Deng Hua-Zhen, Zhang Han-Wen, Huang Biao, Deng Jin-Huan, Luo Si-Ping, Li Wei-Hua, Lei Yi, Liu Xiao-Lei, Lin Fan
Shantou University Medical College, Shantou City, China.
Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China.
Front Neurosci. 2024 Jul 31;18:1424316. doi: 10.3389/fnins.2024.1424316. eCollection 2024.
Chemical Exchange Saturation Transfer (CEST) is a technique that uses specific off-resonance saturation pulses to pre-saturate targeted substances. This process influences the signal intensity of free water, thereby indirectly providing information about the pre-saturated substance. Among the clinical applications of CEST, Amide Proton Transfer (APT) is currently the most well-established. APT can be utilized for the preoperative grading of gliomas. Tumors with higher APTw signals generally indicate a higher likelihood of malignancy. In predicting preoperative molecular typing, APTw values are typically lower in tumors with favorable molecular phenotypes, such as isocitrate dehydrogenase (IDH) mutations, compared to IDH wild-type tumors. For differential diagnosis, the average APTw values of meningiomas are significantly lower than those of high-grade gliomas. Various APTw measurement indices assist in distinguishing central nervous system lesions with similar imaging features, such as progressive multifocal leukoencephalopathy, central nervous system lymphoma, solitary brain metastases, and glioblastoma. Regarding prognosis, APT effectively differentiates between tumor recurrence and treatment effects, and also possesses predictive capabilities for overall survival (OS) and progression-free survival (PFS).
化学交换饱和转移(CEST)是一种利用特定的偏离共振饱和脉冲对目标物质进行预饱和的技术。这一过程会影响自由水的信号强度,从而间接提供有关预饱和物质的信息。在CEST的临床应用中,酰胺质子转移(APT)是目前最成熟的。APT可用于胶质瘤的术前分级。具有较高APTw信号的肿瘤通常表明恶性可能性更高。在预测术前分子分型时,与异柠檬酸脱氢酶(IDH)野生型肿瘤相比,具有良好分子表型(如IDH突变)的肿瘤中APTw值通常较低。在鉴别诊断方面,脑膜瘤的平均APTw值显著低于高级别胶质瘤。各种APTw测量指标有助于区分具有相似影像学特征的中枢神经系统病变,如进行性多灶性白质脑病、中枢神经系统淋巴瘤、孤立性脑转移瘤和胶质母细胞瘤。在预后方面,APT能有效区分肿瘤复发和治疗效果,还具有预测总生存期(OS)和无进展生存期(PFS)的能力。