging that the APT dominates over the relayed nuclear Overhauser enhancement (rNOE) and other CEST effects such as those from amines/guanidines, thereby providing imaging of mobile proteins/peptides. METHODS We introduced two auxiliary asymmetric analysis metrics that can vary the relative contributions from amine/guanidinium CEST and other effects. By comparing these metrics with the conventional asymmetric analysis metric on healthy rat brains, we can approximately assess the contribution from amines/guanidines to APTw and determine whether the APT dominates over the rNOE effect. To further investigate the molecular origin of APTw, we used samples of dialyzed tissue homogenates to eliminate small metabolites and supernatants of homogenates to separate lipids from other components. RESULTS When the APTw signal is positive using high saturation amplitudes (e.g., 2-3 μT), the contributions from amines/guanidines are significant and cannot be ignored. The APTw signal from the dialyzed homogenates and the controls has negligible changes, indicating that it primarily originates from macromolecules rather than small metabolites. Additionally, the APTw signals with low saturation amplitudes (e.g., 1 μT) were negative in tissue homogenates but positive in their supernatants, suggesting that proteins contribute positively to APTw signals, whereas lipids contribute negatively to it. CONCLUSION The positive APTw signal using high saturation amplitudes could have significant contributions from soluble proteins through CEST, including amide/amine/guanidine proton transfer effects. In contrast, the negative APTw signal using low saturation amplitudes has significant contribution from lipids through rNOE.
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Affiliation(s)
- Casey Sun
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Chemistry, University of Florida, Gainesville, US
| | - Yu Zhao
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
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7
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Viswanathan M, Yin L, Kurmi Y, Zu Z. Amide Proton Transfer (APT) imaging in tumor with a machine learning approach using partially synthetic data. ARXIV 2023:arXiv:2311.01683v2. [PMID: 37961738 PMCID: PMC10635304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Purpose Machine learning (ML) has been increasingly used to quantify chemical exchange saturation transfer (CEST) effect. ML models are typically trained using either measured data or fully simulated data. However, training with measured data often lacks sufficient training data, while training with fully simulated data may introduce bias due to limited simulations pools. This study introduces a new platform that combines simulated and measured components to generate partially synthetic CEST data, and to evaluate its feasibility for training ML models to predict amide proton transfer (APT) effect. Methods Partially synthetic CEST signals were created using an inverse summation of APT effects from simulations and the other components from measurements. Training data were generated by varying APT simulation parameters and applying scaling factors to adjust the measured components, achieving a balance between simulation flexibility and fidelity. First, tissue-mimicking CEST signals along with ground truth information were created using multiple-pool model simulations to validate this method. Second, an ML model was trained individually on partially synthetic data, in vivo data, and fully simulated data, to predict APT effect in rat brains bearing 9L tumors. Results Experiments on tissue-mimicking data suggest that the ML method using the partially synthetic data is accurate in predicting APT. In vivo experiments suggest that our method provides more accurate and robust prediction than the training using in vivo data and fully synthetic data. Conclusion Partially synthetic CEST data can address the challenges in conventional ML methods.
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Affiliation(s)
- Malvika Viswanathan
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
| | - Leqi Yin
- School of Engineering, Vanderbilt University, Nashville, US
| | - Yashwant Kurmi
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
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8
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Wu Y, Wood TC, Derks SHAE, Pruis IJ, van der Voort S, van Zanten SEMV, Smits M, Warnert EAH. Reproducibility of APT-weighted CEST-MRI at 3T in healthy brain and tumor across sessions and scanners. Sci Rep 2023; 13:18115. [PMID: 37872418 PMCID: PMC10593824 DOI: 10.1038/s41598-023-44891-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
Amide proton transfer (APT)-weighted chemical exchange saturation transfer (CEST) imaging is a recent MRI technique making its way into clinical application. In this work, we investigated whether APT-weighted CEST imaging can provide reproducible measurements across scan sessions and scanners. Within-session, between-session and between scanner reproducibility was calculated for 19 healthy volunteers and 7 patients with a brain tumor on two 3T MRI scanners. The APT-weighted CEST effect was evaluated by calculating the Lorentzian Difference (LD), magnetization transfer ratio asymmetry (MTRasym), and relaxation-compensated inverse magnetization transfer ratio (MTRREX) averaged in whole brain white matter (WM), enhancing tumor and necrosis. Within subject coefficient of variation (COV) calculations, Bland-Altman plots and mixed effect modeling were performed to assess the repeatability and reproducibility of averaged values. The group median COVs of LD APT were 0.56% (N = 19), 0.84% (N = 6), 0.80% (N = 9) in WM within-session, between-session and between-scanner respectively. The between-session COV of LD APT in enhancing tumor (N = 6) and necrotic core (N = 3) were 4.57% and 5.67%, respectively. There were no significant differences in within session, between session and between scanner comparisons of the APT effect. The COVs of LD and MTRREX were consistently lower than MTRasym in all experiments, both in healthy tissues and tumor. The repeatability and reproducibility of APT-weighted CEST was clinically acceptable across scan sessions and scanners. Although MTRasym is simple to acquire and compute and sufficient to provide robust measurement, it is beneficial to include LD and MTRREX to obtain higher reproducibility for detecting minor signal difference in different tissue types.
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Affiliation(s)
- Yulun Wu
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Tobias C Wood
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sophie H A E Derks
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Ilanah J Pruis
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sebastian van der Voort
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Medical Delta, Delft, The Netherlands
| | - Sophie E M Veldhuijzen van Zanten
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Medical Delta, Delft, The Netherlands
| | - Esther A H Warnert
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
- Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
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9
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Sun C, Zhao Y, Zu Z. Validation of the presence of fast exchanging amine CEST effect at low saturation powers and its influence on the quantification of APT. Magn Reson Med 2023; 90:1502-1517. [PMID: 37317709 PMCID: PMC10614282 DOI: 10.1002/mrm.29742] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Accurately quantifying the amide proton transfer (APT) effect and the underlying exchange parameters is crucial for its applications, but previous studies have reported conflicting results. In these quantifications, the CEST effect from the fast exchange amine was always ignored because it was considered weak with low saturation powers. This paper aims to evaluate the influence of the fast exchange amine CEST on the quantification of APT at low saturation powers. METHODS A quantification method with low and high saturation powers was used to distinguish APT from the fast exchange amine CEST effect. Simulations were conducted to assess the method's capability to separate APT from the fast exchange amine CEST effect. Animal experiments were performed to assess the relative contributions from the fast exchange amine and amide to CEST signals at 3.5 ppm. Three APT quantification methods, each with varying degrees of contamination from the fast exchange amine, were employed to process the animal data to assess the influence of the amine on the quantification of APT effect and the exchange parameters. RESULTS The relative size of the fast exchange amine CEST effect to APT effect gradually increases with increasing saturation power. At 9.4 T, it increases from approximately 20% to 40% of APT effect with a saturation power increase from 0.25 to 1 μT. CONCLUSION The fast exchange amine CEST effect leads overestimation of APT effect, fitted amide concentration, and amide-water exchange rate, potentially contributing to the conflicting results reported in previous studies.
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Affiliation(s)
- Casey Sun
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Chemistry, University of Florida, Gainesville, US
| | - Yu Zhao
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
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10
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Dan Q, Jiang X, Wang R, Dai Z, Sun D. Biogenic Imaging Contrast Agents. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2207090. [PMID: 37401173 PMCID: PMC10477908 DOI: 10.1002/advs.202207090] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/08/2023] [Indexed: 07/05/2023]
Abstract
Imaging contrast agents are widely investigated in preclinical and clinical studies, among which biogenic imaging contrast agents (BICAs) are developing rapidly and playing an increasingly important role in biomedical research ranging from subcellular level to individual level. The unique properties of BICAs, including expression by cells as reporters and specific genetic modification, facilitate various in vitro and in vivo studies, such as quantification of gene expression, observation of protein interactions, visualization of cellular proliferation, monitoring of metabolism, and detection of dysfunctions. Furthermore, in human body, BICAs are remarkably helpful for disease diagnosis when the dysregulation of these agents occurs and can be detected through imaging techniques. There are various BICAs matched with a set of imaging techniques, including fluorescent proteins for fluorescence imaging, gas vesicles for ultrasound imaging, and ferritin for magnetic resonance imaging. In addition, bimodal and multimodal imaging can be realized through combining the functions of different BICAs, which helps overcome the limitations of monomodal imaging. In this review, the focus is on the properties, mechanisms, applications, and future directions of BICAs.
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Affiliation(s)
- Qing Dan
- Shenzhen Key Laboratory for Drug Addiction and Medication SafetyDepartment of UltrasoundInstitute of Ultrasonic MedicinePeking University Shenzhen HospitalShenzhen Peking University‐The Hong Kong University of Science and Technology Medical CenterShenzhen518036P. R. China
| | - Xinpeng Jiang
- Department of Biomedical EngineeringCollege of Future TechnologyPeking UniversityBeijing100871P. R. China
| | - Run Wang
- Shenzhen Key Laboratory for Drug Addiction and Medication SafetyDepartment of UltrasoundInstitute of Ultrasonic MedicinePeking University Shenzhen HospitalShenzhen Peking University‐The Hong Kong University of Science and Technology Medical CenterShenzhen518036P. R. China
| | - Zhifei Dai
- Department of Biomedical EngineeringCollege of Future TechnologyPeking UniversityBeijing100871P. R. China
| | - Desheng Sun
- Shenzhen Key Laboratory for Drug Addiction and Medication SafetyDepartment of UltrasoundInstitute of Ultrasonic MedicinePeking University Shenzhen HospitalShenzhen Peking University‐The Hong Kong University of Science and Technology Medical CenterShenzhen518036P. R. China
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Özdemir İ, Ganji S, Gillen J, Etyemez S, Považan M, Barker PB. Downfield proton MRSI with whole-brain coverage at 3T. Magn Reson Med 2023; 90:814-822. [PMID: 37249071 PMCID: PMC10330175 DOI: 10.1002/mrm.29706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE To develop a 3D downfield (DF) MRSI protocol with whole brain coverage and post-processing pipeline for creation of metabolite maps. METHODS A 3D, circularly phase-encoded version of the previously developed 2D DF MRSI sequence with1 3 ‾ 3 1 ‾ $$ 1\overline{3}3\overline{1} $$ spectral-spatial excitation and frequency selective refocusing was implemented and tested in five healthy volunteers at 3T. The DF metabolite maps with a nominal spatial resolution of 0.7 cm3 were recorded in eight slices at 3T in a scan time of 22 m 40 s. An MRSI post-processing pipeline was developed to create DF metabolite maps. Metabolite concentrations and uncertainty estimates were compared between region differences for nine DF peaks. RESULTS LCModel analysis showed Cramer Rao lower bounds average values of 3%-4% for protein amide resonances in the three selected regions (anterior cingulate, dorsolateral prefrontal cortex, and centrum semiovale); Cramer Rao lower bounds were somewhat higher for individual peaks but for the most part were less than 20%. While DF concentration maps were visually quite homogeneous throughout the brain, general linear regression analysis corrected for multiple comparisons found significant differences between centrum semiovale and dorsolateral prefrontal cortex for peaks at 7.09 ppm (p = 0.014), 7.90 ppm (p = 0.009), 8.18 ppm (p = 0.009), combined amides (p = 0.009), and between anterior cingulate and dorsolateral prefrontal cortex for the 7.30 ppm peak (p = 0.020). Cramer Rao lower bounds values were not significantly different between brain regions for any of the DF peaks. CONCLUSION The 3D DF MRSI of the human brain at 3T with wide spatial coverage for the mapping of exchangeable amide and other resonances is feasible at a nominal spatial resolution of 0.7 cm3 .
