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.
J Magn Reson Imaging. 2023 Jan;57(1):206-215. doi: 10.1002/jmri.28239. Epub 2022 May 28.
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.
To investigate whether cerebral APT-CEST with clinically feasible scan time is reproducible in healthy tissue and glioma for clinical use at 3 T.
Prospective, longitudinal.
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).
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 APT values and standard deviation of the within-subject difference (SD ) 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.
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.
Intratumoral mean APT was significantly higher than APT in healthy-appearing tissue in patients (0.5 ± 0.46%). The average within-session, between-sessions, and between-days SD of healthy control brains was 0.2% and did not differ significantly with each other (0.76 > P > 0.22). The within-session SD 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.
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.
2 TECHNICAL EFFICACY: Stage 2.
酰胺质子转移（APT）成像是一种化学交换饱和转移（CEST）技术，具有潜在的临床应用，如在胶质瘤患者的诊断、特征描述、治疗计划和监测中。虽然 APT-CEST 具有很高的潜力，但重复性仍未得到充分探索。
研究在 3T 下，临床可行的扫描时间是否可用于健康组织和胶质瘤的脑 APT-CEST 重复性。
前瞻性、纵向。
21 名健康志愿者（11 名女性；平均年龄±标准差：39±11 岁）和 6 名胶质瘤患者（3 名女性；50±17 岁：4 名胶质母细胞瘤，1 名少突胶质细胞瘤，1 名影像学疑似低级别胶质瘤）。
磁场强度/序列：3T，Turbo Spin Echo-ampling 完美应用，使用不同的翻转角演化-化学交换饱和传递（TSE SPACE-CEST）优化对比度。
在单次扫描内（胶质瘤患者，扫描第 1 次；健康志愿者扫描第 1、2 和 3 次）、单次扫描间（健康志愿者扫描第 1 和 2 次）和多天间（健康志愿者，扫描第 1 和 3 次）评估 APT-CEST 测量的重复性。在患者中，通过感兴趣区域（ROI）计算整个肿瘤的 APT 值和受试者内差异的标准差（SD）的平均值，在健康志愿者中，通过 ROI 计算整个大脑、皮质灰质、壳核、丘脑、眶额回、枕叶、中央脑的 APT 值和 SD 的平均值。
使用 Brown-Forsythe 检验和方差成分分析（VCA）来评估三个时间间隔的 ROI 重复性。在 Bonferroni 校正后，设 P<0.003 为显著性水平。
肿瘤内平均 APT 明显高于患者健康表现组织中的 APT（0.5±0.46%）。健康对照大脑的平均单次扫描内、单次扫描间和多天间 SD 为 0.2%，彼此之间无显著差异（0.76>P>0.22）。健康志愿者和患者的单次扫描内全脑 SD 均为 0.2%，分割肿瘤的 SD 为 0.21%。VCA 显示，单次扫描内因素是扫描变异性的最重要因素（60%）。
在 3T 下，具有临床可行扫描时间的脑 APT-CEST 成像在健康组织和肿瘤中可能具有良好的扫描-再扫描可重复性。短期测量效果可能是重复性的主要因素。
2 技术功效：2 级。
