Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.
Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Applied Mathematics and Statistics, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.
Magn Reson Imaging. 2023 Oct;102:222-228. doi: 10.1016/j.mri.2023.06.003. Epub 2023 Jun 14.
New or enlarged lesions in malignant gliomas after surgery and chemoradiation can be associated with tumor recurrence or treatment effect. Due to similar radiographic characteristics, conventional-and even some advanced MRI techniques-are limited in distinguishing these two pathologies. Amide proton transfer-weighted (APTw) MRI, a protein-based molecular imaging technique that does not require the administration of any exogenous contrast agent, was recently introduced into the clinical setting. In this study, we evaluated and compared the diagnostic performances of APTw MRI with several non-contrast-enhanced MRI sequences, such as diffusion-weighted imaging, susceptibility-weighted imaging, and pseudo-continuous arterial spin labeling. Thirty-nine scans from 28 glioma patients were obtained on a 3 T MRI scanner. A histogram analysis approach was employed to extract parameters from each tumor area. Statistically significant parameters (P < 0.05) were selected to train multivariate logistic regression models to evaluate the performance of MRI sequences. Multiple histogram parameters, particularly from APTw and pseudo-continuous arterial spin labeling images, demonstrated significant differences between treatment effect and recurrent tumor. The regression model trained on the combination of all significant histogram parameters achieved the best result (area under the curve = 0.89). We found that APTw images added value to other advanced MR images for the differentiation of treatment effect and tumor recurrence.
术后放化疗后恶性胶质瘤的新发病灶或扩大病灶可能与肿瘤复发或治疗效果有关。由于具有相似的影像学特征,常规甚至一些先进的 MRI 技术在区分这两种病理方面存在局限性。酰胺质子转移加权(APTw)MRI 是一种基于蛋白质的分子成像技术,不需要任何外源性造影剂,最近已引入临床应用。在这项研究中,我们评估并比较了 APTw MRI 与几种非增强 MRI 序列(如扩散加权成像、磁化率加权成像和伪连续动脉自旋标记)的诊断性能。在 3T MRI 扫描仪上获得了 28 名胶质瘤患者的 39 次扫描。采用直方图分析方法从每个肿瘤区域提取参数。选择具有统计学意义的参数(P < 0.05)来训练多元逻辑回归模型,以评估 MRI 序列的性能。多个直方图参数,特别是来自 APTw 和伪连续动脉自旋标记图像的参数,在治疗效果和复发性肿瘤之间表现出显著差异。基于所有显著直方图参数的回归模型取得了最佳结果(曲线下面积= 0.89)。我们发现 APTw 图像为区分治疗效果和肿瘤复发提供了其他高级 MR 图像的附加价值。