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Affiliation(s)
- İpek Özdemir
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Joseph Gillen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kennedy Krieger Institute, Baltimore, MD, United States
| | - Semra Etyemez
- Department of Obstetrics & Gynecology, Weill Cornell Medicine, New York, NY, United States
| | | | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kennedy Krieger Institute, Baltimore, MD, United States
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12
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Zhao Y, Sun C, Zu Z. Isolation of amide proton transfer effect and relayed nuclear Overhauser enhancement effect at -3.5ppm using CEST with double saturation powers. Magn Reson Med 2023; 90:1025-1040. [PMID: 37154382 PMCID: PMC10646838 DOI: 10.1002/mrm.29691] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/18/2023] [Accepted: 04/16/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Quantifications of amide proton transfer (APT) and nuclear Overhauser enhancement (rNOE(-3.5)) mediated saturation transfer with high specificity are challenging because their signals measured in a Z-spectrum are overlapped with confounding signals from direct water saturation (DS), semi-solid magnetization transfer (MT), and CEST of fast-exchange pools. In this study, based on two canonical CEST acquisitions with double saturation powers (DSP), a new data-postprocessing method is proposed to specifically quantify the effects of APT and rNOE. METHODS For CEST imaging with relatively low saturation powers (ω 1 2 $$ {\upomega}_1^2 $$ ), both the fast-exchange CEST effect and the semi-solid MT effect roughly depend onω 1 2 $$ {\upomega}_1^2 $$ , whereas the slow-exchange APT/rNOE(-3.5) effect do not, which is exploited to isolate a part of the APT and rNOE effects from the confounding signals in this study. After a mathematical derivation for the establishment of the proposed method, numerical simulations based on Bloch equations are then performed to demonstrate its specificity to detections of the APT and rNOE effects. Finally, an in vivo validation of the proposed method is conducted using an animal tumor model at a 4.7 T MRI scanner. RESULTS The simulations show that DSP-CEST can quantify the effects of APT and rNOE and substantially eliminate the confounding signals. The in vivo experiments demonstrate that the proposed DSP-CEST method is feasible for the imaging of tumors. CONCLUSION The data-postprocessing method proposed in this study can quantify the APT and rNOE effects with considerably increased specificities and a reduced cost of imaging time.
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Affiliation(s)
- Yu Zhao
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Casey Sun
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Chemistry, University of Florida, Gainesville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
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13
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Cui J, Zhao Y, Sun C, Xu J, Zu Z. Evaluation of contributors to amide proton transfer-weighted imaging and nuclear Overhauser enhancement-weighted imaging contrast in tumors at a high magnetic field. Magn Reson Med 2023; 90:596-614. [PMID: 37093984 PMCID: PMC10616782 DOI: 10.1002/mrm.29675] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE The purpose is to evaluate the relative contribution from confounding factors (T1 weighting and magnetization transfer) to the CEST ratio (CESTR)-quantified amide proton transfer (APT) and nuclear Overhauser enhancement (NOE) (-3.5) in tumors as well as whether the CESTR can reflect the distribution of the solute concentration (fs ). METHODS We first provided a signal model that shows the separate dependence of CESTR on these confounding factors and the clean CEST/NOE effects quantified by an apparent exchange-dependent relaxation (AREX) method. We then measured the change in these effects in the 9-L tumor model in rats, through which we calculated the relative contribution of each confounding factor. fs was also fitted, and its correlations with the CESTR and AREX were assessed to evaluate their capabilities to reflect fs . RESULTS The CESTR-quantified APT shows "positive" contrast in tumors, which arises primarily from R1w at low powers and both R1w and magnetization transfer at high powers. CESTR-quantified NOE (-3.5) shows no or weak contrast in tumors, which is due to the cancelation of R1w and NOE (-3.5), which have opposite contributions. CESTR-quantified APT has a stronger correlation with APT fs than AREX-quantified APT. CESTR-quantified NOE (-3.5) has a weaker correlation with NOE (-3.5) fs than AREX-quantified NOE (-3.5). CONCLUSION CESTR reflects a combined effect of T1 weighting and CEST/NOE. Both factors depend on fs , which contributes positively to the dependence of CESTR on fs in APT imaging and enhances its correlation with fs . In contrast, these factors have opposite contributions to its dependence on fs in NOE (-3.5) imaging, thereby weakening the correlation.
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Affiliation(s)
- Jing Cui
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Yu Zhao
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Casey Sun
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Chemistry, University of Florida, Gainesville, US
| | - Junzhong Xu
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
- Department of Physics and Astronomy, Vanderbilt University, Nashville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Biomedical Engineering, Vanderbilt University, Nashville, US
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14
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Xu J, Chung JJ, Jin T. Chemical exchange saturation transfer imaging of creatine, phosphocreatine, and protein arginine residue in tissues. NMR IN BIOMEDICINE 2023; 36:e4671. [PMID: 34978371 PMCID: PMC9250548 DOI: 10.1002/nbm.4671] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/06/2021] [Accepted: 12/02/2021] [Indexed: 05/05/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI has become a promising technique to assay target proteins and metabolites through their exchangeable protons, noninvasively. The ubiquity of creatine (Cr) and phosphocreatine (PCr) due to their pivotal roles in energy homeostasis through the creatine phosphate pathway has made them prime targets for CEST in the diagnosis and monitoring of disease pathologies, particularly in tissues heavily dependent on the maintenance of rich energy reserves. Guanidinium CEST from protein arginine residues (i.e. arginine CEST) can also provide information about the protein profile in tissue. However, numerous obfuscating factors stand as obstacles to the specificity of arginine, Cr, and PCr imaging through CEST, such as semisolid magnetization transfer, fast chemical exchanges such as primary amines, and the effects of nuclear Overhauser enhancement from aromatic and amide protons. In this review, the specific exchange properties of protein arginine residues, Cr, and PCr, along with their validation, are discussed, including the considerations necessary to target and tune their signal effects through CEST imaging. Additionally, strategies that have been employed to enhance the specificity of these exchanges in CEST imaging are described, along with how they have opened up possible applications of protein arginine residues, Cr and PCr CEST imaging in the study and diagnosis of pathology. A clear understanding of the capabilities and caveats of using CEST to image these vital metabolites and mitigation strategies is crucial to expanding the possibilities of this promising technology.
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Affiliation(s)
- Jiadi Xu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julius Juhyun Chung
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tao Jin
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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15
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Jiang S, Wen Z, Ahn SS, Cai K, Paech D, Eberhart CG, Zhou J. Applications of chemical exchange saturation transfer magnetic resonance imaging in identifying genetic markers in gliomas. NMR IN BIOMEDICINE 2023; 36:e4731. [PMID: 35297117 PMCID: PMC10557022 DOI: 10.1002/nbm.4731] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) imaging is an important molecular magnetic resonance imaging technique that can image numerous low-concentration biomolecules with water-exchangeable protons (such as cellular proteins) and tissue pH. CEST, or more specially amide proton transfer-weighted imaging, has been widely used for the detection, diagnosis, and response assessment of brain tumors, and its feasibility in identifying molecular markers in gliomas has also been explored in recent years. In this paper, after briefing on the basic principles and quantification methods of CEST imaging, we review its early applications in identifying isocitrate dehydrogenase mutation status, MGMT methylation status, 1p/19q deletion status, and H3K27M mutation status in gliomas. Finally, we discuss the limitations or weaknesses in these studies.
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Affiliation(s)
- Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Kejia Cai
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
- Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany
| | | | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
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16
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Zhou Y, Bie C, van Zijl PC, Yadav NN. The relayed nuclear Overhauser effect in magnetization transfer and chemical exchange saturation transfer MRI. NMR IN BIOMEDICINE 2023; 36:e4778. [PMID: 35642102 PMCID: PMC9708952 DOI: 10.1002/nbm.4778] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
Magnetic resonance (MR) is a powerful technique for noninvasively probing molecular species in vivo but suffers from low signal sensitivity. Saturation transfer (ST) MRI approaches, including chemical exchange saturation transfer (CEST) and conventional magnetization transfer contrast (MTC), allow imaging of low-concentration molecular components with enhanced sensitivity using indirect detection via the abundant water proton pool. Several recent studies have shown the utility of chemical exchange relayed nuclear Overhauser effect (rNOE) contrast originating from nonexchangeable carbon-bound protons in mobile macromolecules in solution. In this review, we describe the mechanisms leading to the occurrence of rNOE-based signals in the water saturation spectrum (Z-spectrum), including those from mobile and immobile molecular sources and from molecular binding. While it is becoming clear that MTC is mainly an rNOE-based signal, we continue to use the classical MTC nomenclature to separate it from the rNOE signals of mobile macromolecules, which we will refer to as rNOEs. Some emerging applications of the use of rNOEs for probing macromolecular solution components such as proteins and carbohydrates in vivo or studying the binding of small substrates are discussed.
