Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Cancer Imaging. 2024 Sep 2;24(1):118. doi: 10.1186/s40644-024-00764-x.
Cystathionine accumulates selectively in 1p/19q-codeleted gliomas, and can serve as a possible noninvasive biomarker. This study aims to optimize the echo time (TE) of point-resolved spectroscopy (PRESS) for cystathionine detection in gliomas, and evaluate the diagnostic accuracy of PRESS for 1p/19q-codeletion identification.
The TE of PRESS was optimized with numerical and phantom analysis to better resolve cystathionine from the overlapping aspartate multiplets. The optimized and 97 ms TE PRESS were then applied to 84 prospectively enrolled patients suspected of glioma or glioma recurrence to examine the influence of aspartate on cystathionine quantification by fitting the spectra with and without aspartate. The diagnostic performance of PRESS for 1p/19q-codeleted gliomas were assessed.
The TE of PRESS was optimized as (TE1, TE2) = (17 ms, 28 ms). The spectral pattern of cystathionine and aspartate were consistent between calculation and phantom. The mean concentrations of cystathionine in vivo fitting without aspartate were significantly higher than those fitting with full basis-set for 97 ms TE PRESS (1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM, p < 0.01), but not significantly different for 45 ms method (0.801 ± 1.217 mM and 0.796 ± 1.217 mM, p = 0.494). The cystathionine concentrations of 45 ms approach was better correlated with those of edited MRS than 97 ms counterparts (r = 0.68 vs. 0.49, both p < 0.01). The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7% and 73.7% for 45 ms method, and 44.4% and 52.5% for 97 ms method, respectively.
The 45 ms TE PRESS yields more precise cystathionine estimates than the 97 ms method, and is anticipated to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas, and treatment response monitoring in those patients. Medium diagnostic performance of PRESS for 1p/19q-codeleted gliomas were observed, and warrants further investigations.
胱硫醚在 1p/19q 缺失型胶质瘤中选择性积累，可作为一种潜在的非侵入性生物标志物。本研究旨在优化点分辨波谱（PRESS）的回波时间（TE），以检测胶质瘤中的胱硫醚，并评估 PRESS 对 1p/19q 缺失识别的诊断准确性。
通过数值和体模分析优化 PRESS 的 TE，以更好地从重叠的天冬氨酸多重峰中分辨胱硫醚。然后，将优化后的 97 ms TE PRESS 应用于 84 例前瞻性疑似胶质瘤或胶质瘤复发的患者，通过拟合有无天冬氨酸的光谱来检查天冬氨酸对胱硫醚定量的影响。评估 PRESS 对 1p/19q 缺失型胶质瘤的诊断性能。
PRESS 的 TE 被优化为（TE1，TE2）=（17 ms，28 ms）。胱硫醚和天冬氨酸的光谱模式在计算和体模之间是一致的。体内无天冬氨酸拟合的胱硫醚平均浓度明显高于 97 ms TE PRESS 全基组拟合的浓度（1.97±2.01 mM 比 1.55±1.95 mM，p<0.01），但与 45 ms 方法无显著差异（0.801±1.217 mM 和 0.796±1.217 mM，p=0.494）。45 ms 方法的胱硫醚浓度与编辑后的 MRS 相关性更好（r=0.68 比 0.49，均 p<0.01）。45 ms 方法区分 1p/19q 缺失型胶质瘤的敏感性和特异性分别为 66.7%和 73.7%，97 ms 方法分别为 44.4%和 52.5%。
45 ms TE PRESS 比 97 ms 方法产生更精确的胱硫醚估计值，有望促进 1p/19q 缺失型胶质瘤的无创诊断和这些患者的治疗反应监测。PRESS 对 1p/19q 缺失型胶质瘤的诊断性能中等，需要进一步研究。
