Hou Huimin, Chen Weibo, Diao Yanzhao, Wang Yuhan, Zhang Li, Wang Liming, Xu Min, Yu Jinchao, Song Tao, Liu Yu, Yuan Zhenguo
Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
Mol Imaging Biol. 2023 Apr;25(2):343-352. doi: 10.1007/s11307-022-01762-w. Epub 2022 Aug 12.
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.
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.
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.
3D-APTW imaging combined with 3D-pCASL imaging may be used to aid assessment of grading glioma and IDH mutation status.
本研究的目的是评估三维酰胺质子转移加权成像（3D-APTW）和三维伪连续动脉自旋标记成像（3D-pCASL）单独及联合应用在胶质瘤分级（低级别胶质瘤（LGG）与高级别胶质瘤（HGG））以及与异柠檬酸脱氢酶（IDH）突变状态相关性方面的诊断性能。
术前，81例经病理证实的胶质瘤患者接受了3.0-T磁共振成像（MRI）检查。计算APTW、相对APTW（rAPTW）、脑血流量（CBF）和相对CBF（rCBF）值以评估肿瘤的实性成分。通过独立样本和配对样本t检验比较MRI参数在胶质瘤分类中的差异。构建受试者操作特征（ROC）曲线，并计算ROC曲线下面积（AUC）以评估每个参数以及rAPTW和rCBF值组合的诊断性能。
HGG患者的APTW、rAPTW、CBF和rCBF值显著高于LGG患者（均p < 0.001）。在ROC曲线分析中，rAPTW的AUC最高，为0.90。将rAPTW信号添加到rCBF值中，联合参数的诊断能力从0.90提高到0.96。rAPTW值在与IDH突变状态相关性方面产生了最高的AUC（0.92），将其添加到rCBF值中诊断能力提高到0.96。
3D-APTW成像联合3D-pCASL成像可用于辅助评估胶质瘤分级和IDH突变状态。