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Affiliation(s)
- Yang Zhou
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, Guangdong 518055 (China)
| | - Chongxue Bie
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
- Department of Information Science and Technology, Northwest University, No.1 Xuefu Avenue, Xi’an, Shanxi 710127 (China)
| | - Peter C.M. van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
| | - Nirbhay N. Yadav
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
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17
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3D Amide Proton Transfer-Weighted Imaging for Grading Glioma and Correlating IDH Mutation Status: Added Value to 3D Pseudocontinuous Arterial Spin Labelling Perfusion. Mol Imaging Biol 2023; 25:343-352. [PMID: 35962302 DOI: 10.1007/s11307-022-01762-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE The goal of this study was to evaluate the diagnostic performance of 3D amide proton transfer-weighted (3D-APTW) imaging and 3D pseudocontinuous arterial spin labelling (3D-pCASL) alone and in combination in grading gliomas (low-grade glioma (LGG) vs. high-grade glioma (HGG)) and correlating isocitrate dehydrogenase (IDH) mutation status. PROCEDURES Preoperatively, 81 patients with pathologically confirmed gliomas underwent 3.0-T magnetic resonance imaging (MRI) examinations. The APTW, relative APTW (rAPTW), cerebral blood flow (CBF), and relative CBF (rCBF) values were calculated to evaluate the solid components of the tumours. The MRI parameters were compared in the classification of gliomas by independent- and paired-samples t tests. A receiver operating characteristic (ROC) curve was constructed, and the area under the ROC curve (AUC) was calculated to assess the diagnostic performance of each parameter and the combination of the rAPTW and rCBF values. RESULTS Patients with HGG showed significantly higher APTW, rAPTW, CBF, and rCBF values than those with LGG (all p < 0.001). In the ROC curve analysis, the AUC of rAPTW was the highest at 0.90. By adding the rAPTW signal to the rCBF values, the diagnostic ability of the combined parameters improved from 0.90 to 0.96. The rAPTW value yielded the highest AUC (0.92) in correlating the IDH mutation status, and the diagnostic ability improved to 0.96 by adding it to the rCBF value. CONCLUSION 3D-APTW imaging combined with 3D-pCASL imaging may be used to aid assessment of grading glioma and IDH mutation status.
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18
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Cui J, Sun C, Zu Z. NOE-weighted imaging in tumors using low-duty-cycle 2π-CEST. Magn Reson Med 2023; 89:636-651. [PMID: 36198015 PMCID: PMC9792266 DOI: 10.1002/mrm.29475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE Nuclear Overhauser enhancement (NOE)-mediated CEST imaging at -3.5 ppm has shown clinical interest in diagnosing tumors. Multiple-pool Lorentzian fit has been used to quantify NOE, which, however, requires a long scan time. Asymmetric analysis of CEST signals could be a simple and fast method to quantify this NOE, but it has contamination from the amide proton transfer (APT) at 3.5 ppm. This work proposes a new method using an asymmetric analysis of a low-duty-cycle pulsed-CEST sequence with a flip angle of 360°, termed 2π-CEST, to reduce the contribution from APT. METHODS Simulations were used to evaluate the capability of the 2π-CEST to reduce APT. Experiments on animal tumor models were performed to show its advantages compared with the conventional asymmetric analysis. Samples of reconstituted phospholipids and proteins were used to evaluate the molecular origin of this NOE. RESULTS The 2π-CEST has reduced contribution from APT. In tumors where we show that the NOE is comparable to the APT effect, reducing the contamination from APT is crucial. The results show that the NOE signal obtained with 2π-CEST in tumor regions appears more homogeneous than that obtained with the conventional method. The phantom study showed that both phospholipids and proteins contribute to the NOE at -3.5 ppm. CONCLUSION The NOE at -3.5 ppm has a different contrast mechanism from APT and other CEST/NOE effects. The proposed 2π-CEST is more accurate than the conventional asymmetric analysis in detecting NOE, and requires much less scan time than the multiple-pool Lorentzian fit.
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Affiliation(s)
- Jing Cui
- Vanderbilt University Institute of Imaging Science, Nashville, US,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
| | - Casey Sun
- Vanderbilt University Institute of Imaging Science, Nashville, US,Department of Chemistry, University of Florida, Gainesville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Nashville, US,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
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19
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Jellema PEJ, Wijnen JP, De Luca A, Mutsaerts HJMM, Obdeijn IV, van Baarsen KM, Lequin MH, Hoving EW. Advanced intraoperative MRI in pediatric brain tumor surgery. Front Physiol 2023; 14:1098959. [PMID: 37123260 PMCID: PMC10134397 DOI: 10.3389/fphys.2023.1098959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides "real-time" imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging. Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care. Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent. Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.
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Affiliation(s)
- Pien E. J. Jellema
- Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, Netherlands
- Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, Netherlands
- *Correspondence: Pien E. J. Jellema,
| | - Jannie P. Wijnen
- Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Alberto De Luca
- Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, Netherlands
- Department of Neurology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Henk J. M. M. Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands
| | - Iris V. Obdeijn
- Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Kirsten M. van Baarsen
- Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, Netherlands
- Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Maarten H. Lequin
- Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, Netherlands
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Eelco W. Hoving
- Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, Netherlands
- Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, Netherlands
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20
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Wamelink IJHG, Kuijer JPA, Padrela BE, Zhang Y, Barkhof F, Mutsaerts HJMM, Petr J, van de Giessen E, Keil VC. Reproducibility of 3 T APT-CEST in Healthy Volunteers and Patients With Brain Glioma. J Magn Reson Imaging 2023; 57:206-215. [PMID: 35633282 PMCID: PMC10084114 DOI: 10.1002/jmri.28239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging is a chemical exchange saturation transfer (CEST) technique offering potential clinical applications such as diagnosis, characterization, and treatment planning and monitoring in glioma patients. While APT-CEST has demonstrated high potential, reproducibility remains underexplored. PURPOSE To investigate whether cerebral APT-CEST with clinically feasible scan time is reproducible in healthy tissue and glioma for clinical use at 3 T. STUDY TYPE Prospective, longitudinal. SUBJECTS Twenty-one healthy volunteers (11 females; mean age ± SD: 39 ± 11 years) and 6 glioma patients (3 females; 50 ± 17 years: 4 glioblastomas, 1 oligodendroglioma, 1 radiologically suspected low-grade glioma). FIELD STRENGTH/SEQUENCE 3 T, Turbo Spin Echo - ampling perfection with application optimized contrasts using different flip angle evolution - chemical exchange saturation transfer (TSE SPACE-CEST). ASSESSMENT APT-CEST measurement reproducibility was assessed within-session (glioma patients, scan session 1; healthy volunteers scan sessions 1, 2, and 3), between-sessions (healthy volunteers scan sessions 1 and 2), and between-days (healthy volunteers, scan sessions 1 and 3). The mean APTCEST values and standard deviation of the within-subject difference (SDdiff ) were calculated in whole tumor enclosed by regions of interest (ROIs) in patients, and eight ROIs in healthy volunteers-whole-brain, cortical gray matter, putamen, thalami, orbitofrontal gyri, occipital lobes, central brain-and compared. STATISTICAL TESTS Brown-Forsythe tests and variance component analysis (VCA) were used to assess the reproducibility of ROIs for the three time intervals. Significance was set at P < 0.003 after Bonferroni correction. RESULTS Intratumoral mean APTCEST was significantly higher than APTCEST in healthy-appearing tissue in patients (0.5 ± 0.46%). The average within-session, between-sessions, and between-days SDdiff of healthy control brains was 0.2% and did not differ significantly with each other (0.76 > P > 0.22). The within-session SDdiff of whole-brain was 0.2% in both healthy volunteers and patients, and 0.21% in the segmented tumor. VCA showed that within-session factors were the most important (60%) for scanning variance. DATA CONCLUSION Cerebral APT-CEST imaging may show good scan-rescan reproducibility in healthy tissue and tumors with clinically feasible scan times at 3 T. Short-term measurement effects may be the dominant components for reproducibility. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ivar J H G Wamelink
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Joost P A Kuijer
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Beatriz E Padrela
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, UK
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jan Petr
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Elsmarieke van de Giessen
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Vera C Keil
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Hou H, Diao Y, Yu J, Xu M, Wang L, Li Z, Song T, Liu Y, Yuan Z. Differentiation of true progression from treatment response in high-grade glioma treated with chemoradiation: a comparison study of 3D-APTW and 3D-PcASL imaging and DWI. NMR IN BIOMEDICINE 2023; 36:e4821. [PMID: 36031734 DOI: 10.1002/nbm.4821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To assess and compare the diagnostic performance of 3D amide proton-transfer-weighted (3D-APTW) imaging, 3D pseudocontinuous arterial spin-labeling (3D-PcASL) imaging, and diffusion-weighted imaging in distinguishing true progression (TP) from treatment response (TR) in posttreatment malignant glioma patients. MATERIALS AND METHODS Forty-eight patients with suspected tumor recurrence were prospectively enrolled. Histological or longitudinal routine MRI follow-up over six months was assessed to confirm lesion type. The apparent diffusion coefficient (ADC), relative APTWmax (rAPTW), and relative CBFmax values (rCBF) were measured in lesions with enhancing regions on post-gadolinium T1 -weighted MRI. MRI parameters between the TP and TR groups were compared using Student's t tests. In addition, a receiver operating characteristic (ROC) curve was constructed, and the area under the ROC curve (AUC) was calculated to assess the differentiation diagnostic performance of each parameter. RESULTS The TP group showed a significantly higher rAPTW and rCBF than the TR group; the AUCs of rAPTW and rCBF to distinguish between TP and TR were 0.911 (with sensitivity of 90.3% and specificity of 82.4%) and 0.852 (with sensitivity of 80.6% and specificity of 82.4%), respectively. By adding the rAPTW values to rCBF values, the diagnostic ability was improved from 0.852 to 0.951. ADC showed no significant differences between the TP and TR groups, with an AUC lower than 0.70. CONCLUSION Both 3D-PcASL and 3D-APTW imaging could distinguish TP from TR, and 3D-APTW had a better diagnostic performance. Combining the rAPTW values and rCBF values achieved a better diagnostic performance.
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Affiliation(s)
- Huimin Hou
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Yanzhao Diao
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jinchao Yu
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Min Xu
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Liming Wang
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Zhenzhi Li
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Tao Song
- Department of Neurosurgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yu Liu
- Department of Pathology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhenguo Yuan
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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22
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Fatania K, Frood R, Tyyger M, McDermott G, Fernandez S, Shaw GC, Boissinot M, Salvatore D, Ottobrini L, Teh I, Wright J, Bailey MA, Koch-Paszkowski J, Schneider JE, Buckley DL, Murray L, Scarsbrook A, Short SC, Currie S. Exploratory Analysis of Serial 18F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma. Cancers (Basel) 2022; 14:3485. [PMID: 35884545 PMCID: PMC9315674 DOI: 10.3390/cancers14143485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 12/03/2022] Open
Abstract
Anti-1-amino-3-18fluorine-fluorocyclobutane-1-carboxylic acid (18F-fluciclovine) positron emission tomography (PET) shows preferential glioma uptake but there is little data on how uptake correlates with post-contrast T1-weighted (Gd-T1) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) activity during adjuvant treatment. This pilot study aimed to compare 18F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM), and in a parallel pre-clinical GBM model, to investigate correlation between 18F-fluciclovine uptake, MRI findings, and tumour biology. 18F-fluciclovine-PET-computed tomography (PET-CT) and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients. MRI volumes were manually contoured; PET volumes were defined using semi-automatic thresholding. The similarity of the PET and DCE-MRI volumes outside the Gd-T1 volume boundary was measured using the Dice similarity coefficient (DSC). CT-2A tumour-bearing mice underwent MRI and 18F-fluciclovine PET-CT. Post-mortem mice brains underwent immunohistochemistry staining for ASCT2 (amino acid transporter), nestin (stemness) and Ki-67 (proliferation) to assess for biologically active tumour. 6 patients were recruited (GBM 1-6) and grouped according to overall survival (OS)-short survival (GBM-SS, median OS 249 days) and long survival (GBM-LS, median 903 days). For GBM-SS, PET tumour volumes were greater than DCE-MRI, in turn greater than Gd-T1. For GBM-LS, Gd-T1 and DCE-MRI were greater than PET. Tumour-specific 18F-fluciclovine uptake on pre-clinical PET-CT corresponded to immunostaining for Ki-67, nestin and ASCT2. Results suggest volumes of 18F-fluciclovine-PET activity beyond that depicted by DCE-MRI and Gd-T1 are associated with poorer prognosis in patients undergoing chemoradiotherapy for GBM. The pre-clinical model confirmed 18F-fluciclovine uptake reflected biologically active tumour.
