Multi-parametric Z-spectral MRI may have a good performance for glioma stratification in clinical patients

Su, Changliang; Shijie, Xu; Lin, Danlin; He, Hualiang; Chen, Zhenghe; Damen, Frederick W.; Ke, Chao; Lv, Xiaofei; Cai, Kejia

doi:10.1007/s00330-021-08175-3

Cited by 21 publications

(23 citation statements)

References 44 publications

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“…104 It is worth noting that the linewidth of some nearby intermediate-exchange resonances (including those from guanidinium protons at 2 ppm, which have an exchange rate of about 800-1000 Hz 105,106 and, therefore, an effective linewidth of about 2.0-2.5 ppm at 3 T) may be sufficiently large to be partially irradiated and detected at 3.5 ppm. 107,108 (9) APTw effect from mobile proteins in liquefactive necrosis. Proteinaceous fluid compartments in tumors, such as liquefactive necrosis, would result in large hyperintensity on APTw images 12,24 because of the abundance of proteins and protein fractions at higher mobility.…”

Section: History Of the Mechanism And The Evolution Of Its Understandingmentioning

confidence: 99%

Review and consensus recommendations on clinical APT‐weighted imaging approaches at 3T: Application to brain tumors

Zhou

Zaiß

Knutsson

et al. 2022

Magnetic Resonance in Med

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119

138

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Amide proton transfer-weighted (APTw) MR imaging shows promise as a biomarker of brain tumor status. Currently used APTw MRI pulse sequences and protocols vary substantially among different institutes, and there are no agreed-on standards in the imaging community. Therefore, the results acquired from different research centers are difficult to compare, which hampers uniform clinical application and interpretation. This paper reviews current clinical APTw imaging approaches and provides a rationale for optimized APTw brain tumor imaging at 3 T, including specific recommendations for pulse sequences, acquisition protocols, and data processing methods. We expect that these consensus recommendations will become the first broadly accepted guidelines for APTw imaging of brain tumors on 3 T MRI systems from different vendors. This will allow more medical centers to use the same or comparable APTw MRI techniques for the detection, characterization, and monitoring of brain tumors, enabling multi-center trials in larger patient cohorts and, ultimately, routine clinical use. K E Y W O R D APTw standardization, APT-weighted imaging, brain tumor, CEST imaging How to cite this article: Zhou J, Zaiss M, Knutsson L, et al. Review and consensus recommendations on clinical APT-weighted imaging approaches at 3T: Application to brain tumors.

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Section: History Of the Mechanism And The Evolution Of Its Understandingmentioning

confidence: 99%

Review and consensus recommendations on clinical APT‐weighted imaging approaches at 3T: Application to brain tumors

Zhou

Zaiß

Knutsson

et al. 2022

Magnetic Resonance in Med

Self Cite

119

138

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“…CEST at 3.5 ppm demonstrated hyperintensity in IDH-wild type when compared with IDH-mutant glioma patients, along with a high level of relative CBV [16,22,29], while showed no significant differences regarding the MGMT promoter methylation status [22]. NOE imaging related to this mutation is quite diverse [5,22]. Overall, CEST at 3.5 ppm may serve as the IDH mutation marker and help in glioma status prediction.…”

Section: Glioblastoma and Gliomas (Grade II Iii)mentioning

confidence: 87%

“…CEST is capable of detecting the presence of millimolar concentrations of molecules in vivo. The two unique CEST contrasts at 3.5 ppm (APT) and −3.5 ppm (NOE) are widely used to assess brain tumors [5,8,9,13,14,16,17,[19][20][21][22][23][24]27,[29][30][31][32][33]39,40,[59][60][61][62][63][64][65][66][67][68][69][70][71][72]. Tumors have an acidic microenvironment and CEST is sensitive to pH; hence, CEST could further enhance the detectability of these molecular alterations in tumors [3,58,73].…”

Section: Endogenous Contrastmentioning

confidence: 99%

“…Amine/amide concentration independent detection (AACID) calculated based on an amide signal at 3.5 ppm and an amine signal at 2.75 ppm indicated the intracellular pH changes in mice at 9.4 T [66]. A recently published study including 113 brain tumor patients revealed changes in these multiple contrasts, including direct water saturation (DS), MTC, APT, NOE, and CEST at 2 ppm, reflected different tumor status and provided improved sensitivity and specificity in tumor diagnosis [5].…”

