Improved Differentiation of Low-Grade and High-Grade Gliomas and Detection of Tumor Proliferation Using APT Contrast Fitted from Z-Spectrum.

Purpose: The purpose of the study is to demonstrate the value of quantitative amide proton transfer (APT) imaging for differentiating glioma grades and detecting tumor proliferation.Procedures: This study included 32 subjects with 16 low-grade gliomas (LGG) and 16 high-grade gliomas (HGG) confirmed...

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Publicado en:Molecular Imaging & Biology Vol. 20; no. 4; pp. 623 - 632
Autores principales: Zhang, Jiaxuan, Zhu, Wenzhen, Tain, Rongwen, Zhou, Xiaohong Joe, Cai, Kejia
Formato: research Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Springer Nature
      place: New York, New York
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        atl: Improved Differentiation of Low-Grade and High-Grade Gliomas and Detection of Tumor Proliferation Using APT Contrast Fitted from Z-Spectrum.
      aug:
        au:
          Zhang, Jiaxuan
          Zhu, Wenzhen
          Tain, Rongwen
          Zhou, Xiaohong Joe
          Cai, Kejia
        affil: Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, 1095 Jiefang Ave., 430030, Wuhan, Hubei, China
      sug:
        subj:
          Protons
          Glioma Diagnosis
          Magnetic Resonance Imaging
          Brain Neoplasms Diagnosis
          Amides
          Brain Neoplasms Pathology
          Glioma Pathology
          Aged
          Tumor Markers, Biological Metabolism
          Adult
          Adolescence
          Young Adult
          ROC Curve
          Human
          Male
          Female
          Cell Physiology
          Middle Age
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Aged: 65+ years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: The purpose of the study is to demonstrate the value of quantitative amide proton transfer (APT) imaging for differentiating glioma grades and detecting tumor proliferation.Procedures: This study included 32 subjects with 16 low-grade gliomas (LGG) and 16 high-grade gliomas (HGG) confirmed by histopathology. Chemical exchange saturation transfer (CEST) magnetic resonance imaging with APT weighting was performed on a 3 T scanner. After B0 correction, Z-spectra were fitted with Lorentzian functions corresponding to the upfield semi-solid magnetization transfer and nuclear overhauser enhancement (MT&NOE) effect, the direct saturation (DS) effect, and the downfield APT effect centered at around - 1.5, 0, and + 3.5 ppm, respectively. To compute the Z-spectral fitted APT (fitted_APT) in solid tumor tissue, double-peak histogram fitting of pixel MT&NOE effect from the whole tumor was used to remove necrosis regions. The fitted APT was then compared with the conventional APT based on magnetization transfer ratio asymmetry. Receiver operating characteristic (ROC) analysis was used to compare the performance between Z-spectral fitted contrasts and the con_APT for LGG versus HGG differentiation. Additionally, the correlations between the imaging contrasts (fitted_APT, con_APT, and fitted_MT&NOE) and Ki-67 labeling index for tumor proliferation were also evaluated.Results: Z-spectral fitted_APT shows improved statistical power for differentiating HGG and LGG (7.58 ± 0.99 vs. 6.79 ± 1.05 %, p < 0.05) than con_APT (4.34 ± 0.95 vs. 4.05 ± 2.02 %, p > 0.05) in solid tumor tissues. Analyses of whole tumor, on the other hand, have less differentiating power for both fitted_APT (p from 0.032 to 0.08) and con_APT (p from 0.696 to 0.809). Similarly, based on ROC analyses, fitted_APT shows larger area under the curve (AUC = 0.723) than con_APT (AUC = 0.543). The combination of fitted APT, DS, and MT&NOE further improved the specificity (75 %), diagnostic accuracy (78.2 %), and area under the curve (0.758) in differentiating LGG and HGG. Consistently, fitted_APT (r = 0.451, p = 0.018) is better correlated with Ki-67 than con_APT (r = 0.331, p = 0.092).Conclusions: Fitted APT from Z-spectrum improves differentiation of low- and high-grade gliomas and better correlated with tumor proliferation than conventional APT.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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