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Affiliation(s)
- Kavi Fatania
- Department of Radiology, Leeds Teaching Hospitals Trust, Leeds General Infirmary, Leeds LS1 3EX, UK; (R.F.); (A.S.); (S.C.)
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
| | - Russell Frood
- Department of Radiology, Leeds Teaching Hospitals Trust, Leeds General Infirmary, Leeds LS1 3EX, UK; (R.F.); (A.S.); (S.C.)
| | - Marcus Tyyger
- Department of Medical Physics, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (M.T.); (G.M.)
| | - Garry McDermott
- Department of Medical Physics, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (M.T.); (G.M.)
| | - Sharon Fernandez
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds LS9 7TF, UK;
| | - Gary C. Shaw
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
| | - Marjorie Boissinot
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
| | - Daniela Salvatore
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Segrate, Italy; (D.S.); (L.O.)
| | - Luisa Ottobrini
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Segrate, Italy; (D.S.); (L.O.)
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), 20054 Segrate, Italy
| | - Irvin Teh
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
| | - John Wright
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
| | - Marc A. Bailey
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
- Leeds Vascular Institute, Leeds Teaching Hospitals Trust, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - Joanna Koch-Paszkowski
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
| | - Jurgen E. Schneider
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
| | - David L. Buckley
- Biomedical Imaging Science Department, and Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9TJ, UK; (I.T.); (J.W.); (M.A.B.); (J.K.-P.); (J.E.S.); (D.L.B.)
| | - Louise Murray
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds LS9 7TF, UK;
| | - Andrew Scarsbrook
- Department of Radiology, Leeds Teaching Hospitals Trust, Leeds General Infirmary, Leeds LS1 3EX, UK; (R.F.); (A.S.); (S.C.)
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
| | - Susan C. Short
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust, St James’s University Hospital, Leeds LS9 7TF, UK;
| | - Stuart Currie
- Department of Radiology, Leeds Teaching Hospitals Trust, Leeds General Infirmary, Leeds LS1 3EX, UK; (R.F.); (A.S.); (S.C.)
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (G.C.S.); (M.B.); (L.M.); (S.C.S.)
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23
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Dong Y, Gu Y, Lu J, Wan J, Jiang S, Koehler RC, Wang J, Zhou J. Amide Proton Transfer-Weighted Magnetic Resonance Imaging for Detecting Severity and Predicting Outcome after Traumatic Brain Injury in Rats. Neurotrauma Rep 2022; 3:261-275. [PMID: 35982981 PMCID: PMC9380886 DOI: 10.1089/neur.2021.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
After traumatic brain injury (TBI), early assessment of secondary injury severity is critically important for estimating prognosis and treatment stratification. Currently, secondary injury severity is difficult to estimate. The objective of this study was to investigate the capacity of non-invasive amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI) techniques to assess TBI injury in different brain regions and predict long-term neurobehavior outcomes. Fifty-five male and female rats were subjected to a controlled cortical impact with one of three different impactor depths to produce different degrees of TBI. Multi-parameter MRI data were acquired on a 4.7-Tesla scanner at 1 h, 1 day, and 3 days. Immunofluorescence staining was used to detect activated microglia at 3 days, and neurobehavioral tests were performed to assess long-term outcomes after 28 days. The APTw signal in the injury core at 1 day correlated with deficits in sensorimotor function, the sucrose preference test (a test for anhedonia), and spatial memory function on the Barnes maze. The APTw signal in the perilesion ipsilateral cortex gradually increased after TBI, and the value at 3 days correlated with microglia density at 3 days and with spatial memory decline and anhedonia at 28 days. The correlation between APTw and activated microglia was also observed in the ipsilateral thalamus, and its correlation to memory deficit and depression was evident in other ipsilateral sites. These results suggest that APTw imaging can be used for detecting secondary injury and as a potential predictor of long-term outcomes from TBI.
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Affiliation(s)
- Yinfeng Dong
- Department of Anesthesiology and Critical Care Medicine, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yanting Gu
- Department of Anesthesiology and Critical Care Medicine, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jianhua Lu
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jieru Wan
- Department of Anesthesiology and Critical Care Medicine, 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
| | - Raymond C. Koehler
- Department of Anesthesiology and Critical Care Medicine, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jian Wang
- Department of Anesthesiology and Critical Care Medicine, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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24
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Comparison of amide proton transfer imaging with perfusion imaging of using arterial spin-labeling for evidence of tumor invasion in glioblastoma. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2021.101461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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25
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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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26
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Molecular Imaging of Brain Tumors and Drug Delivery Using CEST MRI: Promises and Challenges. Pharmaceutics 2022; 14:pharmaceutics14020451. [PMID: 35214183 PMCID: PMC8880023 DOI: 10.3390/pharmaceutics14020451] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022] Open
Abstract
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) detects molecules in their natural forms in a sensitive and non-invasive manner. This makes it a robust approach to assess brain tumors and related molecular alterations using endogenous molecules, such as proteins/peptides, and drugs approved for clinical use. In this review, we will discuss the promises of CEST MRI in the identification of tumors, tumor grading, detecting molecular alterations related to isocitrate dehydrogenase (IDH) and O-6-methylguanine-DNA methyltransferase (MGMT), assessment of treatment effects, and using multiple contrasts of CEST to develop theranostic approaches for cancer treatments. Promising applications include (i) using the CEST contrast of amide protons of proteins/peptides to detect brain tumors, such as glioblastoma multiforme (GBM) and low-grade gliomas; (ii) using multiple CEST contrasts for tumor stratification, and (iii) evaluation of the efficacy of drug delivery without the need of metallic or radioactive labels. These promising applications have raised enthusiasm, however, the use of CEST MRI is not trivial. CEST contrast depends on the pulse sequences, saturation parameters, methods used to analyze the CEST spectrum (i.e., Z-spectrum), and, importantly, how to interpret changes in CEST contrast and related molecular alterations in the brain. Emerging pulse sequence designs and data analysis approaches, including those assisted with deep learning, have enhanced the capability of CEST MRI in detecting molecules in brain tumors. CEST has become a specific marker for tumor grading and has the potential for prognosis and theranostics in brain tumors. With increasing understanding of the technical aspects and associated molecular alterations detected by CEST MRI, this young field is expected to have wide clinical applications in the near future.
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27
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Wu Y, Wood TC, Arzanforoosh F, Hernandez-Tamames JA, Barker GJ, Smits M, Warnert EAH. 3D APT and NOE CEST-MRI of healthy volunteers and patients with non-enhancing glioma at 3 T. MAGMA (NEW YORK, N.Y.) 2022; 35:63-73. [PMID: 34994858 PMCID: PMC8901510 DOI: 10.1007/s10334-021-00996-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
Abstract
Objective Clinical application of chemical exchange saturation transfer (CEST) can be performed with investigation of amide proton transfer (APT) and nuclear Overhauser enhancement (NOE) effects. Here, we investigated APT- and NOE-weighted imaging based on advanced CEST metrics to map tumor heterogeneity of non-enhancing glioma at 3 T. Materials and methods APT- and NOE-weighted maps based on Lorentzian difference (LD) and inverse magnetization transfer ratio (MTRREX) were acquired with a 3D snapshot CEST acquisition at 3 T. Saturation power was investigated first by varying B1 (0.5–2 µT) in 5 healthy volunteers then by applying B1 of 0.5 and 1.5 µT in 10 patients with non-enhancing glioma. Tissue contrast (TC) and contrast-to-noise ratios (CNR) were calculated between glioma and normal appearing white matter (NAWM) and grey matter, in APT- and NOE-weighted images. Volume percentages of the tumor showing hypo/hyperintensity (VPhypo/hyper,CEST) in APT/NOE-weighted images were calculated for each patient. Results LD APT resulting from using a B1 of 1.5 µT was found to provide significant positive TCtumor,NAWM and MTRREX NOE (B1 of 1.5 µT) provided significant negative TCtumor,NAWM in tissue differentiation. MTRREX-based NOE imaging under 1.5 µT provided significantly larger VPhypo,CEST than MTRREX APT under 1.5 µT. Conclusion This work showed that with a rapid CEST acquisition using a B1 saturation power of 1.5 µT and covering the whole tumor, analysis of both LD APT and MTRREX NOE allows for observing tumor heterogeneity, which will be beneficial in future studies using CEST-MRI to improve imaging diagnostics for non-enhancing glioma.
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Affiliation(s)
- Yulun Wu
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. .,Brain Tumor Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Tobias C Wood
- Centre for Neuroimaging Science, King's College London, London, UK
| | - Fatemeh Arzanforoosh
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.,Brain Tumor Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Gareth J Barker
- Centre for Neuroimaging Science, King's College London, London, UK
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.,Brain Tumor Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Esther A H Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. .,Brain Tumor Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
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28
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Guo P, Unberath M, Heo HY, Eberhart CG, Lim M, Blakeley JO, Jiang S. Learning-based analysis of amide proton transfer-weighted MRI to identify true progression in glioma patients. NEUROIMAGE: CLINICAL 2022; 35:103121. [PMID: 35905666 PMCID: PMC9421489 DOI: 10.1016/j.nicl.2022.103121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Pengfei Guo
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Mathias Unberath
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Hye-Young Heo
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Michael Lim
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | | | - Shanshan Jiang
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
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29
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Považan M, Schär M, Gillen J, Barker PB. Magnetic resonance spectroscopic imaging of downfield proton resonances in the human brain at 3 T. Magn Reson Med 2021; 87:1661-1672. [PMID: 34971460 DOI: 10.1002/mrm.29142] [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] [Received: 08/17/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To develop an MRSI technique capable of mapping downfield proton resonances in the human brain. METHODS A spectral-spatial excitation and frequency-selective refocusing scheme, in combination with 2D phase encoding, was developed for mapping of downfield resonances without any perturbation of the water magnetization. An alternative scheme using spectral-spatial refocusing was also investigated for simultaneous detection of both downfield and upfield resonances. The method was tested in 5 healthy human volunteers. RESULTS Downfield metabolite maps with a nominal spatial resolution of 1.5 cm3 were recorded at 3 T in a scan time of 12 minutes. Cramer-Rao lower bounds for nine different downfield peaks were 20% or less over a single supraventricular slice. Downfield spectral profiles were similar to those in the literature recorded previously using single-voxel localization methods. The same approach was also used for upfield MRSI, and simultaneous upfield and downfield acquisitions. CONCLUSION The developed MRSI pulse sequence was shown to be an efficient way of rapidly mapping downfield resonances in the human brain at 3 T, maximizing sensitivity through the relaxation enhancement effect. Because the MRSI approach is efficient in terms of data collection and can be readily implemented at short TE, somewhat higher spatial resolution can be achieved than has been reported in previous single-voxel downfield MRS studies. With this approach, nine downfield resonances could be mapped in a single slice for the first time using MRSI at 3 T.
