Histogram Analysis of Amide Proton Transfer Imaging to Identify Contrast-enhancing Low-Grade Brain Tumor That Mimics High-Grade Tumor: Increased Accuracy of MR Perfusion

Park, Ji Eun; Kim, Ho Sung; Park, Kye Jin; Choi, Choong Gon; Kim, Sang Joon

doi:10.1148/radiol.2015142347

Cited by 61 publications

(93 citation statements)

References 20 publications

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“…In contrast, the observed negative correlation between the APT signal and pH conflicts with studies showing increased APT signalling with increasing pH. However, these previous studies used a creatine phantom and measured the APT signal from mobile amine protons [22, 23], whereas we used a BSA phantom and measured the APT signal primarily from amide, intermixed with the signal from amine. Thus, the conflicting results may be partially attributed to the different phantoms and to the mobile proton sources for the APT signal, resulting in mixed effects of the amide, amine and other factors on the APT signal changes according to the pH.…”

Section: Discussioncontrasting

confidence: 85%

“…However, the clinical feasibility of these studies was limited, since they scanned animal models using experimental MRI or assessed human patients using only one representative tumour slice. A recent clinical MRI study reported that APT imaging increased the accuracy of rCBV for differentiating contrast-enhanced low-grade from high-grade tumours [22]. Here, we restricted our cohort to cases with gliomas, the most common primary brain tumour, and we investigated the compatibility and added value of APT imaging to DTI and perfusion MRI.…”

Section: Discussionmentioning

confidence: 99%

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Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

et al. 2017

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Objectives To evaluate the added value of amide proton transfer (APT) imaging to the apparent diffusion coefficient (ADC) from diffusion tensor imaging (DTI) and the relative cerebral blood volume (rCBV) from perfusion magnetic resonance imaging (MRI) for discriminating between high- and low-grade gliomas. Methods Forty-six consecutive adult patients with diffuse gliomas who underwent preoperative APT imaging, DTI and perfusion MRI were enrolled. APT signals were compared according to the World Health Organization grade. The diagnostic ability and added value of the APT signal to the ADC and rCBV for discriminating between low- and high-grade gliomas were evaluated using receiver operating characteristic (ROC) analyses and integrated discrimination improvement. Results The APT signal increased as the glioma grade increased. The discrimination abilities of the APT, ADC and rCBV values were not significantly different. Using both the APT signal and ADC significantly improved discrimination vs. the ADC alone (area under the ROC curve [AUC], 0.888−0.910; P = 0.007), whereas using both the APT signal and rCBV did not improve discrimination vs. the rCBV alone (AUC, 0.927−0.923; P = 0.222). Conclusions APT imaging may be a useful imaging biomarker that adds value to the ADC for discriminating between low- and high-grade gliomas.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

et al. 2017

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“…3,[11][12][13][14][15][16][17][18] However, details of the relationships between APT imaging and other clinical imaging parameters of malignancy have yet to be fully elucidated. This study confirmed that APT imaging can be used for grading glial tumors, with a diagnostic accuracy comparable with that of other imaging biomarkers derived from DWI and FDG-PET.…”

Section: Additive Value Of Apt Imaging To Dwi For Glioma Gradingmentioning

confidence: 99%

“…22 As in previous studies, our results also demonstrated excellent interrater reproducibility in the measurement of APT. 3,[11][12][13][14][15][16] We believe that for the preoperative grading of brain tumors, APT can be considered an alternative approach to PET and other MR imaging methods such as DWI.…”

Section: Additive Value Of Apt Imaging To Dwi For Glioma Gradingmentioning

confidence: 99%

“…9 This technique has been successfully applied to human brain tumors. 3,[10][11][12][13][14][15][16] Some reports have shown that the APT asymmetry value is useful in tumor grading, allowing differentiation of pseudoprogression from recurrence 17 and the assessment of treatment response. 18,19 However, the relationship between APT and other quantitative imaging values has yet to be investigated.…”

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confidence: 99%

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Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

Sakata¹,

Okada²,

Yamamoto

et al. 2018

AJNR Am J Neuroradiol

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Proton Chemical Exchange Saturation Transfer (CEST) MRS and MRI

Zijl

Sehgal

2016

eMagRes

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Proton magnetic resonance spectroscopy ( 1 H MRS) of biological systems has higher specificity than MRI because resonances of multiple metabolites can be distinguished, reflecting chemistry and physiology in situ. Unfortunately, this approach has very low sensitivity as the metabolites are typically at millimolar concentrations compared to the molar signal strength of water-based MRI. As a consequence, even though 1 H MRS is a powerful and common research tool, its inroad into daily clinical practice has been limited. Until very recently, 1 H MRS applications have focused on the resonances upfield (i.e., at lower frequency) of the water resonance. This article deals with protons that are generally not observed in a typical water-suppressed spectrum, namely, the exchangeable protons found predominantly downfield from water. These can usually be detected by MRS only if the transfer of water proton saturation (established during water suppression) is not a confounding factor, or by using water exchange (WEX) spectroscopy, in which RF labeling of the water protons is transferred to the exchangeable protons and subsequently detected. More importantly, it has recently become clear that the presence of such exchangeable protons on low concentration solute molecules can be detected via the water signal by RF labeling of these protons and subsequent transfer of this label to water protons. This process, leading to saturation of the water signal and enhancement of the effect through repeated exchange, can be used for the imaging of metabolite signals or exchangeable-proton-based contrast agents with enhanced sensitivity. This has given rise to the field of chemical exchange saturation transfer (CEST) MRI, which has greatly increased the potential for translating spectroscopic methods to the clinic. Examples include the measurement of pH, temperature, and enzyme activity as well as detection of cellular metabolites, ions, and proteins and peptides. In addition, bio-organic compounds can now be used for contrast agents, cell and nanoparticle labeling, and reporter genes.

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Histogram Analysis of Amide Proton Transfer Imaging to Identify Contrast-enhancing Low-Grade Brain Tumor That Mimics High-Grade Tumor: Increased Accuracy of MR Perfusion

Abstract: Histogram analysis of APT imaging provided increased accuracy of MR perfusion imaging for the identification of contrast-enhancing low-grade tumor that mimics high-grade tumor.

Cited by 61 publications

References 20 publications

Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

Proton Chemical Exchange Saturation Transfer (CEST) MRS and MRI

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