Section: Multiple Cest Contrast In Brain Tumorsmentioning

confidence: 99%

“…Nevertheless, detecting molecular alterations and their location is invaluable in assessing brain tumors, especially when more than one molecule is altered in brain tumors in various regions [55][56][57][58]. CEST MRI has been applied to grade tumors [5,8,9,19,22,23,27,[30][31][32][33]39,[59][60][61][62][63][64][65], assess treatment effects [13,14,21,32,40,[66][67][68][69][70], assess progression survival [13,16,17], and evaluate IDH mutation [5,9,17,20,22,24,29,71,72]. Furthermore, the molecular and regional changes in tumors revealed by CEST could inform the development of theranostic approaches for brain tumors, especially for monitoring the changes of multiple components of drug delivery systems longitudinally.…”

Section: Introductionmentioning

confidence: 99%

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Molecular Imaging of Brain Tumors and Drug Delivery Using CEST MRI: Promises and Challenges

et al. 2022

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Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) detects molecules in their natural forms in a sensitive and non-invasive manner. This makes it a robust approach to assess brain tumors and related molecular alterations using endogenous molecules, such as proteins/peptides, and drugs approved for clinical use. In this review, we will discuss the promises of CEST MRI in the identification of tumors, tumor grading, detecting molecular alterations related to isocitrate dehydrogenase (IDH) and O-6-methylguanine-DNA methyltransferase (MGMT), assessment of treatment effects, and using multiple contrasts of CEST to develop theranostic approaches for cancer treatments. Promising applications include (i) using the CEST contrast of amide protons of proteins/peptides to detect brain tumors, such as glioblastoma multiforme (GBM) and low-grade gliomas; (ii) using multiple CEST contrasts for tumor stratification, and (iii) evaluation of the efficacy of drug delivery without the need of metallic or radioactive labels. These promising applications have raised enthusiasm, however, the use of CEST MRI is not trivial. CEST contrast depends on the pulse sequences, saturation parameters, methods used to analyze the CEST spectrum (i.e., Z-spectrum), and, importantly, how to interpret changes in CEST contrast and related molecular alterations in the brain. Emerging pulse sequence designs and data analysis approaches, including those assisted with deep learning, have enhanced the capability of CEST MRI in detecting molecules in brain tumors. CEST has become a specific marker for tumor grading and has the potential for prognosis and theranostics in brain tumors. With increasing understanding of the technical aspects and associated molecular alterations detected by CEST MRI, this young field is expected to have wide clinical applications in the near future.

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Radiomic feature reliability of amide proton transfer‐weighted MR images acquired with compressed sensing at 3 T

Wu,

Huang,

Shen

et al. 2024

Int J Imaging Syst Tech

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Compressed sensing (CS) is a novel technique for MRI acceleration. The purpose of this paper was to assess the effects of CS on the radiomic features extracted from amide proton transfer‐weighted (APTw) images. Brain tumor MRI data of 40 scans were studied. Standard images using sensitivity encoding (SENSE) with an acceleration factor (AF) of 2 were used as the gold standard, and APTw images using SENSE with CS (CS‐SENSE) with an AF of 4 were assessed. Regions of interest (ROIs), including normal tissue, edema, liquefactive necrosis, and tumor, were manually drawn, and the effects of CS‐SENSE on radiomics were assessed for each ROI category. An intraclass correlation coefficient (ICC) was first calculated for each feature extracted from APTw images with SENSE and CS‐SENSE for all ROIs. Different filters were applied to the original images, and the effects of these filters on the ICCs were further compared between APTw images with SENSE and CS‐SENSE. Feature deviations were also provided for a more comprehensive evaluation of the effects of CS‐SENSE on radiomic features. The ROI‐based comparison showed that most radiomic features extracted from CS‐SENSE‐APTw images and SENSE‐APTw images had moderate or greater reliabilities (ICC ≥ 0.5) for all four ROIs and all eight image sets with different filters. Tumor showed significantly higher ICCs than normal tissue, edema, and liquefactive necrosis. Compared to the original images, filters (such as Exponential or Square) may improve the reliability of radiomic features extracted from CS‐SENSE‐APTw and SENSE‐APTw images.

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Multi-parametric Z-spectral MRI may have a good performance for glioma stratification in clinical patients

Cited by 21 publications

References 44 publications

Review and consensus recommendations on clinical APT‐weighted imaging approaches at 3T: Application to brain tumors

Review and consensus recommendations on clinical APT‐weighted imaging approaches at 3T: Application to brain tumors

Molecular Imaging of Brain Tumors and Drug Delivery Using CEST MRI: Promises and Challenges

Radiomic feature reliability of amide proton transfer‐weighted MR images acquired with compressed sensing at 3 T

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