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Affiliation(s)
- Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Schär
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph Gillen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Li Y, Liu X, Wang X, Lin C, Qi Y, Chen B, Zhou H, Wu Q, Ren J, Zhao J, Yang J, Xiang Y, He Y, Jin Z, Xue H. Using amide proton transfer-weighted MRI to non-invasively differentiate mismatch repair deficient and proficient tumors in endometrioid endometrial adenocarcinoma. Insights Imaging 2021; 12:182. [PMID: 34894294 PMCID: PMC8665952 DOI: 10.1186/s13244-021-01126-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging to differentiate mismatch repair deficient (dMMR) and mismatch repair proficient (pMMR) tumors in endometrioid endometrial adenocarcinoma (EEA). METHODS Forty-nine patients with EEA underwent T1-weighted imaging, T2-weighted imaging, 3D APTw imaging, and diffusion-weighted imaging at 3 T MRI. Image quality and measurement confidence of APTw images were evaluated on a 5-point Likert scale. APTw and apparent diffusion coefficient (ADC) values were calculated and compared between the dMMR and pMMR groups and among the three EEA histologic grades based on the Federation of Gynecology and Obstetrics (FIGO) grading system criteria. Student's t-test, analysis of variance with Scheffe post hoc test, and receiver operating characteristic analysis were performed. Statistical significance was set at p < 0.05. RESULTS Thirty-five EEA patients (9 with dMMR tumors and 26 with pMMR tumors) with good image quality were enrolled in quantitative analysis. APTw values were significantly higher in the dMMR group than in the pMMR group (3.2 ± 0.3% and 2.8 ± 0.5%, respectively; p = 0.019). ADC values of the dMMR and pMMR groups were 0.874 ± 0.104 × 10-3 mm2/s and 0.903 ± 0.100 × 10-3 mm2/s, respectively. No significant between-group difference was noted (p = 0.476). No statistically significant differences were observed in APTw values or ADC values among the three histologic grades (p = 0.766 and p = 0.295, respectively). CONCLUSIONS APTw values may be used as potential imaging markers to differentiate dMMR from pMMR tumors in EEA.
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Affiliation(s)
- Yuan Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Xinyu Liu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Xiaoqi Wang
- Philips Healthcare China, Beijing, People's Republic of China
| | - Chengyu Lin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Yafei Qi
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hailong Zhou
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Qiaoling Wu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Jing Ren
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Jia Zhao
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Junjun Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Yonglan He
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
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Wu Y, Liu Z, Yang Q, Zou L, Zhang F, Qian L, Liu X, Zheng H, Luo D, Sun PZ. Fast and equilibrium CEST imaging of brain tumor patients at 3T. Neuroimage Clin 2021; 33:102890. [PMID: 34864285 PMCID: PMC8645967 DOI: 10.1016/j.nicl.2021.102890] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 02/01/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI, versatile for detecting endogenous mobile proteins and tissue pH, has proved valuable in tumor imaging. However, CEST MRI scans are often performed under non-equilibrium conditions, which confound tissue characterization. This study proposed a quasi-steady-state (QUASS) CEST MRI algorithm to standardize fast and accurate tumor imaging at 3 T. The CEST signal evolution was modeled by longitudinal relaxation rate during relaxation delay (Td) and spinlock relaxation during RF saturation time (Ts), from which the QUASS CEST effect is derived. Numerical simulation and human MR imaging experiments (7 healthy volunteers and 19 tumor patients) were conducted at 3 T to compare the CEST measurements obtained under two representative experimental conditions. In addition, amide proton transfer (APT), combined magnetization transfer (MT) and nuclear overhauser enhancement (NOE) effects, and direct water saturation were isolated using a 3-pool Lorentzian fitting in white matter and gray matter of healthy volunteers and for patients in the contralateral normal-appearing white matter and tumor regions. Finally, the student's t-test was performed between conventional and QUASS CEST measurements. The routine APT and combined MT & NOE measures significantly varied with Ts and Td (P < .001) and were significantly smaller than the corresponding QUASS indices (P < .001). In contrast, the results from the QUASS reconstruction showed little dependence on the scan protocol (P > .05), indicating the accuracy and robustness of QUASS CEST MRI for tumor imaging. To summarize, the QUASS CEST reconstruction algorithm enables fast and accurate tumor CEST imaging at 3 T, promising to expedite and standardize clinical CEST MRI.
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Affiliation(s)
- Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China,Key Laboratory of Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Zhou Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
| | - Liyan Zou
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
| | - Fan Zhang
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China,Key Laboratory of Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China,Key Laboratory of Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
| | - Phillip Zhe Sun
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA,Corresponding author at: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 954 Gatewood Road NE, Atlanta, GA 30329, USA.
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Zhang H, Zhou J, Peng Y. Amide Proton Transfer-Weighted MR Imaging of Pediatric Central Nervous System Diseases. Magn Reson Imaging Clin N Am 2021; 29:631-641. [PMID: 34717850 DOI: 10.1016/j.mric.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Amide proton transfer-weighted (APTw) imaging is a molecular MR imaging technique that can detect the concentration of the amide protons in mobile cellular proteins and peptides or a pH change in vivo. Previous studies have indicated that APTw MR imaging can be used to detect malignant brain tumors, stroke, and other neurologic diseases, although the clinical application in pediatric patients remains limited. The authors briefly introduce the basic principles of APTw imaging. Then, they review early clinical applications of this approach to pediatric central nervous system diseases, including pediatric brain development, hypoxic-ischemic encephalopathy, intracranial infection, and brain tumors.
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Affiliation(s)
- Hong Zhang
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nan Li Shi Road, Xi Cheng District, Beijing, 100045, China
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 336, Baltimore, MD 21287, USA
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nan Li Shi Road, Xi Cheng District, Beijing, 100045, China.
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Abstract
PURPOSE OF REVIEW This review aims to cover current MRI techniques for assessing treatment response in brain tumors, with a focus on radio-induced lesions. RECENT FINDINGS Pseudoprogression and radionecrosis are common radiological entities after brain tumor irradiation and are difficult to distinguish from real progression, with major consequences on daily patient care. To date, shortcomings of conventional MRI have been largely recognized but morphological sequences are still used in official response assessment criteria. Several complementary advanced techniques have been proposed but none of them have been validated, hampering their clinical use. Among advanced MRI, brain perfusion measures increase diagnostic accuracy, especially when added with spectroscopy and susceptibility-weighted imaging. However, lack of reproducibility, because of several hard-to-control variables, is still a major limitation for their standardization in routine protocols. Amide Proton Transfer is an emerging molecular imaging technique that promises to offer new metrics by indirectly quantifying intracellular mobile proteins and peptide concentration. Preliminary studies suggest that this noncontrast sequence may add key biomarkers in tumor evaluation, especially in posttherapeutic settings. SUMMARY Benefits and pitfalls of conventional and advanced imaging on posttreatment assessment are discussed and the potential added value of APT in this clinicoradiological evolving scenario is introduced.
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Affiliation(s)
- Lucia Nichelli
- Department of Neuroradiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière-Charles Foix
- Sorbonne Université, INSERM, CNRS, Assistance Publique-Hôpitaux de Paris, Institut du Cerveau et de la Moelle épinière, boulevard de l’Hôpital, Paris
| | - Stefano Casagranda
- Department of Research & Innovation, Olea Medical, avenue des Sorbiers, La Ciotat, France
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Gao T, Zou C, Li Y, Jiang Z, Tang X, Song X. A Brief History and Future Prospects of CEST MRI in Clinical Non-Brain Tumor Imaging. Int J Mol Sci 2021; 22:11559. [PMID: 34768990 PMCID: PMC8584005 DOI: 10.3390/ijms222111559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 02/08/2023] Open
Abstract
Chemical exchange saturation transfer (CEST) MRI is a promising molecular imaging tool which allows the specific detection of metabolites that contain exchangeable amide, amine, and hydroxyl protons. Decades of development have progressed CEST imaging from an initial concept to a clinical imaging tool that is used to assess tumor metabolism. The first translation efforts involved brain imaging, but this has now progressed to imaging other body tissues. In this review, we summarize studies using CEST MRI to image a range of tumor types, including breast cancer, pelvic tumors, digestive tumors, and lung cancer. Approximately two thirds of the published studies involved breast or pelvic tumors which are sites that are less affected by body motion. Most studies conclude that CEST shows good potential for the differentiation of malignant from benign lesions with a number of reports now extending to compare different histological classifications along with the effects of anti-cancer treatments. Despite CEST being a unique 'label-free' approach with a higher sensitivity than MR spectroscopy, there are still some obstacles for implementing its clinical use. Future research is now focused on overcoming these challenges. Vigorous ongoing development and further clinical trials are expected to see CEST technology become more widely implemented as a mainstream imaging technology.
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Affiliation(s)
- Tianxin Gao
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Chuyue Zou
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Yifan Li
- Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing 100084, China;
| | - Zhenqi Jiang
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Xiaoying Tang
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Xiaolei Song
- Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing 100084, China;
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Guo P, Wang P, Yasarla R, Zhou J, Patel VM, Jiang S. Anatomic and Molecular MR Image Synthesis Using Confidence Guided CNNs. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:2832-2844. [PMID: 33351754 PMCID: PMC8543492 DOI: 10.1109/tmi.2020.3046460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Data-driven automatic approaches have demonstrated their great potential in resolving various clinical diagnostic dilemmas in neuro-oncology, especially with the help of standard anatomic and advanced molecular MR images. However, data quantity and quality remain a key determinant, and a significant limit of the potential applications. In our previous work, we explored the synthesis of anatomic and molecular MR image networks (SAMR) in patients with post-treatment malignant gliomas. In this work, we extend this through a confidence-guided SAMR (CG-SAMR) that synthesizes data from lesion contour information to multi-modal MR images, including T1-weighted ( [Formula: see text]), gadolinium enhanced [Formula: see text] (Gd- [Formula: see text]), T2-weighted ( [Formula: see text]), and fluid-attenuated inversion recovery ( FLAIR ), as well as the molecular amide proton transfer-weighted ( [Formula: see text]) sequence. We introduce a module that guides the synthesis based on a confidence measure of the intermediate results. Furthermore, we extend the proposed architecture to allow training using unpaired data. Extensive experiments on real clinical data demonstrate that the proposed model can perform better than current the state-of-the-art synthesis methods. Our code is available at https://github.com/guopengf/CG-SAMR.
