Predicting radionecrosis and recurrent disease through Amide Proton Transfer weighted imaging in brain metastases

Nichelli, Lucia; Jacob, J.; Leclerq, Delphine; Benbelkacem, Farhat; Lehericy, Stéphane; Casagranda, Stefano

doi:10.58530/2022/0126

Cited by 2 publications

(3 citation statements)

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“…2 Once the fluid or spillover artifact is removed, the generated image contrast is also theoretically expected to correlate stronger with the actual exchange effects (see Equations 5 vs. 6), and shows first signs of a higher diagnostic value, as shown by initial studies. [10][11][12] In this small multicentric clinical study, we have also shown the importance of this metric for both adult and pediatric pathology assessment, both before and after brain surgery.…”

Section: Discussionmentioning

confidence: 59%

“…With the snapshot readout the acquisition time per offset was TA = 6.1 s the total scan time was ∼3 min. For simultaneous B0-B1 mapping, the WASAB1 protocol 10 (2 min) was performed with the same readout parameters as for the CEST measurements. For T1 mapping a saturation recovery sequence was used (1:15 min).…”

Section: In Vitro: Phantomsmentioning

confidence: 99%

“…In addition, the proposed fluid suppression already showed valuable clinical results in tumor imaging. 2,[8][9][10] A major drawback of the equation proposed by the authors is that they are heuristically motivated, as described in more detail below. This leads to problems of clear interpretation of the physical mechanisms underlying this method, which is difficult to justify for the future clinical translation of this novel APTw map.…”

Section: Introductionmentioning

confidence: 99%

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Fluid suppression in amide proton transfer‐weighted (APTw) CEST imaging: New theoretical insights and clinical benefits

Schüre,

Casagranda,

Sedykh

et al. 2023

Magnetic Resonance in Med

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PurposeAmide proton transfer‐weighted (APTw) MRI at 3T provides a unique contrast for brain tumor imaging. However, APTw imaging suffers from hyperintensities in liquid compartments such as cystic or necrotic structures and provides a distorted APTw signal intensity. Recently, it has been shown that heuristically motivated fluid suppression can remove such artifacts and significantly improve the readability of APTw imaging.Theory and MethodsIn this work, we show that the fluid suppression can actually be understood by the known concept of spillover dilution, which itself can be derived from the Bloch‐McConnell equations in comparison to the heuristic approach. Therefore, we derive a novel post‐processing formula that efficiently removes fluid artifact, and explains previous approaches. We demonstrate the utility of this APTw assessment in silico, in vitro, and in vivo in brain tumor patients acquired at MR scanners from different vendors.ResultsOur results show a reduction of the CEST signals from fluid environments while keeping the APTw‐CEST signal intensity almost unchanged for semi‐solid tissue structures such as the contralateral normal appearing white matter. This further allows us to use the same color bar settings as for conventional APTw imaging.ConclusionFluid suppression has considerable value in improving the readability of APTw maps in the neuro‐oncological field. In this work, we derive a novel post‐processing formula from the underlying Bloch‐McConnell equations that efficiently removes fluid artifact, and explains previous approaches which justify the derivation of this metric from a theoretical point of view, to reassure the scientific and medical field about its use.

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