Lingl Julia P, Wunderlich Arthur, Goerke Steffen, Paech Daniel, Ladd Mark E, Liebig Patrick, Pala Andrej, Kim Soung Yung, Braun Michael, Schmitz Bernd L, Beer Meinrad, Rosskopf Johannes
Department of Radiology, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
German Cancer Research Center (DKFZ), Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
Diagnostics (Basel). 2022 Feb 14;12(2):490. doi: 10.3390/diagnostics12020490.
With fast-growing evidence in literature for clinical applications of chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI), this prospective study aimed at applying amide proton transfer-weighted (APTw) CEST imaging in a clinical setting to assess its diagnostic potential in differentiation of intracranial tumors at 3 tesla (T).
Using the asymmetry magnetization transfer ratio (MTRasym) analysis, CEST signals were quantitatively investigated in the tumor areas and in a similar sized region of the normal-appearing white matter (NAWM) on the contralateral hemisphere of 27 patients with intracranial tumors. Area under curve (AUC) analyses were used and results were compared to perfusion-weighted imaging (PWI).
Using APTw CEST, contrast-enhancing tumor areas showed significantly higher APTw CEST metrics than contralateral NAWM (AUC = 0.82; < 0.01). In subgroup analyses of each tumor entity vs. NAWM, statistically significant effects were yielded for glioblastomas (AUC = 0.96; < 0.01) and for meningiomas (AUC = 1.0; < 0.01) but not for lymphomas as well as metastases ( > 0.05). PWI showed results comparable to APTw CEST in glioblastoma ( < 0.01).
This prospective study confirmed the high diagnostic potential of APTw CEST imaging in a routine clinical setting to differentiate brain tumors.
随着化学交换饱和转移（CEST）磁共振成像（MRI）临床应用的文献证据迅速增加，这项前瞻性研究旨在将酰胺质子转移加权（APTw）CEST成像应用于临床环境，以评估其在3特斯拉（T）下鉴别颅内肿瘤的诊断潜力。
使用不对称磁化转移率（MTRasym）分析，对27例颅内肿瘤患者肿瘤区域及对侧半球正常白质（NAWM）中大小相似区域的CEST信号进行定量研究。采用曲线下面积（AUC）分析，并将结果与灌注加权成像（PWI）进行比较。
使用APTw CEST，增强肿瘤区域的APTw CEST指标显著高于对侧NAWM（AUC = 0.82；<0.01）。在各肿瘤实体与NAWM的亚组分析中，胶质母细胞瘤（AUC = 0.96；<0.01）和脑膜瘤（AUC = 1.0；<0.01）有统计学显著效应，而淋巴瘤和转移瘤则无（>0.05）。PWI在胶质母细胞瘤中的结果与APTw CEST相当（<0.01）。
这项前瞻性研究证实了APTw CEST成像在常规临床环境中鉴别脑肿瘤的高诊断潜力。