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Friismose AI, Markovic L, Nguyen N, Gerke O, Schulz MK, Mussmann BR. Amide proton transfer-weighted MRI in the clinical setting - correlation with dynamic susceptibility contrast perfusion in the post-treatment imaging of adult glioma patients at 3T. Radiography (Lond) 2021; 28:95-101. [PMID: 34509365 DOI: 10.1016/j.radi.2021.08.006] [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] [Received: 06/25/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We investigated the correlation between amide proton transfer-weighted magnetic resonance imaging (APTw MRI) and dynamic susceptibility contrast (DSC) perfusion in order to assess the potential of APTw MRI as an alternative to DSC in adult brain tumor (glioma) imaging. METHODS After Ethical Committee approval, forty adult patients, treated for histopathologically confirmed glioma (World Health Organization (WHO) grade II-IV), were prospectively imaged at 3 Tesla (3 T) with DSC perfusion and a commercially available three-dimensional (3D) APTw sequence. Two consultant neuroradiologists independently performed region of interest (ROI) measurements on relative cerebral blood volume (rCBV) and APTw maps, co-registered with anatomical images. The correlation APTw MRI-DSC perfusion was assessed using Spearman's rank-order test. Inter-observer agreement was evaluated by the intraclass correlation coefficient (ICC) and Bland-Altman (BA) plots. RESULTS A statistically significant moderately strong positive correlation was observed between maximum rCBV (rCBVmax) and maximum APTw (APTwmax) values (observer 1: r = 0.73; p < 0.01; observer 2: r = 0.62; p < 0.01). We found good inter-observer agreement for APTwmax (ICC = 0.82; 95% confidence interval (CI) 0.66-0.90), with somewhat broad outer 95% CI for the BA Limits of Agreement (LoA) (-1.6 to 1.9). ICC for APTwmax was higher than ICC for rCBVmax (ICC = 0.74; 95%; CI 0.50-0.86), but the difference was not statistically significant. CONCLUSION APTwmax values correlate positively with rCBVmax in patients treated for brain glioma. APTw imaging is a reproducible technique, with some observer dependence. Results need to be confirmed by a larger population analysis. IMPLICATIONS FOR PRACTICE APTw MRI can be a useful addition to glioma follow-up imaging and a potential alternative to DSC perfusion, especially in patients where contrast agent is contraindicated.
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Affiliation(s)
- A I Friismose
- Radiology Department, Odense University Hospital, Odense, Denmark.
| | - L Markovic
- Radiology Department, Odense University Hospital, Odense, Denmark
| | - N Nguyen
- Radiology Department, Odense University Hospital, Odense, Denmark
| | - O Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - M K Schulz
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
| | - B R Mussmann
- Radiology Department, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN, Odense Patient Data Exploratory Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Li Y, Lin CY, Qi YF, Wang X, Chen B, Zhou HL, Ren J, Yang JJ, Xiang Y, He YL, Xue HD, Jin ZY. Three-dimensional turbo-spin-echo amide proton transfer-weighted and intravoxel incoherent motion MR imaging for type I endometrial carcinoma: Correlation with Ki-67 proliferation status. Magn Reson Imaging 2021; 78:18-24. [PMID: 33556484 DOI: 10.1016/j.mri.2021.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/14/2021] [Accepted: 02/03/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND To evaluate 3-dimensional amide proton transfer weighted (APTw) imaging for type I endometrial carcinoma (EC), and investigate correlations of Ki-67 labelling index with APTw and intravoxel incoherent motion (IVIM) imaging. METHODS 54 consecutive patients suspected of endometrial lesions underwent pelvic APTw and IVIM imaging on a 3 T MR scanner. APTw values and IVIM-derived parameters (Dt, D*, f) were independently measured by two radiologists on 22 postoperative pathological confirmed of type I EC lesions. Results were compared between histological grades and Ki-67 proliferation groups. ROC analysis was performed. Pearson's correlation analysis was performed for APTw values and IVIM-derived parameters with Ki-67 labeling index. RESULTS APTw values and Dt, D*, f of all type I EC were 2.9 ± 0.1%, 0.677 ± 0.027 × 10-3 mm2/s, 31.801 ± 11.492 × 10-3 mm2/s, 0.179 ± 0.050 with inter-observer ICC 0.996, 0.850, 0.956, 0.995, respectively. APTw values of Ki-67 low-proliferation group (<30%, n = 8) were 2.5 ± 0.2%, significantly lower than the high-proliferation group (>30%, n = 14) with APTw values of 3.1 ± 0.1% (p = 0.016). Area under the curve was 0.768. APTw values of type I EC were moderately positively correlated with Ki-67 labelling index (r = 0.583, p = 0.004). There was no significant difference of Dt (p = 0.843), D* (p = 0.262), f (p = 0.553) between the two groups. No correlation was found between IVIM-derived parameters and Ki-67 labelling index (Dt, p = 0.717; D* p = 0.151; f, p = 0.153). CONCLUSION 3D TSE APTw imaging is a feasible approach for detecting type I EC. Ki-67 labeling index positively moderately correlates with APTw not with IVIM.
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Affiliation(s)
- Yuan Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Cheng-Yu Lin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Ya-Fei Qi
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | | | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Hai-Long Zhou
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Jing Ren
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Jun-Jun Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Yong-Lan He
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Hua-Dan Xue
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
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Yin H, Wang D, Yan R, Jin X, Hu Y, Zhai Z, Duan J, Zhang J, Wang K, Han D. Comparison of Diffusion Kurtosis Imaging and Amide Proton Transfer Imaging in the Diagnosis and Risk Assessment of Prostate Cancer. Front Oncol 2021; 11:640906. [PMID: 33937041 PMCID: PMC8082407 DOI: 10.3389/fonc.2021.640906] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/16/2021] [Indexed: 01/31/2023] Open
Abstract
Objectives This study aims to evaluate and compare the diagnostic value of DKI and APT in prostate cancer (PCa), and their correlation with Gleason Score (GS). Materials and Methods DKI and APT imaging of 49 patients with PCa and 51 patients with benign prostatic hyperplasia (BPH) were collected and analyzed, respectively. According to the GS, the patients with PCa were divided into high-risk, intermediate-risk and low-risk groups. The mean kurtosis (MK), mean diffusion (MD) and magnetization transfer ratio asymmetry (MTRasym, 3.5 ppm) values among PCa, BPH, and different GS groups of PCa were compared and analyzed respectively. The diagnostic accuracy of each parameter was evaluated by using the receiver operating characteristic (ROC) curve. The correlation between each parameter and GS was analyzed by using Spearman’s rank correlation. Results The MK and MTRasym (3.5 ppm) values were significantly higher in PCa group than in BPH group, while the MD value was significantly lower than in BPH group. The differences of MK/MD/MTRasym (3.5 ppm) between any two of the low-risk, intermediate-risk, and high-risk groups were all statistically significant (p <0.05). The MK value showed the highest diagnostic accuracy in differentiating PCa and BPH, BPH and low-risk, low-risk and intermediate-risk, intermediate-risk and high-risk (AUC = 0.965, 0.882, 0.839, 0.836). The MK/MD/MTRasym (3.ppm) values showed good and moderate correlation with GS (r = 0.844, −0.811, 0.640, p <0.05), respectively. Conclusion DKI and APT imaging are valuable in the diagnosis of PCa and demonstrate strong correlation with GS, which has great significance in the risk assessment of PCa.
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Affiliation(s)
- Huijia Yin
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Dongdong Wang
- Department of Radiology, People's Hospital of Zhengzhou, Zhengzhou, China
| | - Ruifang Yan
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Xingxing Jin
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Ying Hu
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Zhansheng Zhai
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Jinhui Duan
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Jian Zhang
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing, China
| | - Dongming Han
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
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Quantitative Analysis of Mobile Proteins in Normal Brain Tissue by Amide Proton Transfer Imaging: Age Dependence and Sex Differences. J Comput Assist Tomogr 2021; 45:277-284. [PMID: 33661152 DOI: 10.1097/rct.0000000000001141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The aims of this study were to evaluate the relationship between age change and amide proton transfer (APT) signal in each region of the whole brain and to derive the standard value of APT signal in each brain region of normal adults. MATERIALS AND METHODS Using the mDIXON 3-dimensional-APT sequence of the fast spin echo method, an APT image was obtained. In total, 60 patients (mean age, 49.8 ± 16.9 years) with no abnormal findings on magnetic resonance imaging data were included. For image analysis, registration parameters were created using the FMRIB Software Library 5.0.11, and then a region of interest was set in the Montreal Neurological Institute structural atlas for analysis. Statistical analyses were performed using the age-dependent and sex differences in APT signals from each brain region. RESULTS No significant correlation was seen between APT signal and age and sex in all brain regions. CONCLUSION Under the APT imaging parameter conditions used in this study, local brain APT signals in healthy adults are independent of age and sex.
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Zhang XY, Zhai Y, Jin Z, Li C, Sun PZ, Wu Y. Preliminary demonstration of in vivo quasi-steady-state CEST postprocessing-Correction of saturation time and relaxation delay for robust quantification of tumor MT and APT effects. Magn Reson Med 2021; 86:943-953. [PMID: 33723890 DOI: 10.1002/mrm.28764] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/26/2021] [Accepted: 02/15/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Chemical exchange saturation transfer (CEST) MRI is versatile for measuring the dilute labile protons and microenvironment properties. However, the use of insufficiently long RF saturation duration (Ts) and relaxation delay (Td) may underestimate the CEST measurement. This study proposed a quasi-steady-state (QUASS) CEST analysis for robust CEST quantification. METHODS The CEST signal evolution was modeled as a function of the longitudinal relaxation rate during Td and spin-lock relaxation rate during Ts, from which the QUASS-CEST effect is derived. Numerical simulation and in vivo rat glioma MRI experiments were conducted at 11.7 T to compare the apparent and QUASS-CEST results obtained under different Ts/Td of 2 seconds/2 seconds and 4 seconds/4 seconds. Magnetization transfer and amide proton transfer effects were resolved using a multipool Lorentzian fitting and evaluated in contralateral normal tissue and tumor regions. RESULTS The simulation showed the dependence of the apparent CEST effect on Ts and Td, and such reliance was mitigated with the QUASS algorithm. Animal experiment results showed that the apparent magnetization transfer and amide proton transfer effects and their contrast between contralateral normal tissue and tumor regions increased substantially with Ts and Td. In comparison, the QUASS magnetization transfer and amide proton transfer effects and their difference between contralateral normal tissue and tumor exhibited little dependence on Ts and Td. In addition, the apparent magnetization transfer and amide proton transfer were significantly smaller than the corresponding QUASS indices (P < .05). CONCLUSION The QUASS-CEST algorithm enables robust CEST quantification and offers a straightforward approach to standardize CEST experiments.
