Amide proton transfer-weighted MRI in the clinical setting – correlation with dynamic susceptibility contrast perfusion in the post-treatment imaging of adult glioma patients at 3T

Abstract

Introduction: We investigated the correlation between amide proton transfer-weighted magnetic resonance imaging (APTw MRI) and dynamic susceptibility contrast (DSC) perfusion in order to assess the potential of APTw MRI as an alternative to DSC in adult brain tumor (glioma) imaging. Methods: After Ethical Committee approval, forty adult patients, treated for histopathologically confirmed glioma (World Health Organization (WHO) grade II-IV), were prospectively imaged at 3 Tesla (3 T) with DSC perfusion and a commercially available three-dimensional (3D) APTw sequence. Two consultant neuroradiologists independently performed region of interest (ROI) measurements on relative cerebral blood volume (rCBV) and APTw maps, co-registered with anatomical images. The correlation APTw MRI-DSC perfusion was assessed using Spearman's rank-order test. Inter-observer agreement was evaluated by the intraclass correlation coefficient (ICC) and Bland-Altman (BA) plots. Results: A statistically significant moderately strong positive correlation was observed between maximum rCBV (rCBV max ) and maximum APTw (APTw max ) values (observer 1: r ¼ 0.73; p < 0.01; observer 2: r ¼ 0.62; p < 0.01). We found good inter-observer agreement for APTw max (ICC ¼ 0.82; 95% confidence interval (CI) 0.66e0.90), with somewhat broad outer 95% CI for the BA Limits of Agreement (LoA) (À1.6 to 1.9). ICC for APTw max was higher than ICC for rCBV max (ICC ¼ 0.74; 95%; CI 0.50e0.86), but the difference was not statistically significant. Conclusion: APTw max values correlate positively with rCBV max in patients treated for brain glioma. APTw imaging is a reproducible technique, with some observer dependence. Results need to be confirmed by a larger population analysis. Implications for practice: APTw MRI can be a useful addition to glioma follow-up imaging and a potential alternative to DSC perfusion, especially in patients where contrast agent is contraindicated.

Clinical significance of MRI-DWI and PWI scans in identifying benign prostatic hyperplasia and prostate cancer

“…PCa tissues exhibit abundant internal neovascularization and heightened blood perfusion. SSmax values and ∆R 2 *peak values serve as common parameters in PWI, effectively portraying tissue characteristics [26][27][28]. In this study, we observed lower SSmax values and ∆R 2 *peak values in PCa lesions, which highlights the potential of these parameters in providing insights into the nature of prostate lesions.…”

Advancements in Image-Based Models for High-Grade Gliomas Might Be Accelerated

“…40 adult patients, treated for histopathologically confirmed glioma (WHO grades II-IV). [33] APTw MRI mean values might be helpful in the differential diagnosis of HGGs and meningiomas or HGGs and LGGs.…”

“…The relationship between APTw MRI and DSC perfusion was investigated by Friismose and colleagues [33] who evaluated whether APTw MRI could be used as an alternative to magnetic resonance DSC in the imaging of HGG in adult patients (Figure 3G-M) (Table 1). APTw MRI (max) values correlated positively with rCBV (max) in patients treated for cerebral glioma.…”

“…The relationship between APTw MRI and DSC perfusion was investigated by Friismose and colleagues [33] who evaluated whether APTw MRI could be used as an alternative to magnetic resonance DSC in the imaging of HGG in adult patients (Figure…”

Differentiation between glioma recurrence and treatment effects using amide proton transfer imaging: A mini-Bayesian bivariate meta-analysis

“…Therefore, APT imaging has substantial benefit in that it uses an off-resonance radiofrequency (RF) pulse to detect endogenous mobile proteins and peptides within recurrent gliomas without ionizing radiation. Another clinical advantage of APT imaging is that it is non-invasive with no need for exogenous contrast and is a reproducible technique, which can be a potential alternative to DSC perfusion, especially in patients where contrast agent is contraindicated ( 12 ).…”