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Affiliation(s)
- Xiao-Yong Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
| | - Yuting Zhai
- Institute of Science and Technology for Brain-Inspired Intelligence, Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
| | - Ziyi Jin
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Shanghai, China.,Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Cong Li
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Shanghai, China.,Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
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Warnert EAH, Wood TC, Incekara F, Barker GJ, Vincent AJP, Schouten J, Kros JM, van den Bent M, Smits M, Tamames JAH. Mapping tumour heterogeneity with pulsed 3D CEST MRI in non-enhancing glioma at 3 T. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:53-62. [PMID: 33606114 PMCID: PMC8901516 DOI: 10.1007/s10334-021-00911-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/28/2022]
Abstract
Objective Amide proton transfer (APT) weighted chemical exchange saturation transfer (CEST) imaging is increasingly used to investigate high-grade, enhancing brain tumours. Non-enhancing glioma is currently less studied, but shows heterogeneous pathophysiology with subtypes having equally poor prognosis as enhancing glioma. Here, we investigate the use of CEST MRI to best differentiate non-enhancing glioma from healthy tissue and image tumour heterogeneity. Materials & Methods A 3D pulsed CEST sequence was applied at 3 Tesla with whole tumour coverage and 31 off-resonance frequencies (+6 to -6 ppm) in 18 patients with non-enhancing glioma. Magnetisation transfer ratio asymmetry (MTRasym) and Lorentzian difference (LD) maps at 3.5 ppm were compared for differentiation of tumour versus normal appearing white matter. Heterogeneity was mapped by calculating volume percentages of the tumour showing hyperintense APT-weighted signal. Results LDamide gave greater effect sizes than MTRasym to differentiate non-enhancing glioma from normal appearing white matter. On average, 17.9 % ± 13.3 % (min–max: 2.4 %–54.5 %) of the tumour volume showed hyperintense LDamide in non-enhancing glioma. Conclusion This works illustrates the need for whole tumour coverage to investigate heterogeneity in increased APT-weighted CEST signal in non-enhancing glioma. Future work should investigate whether targeting hyperintense LDamide regions for biopsies improves diagnosis of non-enhancing glioma. Supplementary Information The online version of this article (10.1007/s10334-021-00911-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Esther A H Warnert
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, NL, the Netherlands.
| | - Tobias C Wood
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, NL, the Netherlands.,Department of Neurosurgery, Erasmus MC, Rotterdam, NL, the Netherlands
| | - Gareth J Barker
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Joost Schouten
- Department of Neurosurgery, Erasmus MC, Rotterdam, NL, the Netherlands
| | - Johan M Kros
- Department of Pathology, Erasmus MC, Rotterdam, NL, the Netherlands
| | | | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, NL, the Netherlands
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Overcast WB, Davis KM, Ho CY, Hutchins GD, Green MA, Graner BD, Veronesi MC. Advanced imaging techniques for neuro-oncologic tumor diagnosis, with an emphasis on PET-MRI imaging of malignant brain tumors. Curr Oncol Rep 2021; 23:34. [PMID: 33599882 PMCID: PMC7892735 DOI: 10.1007/s11912-021-01020-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW This review will explore the latest in advanced imaging techniques, with a focus on the complementary nature of multiparametric, multimodality imaging using magnetic resonance imaging (MRI) and positron emission tomography (PET). RECENT FINDINGS Advanced MRI techniques including perfusion-weighted imaging (PWI), MR spectroscopy (MRS), diffusion-weighted imaging (DWI), and MR chemical exchange saturation transfer (CEST) offer significant advantages over conventional MR imaging when evaluating tumor extent, predicting grade, and assessing treatment response. PET performed in addition to advanced MRI provides complementary information regarding tumor metabolic properties, particularly when performed simultaneously. 18F-fluoroethyltyrosine (FET) PET improves the specificity of tumor diagnosis and evaluation of post-treatment changes. Incorporation of radiogenomics and machine learning methods further improve advanced imaging. The complementary nature of combining advanced imaging techniques across modalities for brain tumor imaging and incorporating technologies such as radiogenomics has the potential to reshape the landscape in neuro-oncology.
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Affiliation(s)
- Wynton B. Overcast
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd. Room 0663, Indianapolis, IN 46202 USA
| | - Korbin M. Davis
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd. Room 0663, Indianapolis, IN 46202 USA
| | - Chang Y. Ho
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Goodman Hall, 355 West 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Gary D. Hutchins
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E124, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
| | - Mark A. Green
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E124, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
| | - Brian D. Graner
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Goodman Hall, 355 West 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Michael C. Veronesi
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Research 2 Building (R2), Room E174, 920 W. Walnut Street, Indianapolis, IN 46202-5181 USA
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Durmo F, Rydhög A, Testud F, Lätt J, Schmitt B, Rydelius A, Englund E, Bengzon J, van Zijl P, Knutsson L, Sundgren PC. Assessment of Amide proton transfer weighted (APTw) MRI for pre-surgical prediction of final diagnosis in gliomas. PLoS One 2020; 15:e0244003. [PMID: 33373375 PMCID: PMC7771875 DOI: 10.1371/journal.pone.0244003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/01/2020] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Radiological assessment of primary brain neoplasms, both high (HGG) and low grade tumors (LGG), based on contrast-enhancement alone can be inaccurate. We evaluated the radiological value of amide proton transfer weighted (APTw) MRI as an imaging complement for pre-surgical radiological diagnosis of brain tumors. METHODS Twenty-six patients were evaluated prospectively; (22 males, 4 females, mean age 55 years, range 26-76 years) underwent MRI at 3T using T1-MPRAGE pre- and post-contrast administration, conventional T2w, FLAIR, and APTw imaging pre-surgically for suspected primary/secondary brain tumor. Assessment of the additional value of APTw imaging compared to conventional MRI for correct pre-surgical brain tumor diagnosis. The initial radiological pre-operative diagnosis was based on the conventional contrast-enhanced MR images. The range, minimum, maximum, and mean APTw signals were evaluated. Conventional normality testing was performed; with boxplots/outliers/skewness/kurtosis and a Shapiro-Wilk's test. Mann-Whitney U for analysis of significance for mean/max/min and range APTw signal. A logistic regression model was constructed for mean, max, range and Receiver Operating Characteristic (ROC) curves calculated for individual and combined APTw signals. RESULTS Conventional radiological diagnosis prior to surgery/biopsy was HGG (8 patients), LGG (12 patients), and metastasis (6 patients). Using the mean and maximum: APTw signal would have changed the pre-operative evaluation the diagnosis in 8 of 22 patients (two LGGs excluded, two METs excluded). Using a cut off value of >2.0% for mean APTw signal integral, 4 of the 12 radiologically suspected LGG would have been diagnosed as high grade glioma, which was confirmed by histopathological diagnosis. APTw mean of >2.0% and max >2.48% outperformed four separate clinical radiological assessments of tumor type, P-values = .004 and = .002, respectively. CONCLUSIONS Using APTw-images as part of the daily clinical pre-operative radiological evaluation may improve diagnostic precision in differentiating LGGs from HGGs, with potential improvement of patient management and treatment.
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Affiliation(s)
- Faris Durmo
- Division of Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anna Rydhög
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | | | - Jimmy Lätt
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | | | - Anna Rydelius
- Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Elisabet Englund
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Johan Bengzon
- Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Peter van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States of America
| | - Linda Knutsson
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Pia C. Sundgren
- Division of Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
- LBIC, Lund University Bioimaging Center, Lund University, Lund, Sweden
- * E-mail:
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Non-invasive Differentiation of Endometrial Adenocarcinoma from Benign Lesions in the Uterus by Utilization of Amide Proton Transfer-Weighted MRI. Mol Imaging Biol 2020; 23:446-455. [PMID: 33185840 DOI: 10.1007/s11307-020-01565-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/16/2020] [Accepted: 11/05/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging for differentiation of endometrial adenocarcinoma and uterine benign lesions. PROCEDURES This prospective study enrolled 22 normal volunteers and 113 patients with suspicious uterine lesions, including endometrial adenocarcinoma, leiomyoma, and adenomyosis. Pelvic APTw MRI was performed on a 3-T MRI scanner with default APTw parameters. Two radiologists blindly evaluated uterine lesion APTw image quality by a 3-point Likert scale and independently measured APTw values on images with excellent to good image quality. Inter-reader agreement was evaluated. The Mann-Whitney U test with Bonferroni correction was used to compare the differences among different types of uterine lesions. A receiver operating characteristic analysis was performed. RESULTS A total of 111 lesions (33 endometrial adenocarcinoma, 26 leiomyoma, and 52 adenomyosis lesions) from 99 patients revealing a majority of good quality with excellent inter-reader agreement were included for the image quality evaluation. APTw values of endometrial adenocarcinoma were 2.9 ± 0.1 %, significantly higher than those of leiomyoma (1.9 ± 0.1 %), adenomyosis (2.2 ± 0.1 %), and normal uterine myometrium (1.9 ± 0.1 %) (all p < 0.0001). The area under the receiver operating characteristic curve for differentiating endometrial adenocarcinoma from leiomyoma, adenomyosis, and myometrium was 0.87, 0.85, and 0.91, respectively. Feasible threshold APTw values of each group were determined as 2.4 %, 2.7 %, and 2.4 % with a sensitivity of 83.3 %, 76.7 %, and 83.3 % and a specificity of 83.3 %, 81.6 %, and 86.4 %, respectively. CONCLUSIONS Malignant endometrial adenocarcinoma had significantly higher APTw values than leiomyoma, adenomyosis, and normal uterine myometrium. Our study adds to the growing body of validation on 3D APTw imaging and uterine lesions.
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Sotirios B, Demetriou E, Topriceanu CC, Zakrzewska Z. The role of APT imaging in gliomas grading: A systematic review and meta-analysis. Eur J Radiol 2020; 133:109353. [PMID: 33120241 DOI: 10.1016/j.ejrad.2020.109353] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/15/2020] [Accepted: 10/11/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Gliomas are diagnosed and staged by conventional MRI. Although non-conventional sequences such as perfusion-weighted MRI may differentiate low-grade from high-grade gliomas, they are not reliable enough yet. The latter is of paramount importance for patient management. In this regard, we aim to evaluate the role of Amide Proton Transfer (APT) imaging in grading gliomas as a non-invasive tool to provide reliable differentiation across tumour grades. METHODS A systematic search of PubMed, Medline and Embase was conducted to identify relevant publications between 01/01/2008 and 15/09/2020. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to assess studies' quality. A random-effects model standardized mean difference meta-analysis was performed to assess APT's ability to differentiate low-grade gliomas (LGGs) from high-grade gliomas (HGGs), WHO 2-4 grades, wild-type from mutated isocitrate dehydrogenase (IDH) gliomas, methylated from unmethylated O6-methylguanine-DNA methyltransferase (MGMT) gliomas. Area under the curve (AUC) of the Receiver Operating Characteristic (ROC) meta-analysis was employed to assess the diagnostic performance of APT. RESULTS 23 manuscripts met the inclusion criteria and reported the use of APT to differentiate glioma grades with histopathology as reference standard. APT-weighted signal intensity can differentiate LGGs from HGGs with an estimated size effect of (-1.61 standard deviations (SDs), p < 0.0001), grade 2 from grade 3 (-1.83 SDs, p = 0.005), grade 2 from grade 4 (-2.34 SDs, p < 0.0001) and IDH wild-type from IDH mutated (0.94 SDs, p = 0.003) gliomas. The combined AUC of 0.84 highlights the good diagnostic performance of APT-weighted imaging in differentiating LGGs from HGGs. CONCLUSIONS APT imaging is an exciting prospect in differentiating LGGs from HGGs and with potential to predict the histopathological grade. However, more studies are required to optimize and improve its reliability.
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Affiliation(s)
- Bisdas Sotirios
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom; Department of Brain Repair & Rehabilitation, Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Eleni Demetriou
- Department of Brain Repair & Rehabilitation, Queen Square Institute of Neurology, University College London, London, United Kingdom
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Wu B, Jia F, Li X, Li L, Wang K, Han D. Comparative Study of Amide Proton Transfer Imaging and Intravoxel Incoherent Motion Imaging for Predicting Histologic Grade of Hepatocellular Carcinoma. Front Oncol 2020; 10:562049. [PMID: 33194630 PMCID: PMC7659984 DOI: 10.3389/fonc.2020.562049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/18/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Preoperative grading of hepatocellular carcinoma (HCC) is an important factor associated with prognosis after liver resection. The promising prediction of the differentiation of HCC remains a challenge. The purpose of our study was to investigate the value of amide proton transfer (APT) imaging in predicting the histological grade of HCC, compared with the intravoxel incoherent motion (IVIM) imaging. Methods: From September 2018 to February 2020, 88 patients with HCC were enrolled and divided into four groups (G1, G2, G3, and G4) based on the histologic grades. Preoperative APT signal intensity (SI), apparent diffusion coefficient (ADC), true molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f ) of HCC were independently measured by two radiologists. The averaged values of those parameters were compared using an analysis of variance. The Spearman rank analysis was used to compare the correlation between those imaging parameters and the histological grades. Receiver operating characteristic (ROC) curve analysis was used to explore the predictive performance. Results: There were significant differences in APT SI, ADC, D, and f among the four grades of HCC (all P < 0.001). A moderate to good relationship was found between APT SI and the histologic grade of HCC (r = 0.679, P < 0.001). APT SI had an area under the ROC curve (AUC) of 0.890 (95% CI: 0.805–0.947) for differentiating low- from high-grade HCC, and the corresponding sensitivity and specificity were 85.71% and 82.05%, respectively. Comparison of ROC curves demonstrated that the AUC of APT SI was significantly higher than those of IVIM-derived parameter (Z = 2.603, P = 0.0092; Z = 2.099, P = 0.0358; Z = 4.023, P = 0.0001; Z = 2.435, P = 0.0149, compared with ADC, D, D*, and f , respectively). Moreover, the combination of both techniques further improved the diagnostic performance, with an AUC of 0.929 (95% CI: 0.854–0.973). Conclusion: APT imaging may be a potential noninvasive biomarker for the prediction of histologic grading of HCC and complements IVIM imaging for the more accurate and comprehensive characterization of HCC.
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Affiliation(s)
- Baolin Wu
- Department of Radiology, Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.,Department of Magnetic Resonance, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Fei Jia
- Department of Magnetic Resonance, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xuekun Li
- Department of Magnetic Resonance, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Lei Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing, China
| | - Dongming Han
- Department of Magnetic Resonance, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
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Qamar S, King AD, Ai QYH, Mo FKF, Chen W, Poon DMC, Tong M, Ma BB, Yeung DKW, Wang YX, Yuan J. Pre-treatment amide proton transfer imaging predicts treatment outcome in nasopharyngeal carcinoma. Eur Radiol 2020; 30:6339-6347. [DOI: 10.1007/s00330-020-06985-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/25/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023]
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Amide Proton Transfer-Weighted (APTw) Imaging of Intracranial Infection in Children: Initial Experience and Comparison with Gadolinium-Enhanced T1-Weighted Imaging. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6418343. [PMID: 32509865 PMCID: PMC7251435 DOI: 10.1155/2020/6418343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/21/2020] [Accepted: 04/25/2020] [Indexed: 12/05/2022]
Abstract
Purpose To evaluate the performance of amide proton transfer-weighted (APTw) imaging against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1w) in children with intracranial infection. Materials and Methods Twenty-eight pediatric patients (15 males and 13 females; age range 1-163 months) with intracranial infection were recruited in this study. 2D APTw imaging and conventional MR sequences were conducted using a 3 T MRI scanner. Kappa (κ) statistics and the McNemar test were performed to determine whether the hyperintensity on APTw was related to the enhancement on Gd-T1w. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of APTw imaging to predict lesion enhancement were calculated. Result In twelve patients with brain abscesses, the enhancing rim of the abscesses on the Gd-T1w images was consistently hyperintense on the APTw images. In eight patients with viral encephalitis, three showed slight spotted gadolinium enhancement, while the APTw image also showed a slight spotted high signal. Five of these patients showed no enhancement on Gd-T1w and isointensity on the APTw image. In eleven patients with meningitis, increased APTw signal intensities were clearly visible in gadolinium-enhancing meninges. Sixty infectious lesions (71%) showed enhancement on Gd-T1w images. The sensitivity and specificity of APTw were 93.3% (56/60) and 91.7% (22/24). APTw demonstrated excellent agreement (κ = 0.83) with Gd-T1w, with no significant difference (P = 0.69) in detection of infectious lesions. Conclusions These initial data show that APTw MRI is a noninvasive technique for the detection and characterization of intracranial infectious lesions. APTw MRI enabled similar detection of infectious lesions to Gd-T1w and may provide an injection-free means of evaluation of intracranial infection.
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Song Q, Zhang C, Chen X, Cheng Y. Comparing amide proton transfer imaging with dynamic susceptibility contrast-enhanced perfusion in predicting histological grades of gliomas: a meta-analysis. Acta Radiol 2020; 61:549-557. [PMID: 31495179 DOI: 10.1177/0284185119871667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background As a subtype of chemical exchange saturation transfer imaging without contrast agent administration, amide proton transfer (APT) imaging has demonstrated the potential for differentiating the histologic grades of gliomas. Dynamic susceptibility contrast-enhanced perfusion, a perfusion-weighted imaging technique, is a well-established technique in grading gliomas. Purpose To compare the ability of amide proton transfer and dynamic susceptibility contrast-enhanced imaging for predicting the grades of gliomas. Material and Methods A comprehensive literature search was performed independently by two observers to identify articles about the diagnostic performance of amide proton transfer and dynamic susceptibility contrast-enhanced perfusion in predicting the grade of gliomas. Summary estimates of diagnostic accuracy were obtained by using a random-effects model. Results Of 179 studies identified, 23 studies were included the analysis. Eight studies evaluated amide proton transfer and 16 studies evaluated dynamic susceptibility contrast-enhanced perfusion with the parameter rCBV. The pooled sensitivities and specificities of each study’s best performing parameter were 88% (95% confidence interval [CI] 74–95) and 89% (95% CI 78–95) for amide proton transfer, and 95% (95% CI 87–98), 88% (95% CI 81–93) for perfusion-weighted imaging–dynamic susceptibility contrast-enhanced perfusion, respectively. The pooled sensitivities and specificities for grading gliomas using the two most commonly evaluated parameters, were 92% (95% CI 80–97) and 90% (95% CI 75–96) for APTmax, and 97% (95% CI 91–99) and 87% (95% CI 80–92) for rCBVmax, respectively. Conclusion Considering the similar performance of APT and dynamic susceptibility contrast-enhanced (DSC) in predicting glioma grade, the former method appears preferable since it needs no contrast agent.
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Affiliation(s)
- Qingxu Song
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, PR China
| | - Chencheng Zhang
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, PR China
| | - Xin Chen
- Department of MR, Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, PR China
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Foo LS, Yap WS, Hum YC, Manan HA, Tee YK. Analysis of model-based and model-free CEST effect quantification methods for different medical applications. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2020; 310:106648. [PMID: 31760147 DOI: 10.1016/j.jmr.2019.106648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 06/10/2023]
Abstract
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) holds great potential to provide new metabolic information for clinical applications such as tumor, stroke and Parkinson's Disease diagnosis. Many active research and developments have been conducted to translate this emerging MRI technique for routine clinical applications. In general, there are two CEST quantification techniques: (i) model-free and (ii) model-based techniques. The reliability of these quantification techniques depends heavily on the experimental conditions and quality of the collected data. Errors such as noise may lead to misleading quantification results and thus inaccurate diagnosis when CEST imaging becomes a standard or routine imaging scan in the future. This paper investigates the accuracy and robustness of these quantification techniques under different signal-to-noise (SNR) levels and magnetic field strengths. The quantified CEST effect before and after adding random Gaussian White Noise using model-free and model-based quantification techniques were compared. It was found that the model-free technique consistently yielded larger average percentage error across all tested parameters compared to its model-based counterpart, and that the model-based technique could withstand SNR of about 3 times lower than the model-free technique. When applied on noisy brain tumor, ischemic stroke, and Parkinson's Disease clinical data, the model-free technique failed to produce significant differences between normal and abnormal tissue whereas the model-based technique consistently generated significant differences. Although the model-free technique was less accurate and robust, its simplicity and thus speed would still make it a good approximate when the SNR was high (>50) or when the CEST effect was large and well-defined. For more accurate CEST quantification, model-based techniques should be considered. When SNR was low (<50) and the CEST effect was small such as those acquired from clinical field strength scanners, which are generally 3T and below, model-based techniques should be considered over model-free counterpart to maintain an average percentage error of less than 44% even under very noisy condition as tested in this work.
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Affiliation(s)
- Lee Sze Foo
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Malaysia
| | - Wun-She Yap
- Department of Electrical and Electronic Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Malaysia
| | - Yan Chai Hum
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Malaysia
| | - Hanani Abdul Manan
- Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - Yee Kai Tee
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Malaysia.
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