In:
Magnetic Resonance in Medicine, Wiley, Vol. 90, No. 4 ( 2023-10), p. 1569-1581
Abstract:
The purpose of this study was to compare the potential of asymmetry‐based (APTw asym ), Lorentzian‐fit‐based (PeakAreaAPT and MT const ), and relaxation‐compensated (MTR Rex APT and MTR Rex MT) CEST contrasts of the amide proton transfer (APT) and semi‐solid magnetization transfer (ssMT) for early response assessment and prediction of progression‐free survival (PFS) in patients with glioma. Methods Seventy‐two study participants underwent CEST‐MRI at 3T from July 2018 to December 2021 in a prospective clinical trial four to 6 wk after the completion of radiotherapy for diffuse glioma. Tumor segmentations were performed on T 2w ‐FLAIR and contrast‐enhanced T 1w images. Therapy response assessment and determination of PFS were performed according to response assessment in neuro oncology (RANO) criteria using clinical follow‐up data with a median observation time of 9.2 mo (range, 1.6–40.8) and compared to CEST MRI metrics. Statistical testing included receiver operating characteristic analyses, Mann–Whitney‐ U ‐test, Kaplan–Meier analyses, and logrank‐test. Results MT const (AUC = 0.79, p 〈 0.01) showed a stronger association with RANO response assessment compared to PeakAreaAPT (AUC = 0.71, p = 0.02) and MTR Rex MT (AUC = 0.71, p = 0.02), and enabled differentiation of participants with pseudoprogression ( n = 8) from those with true progression (AUC = 0.79, p = 0.02). Furthermore, MT const (HR = 3.04, p = 0.01), PeakAreaAPT (HR = 0.39, p = 0.03), and APTw asym (HR = 2.63, p = 0.02) were associated with PFS. MTR Rex APT was not associated with any outcome. Conclusion MT const , PeakAreaAPT, and APTw asym imaging predict clinical outcome by means of progression‐free survival. Furthermore, MT const enables differentiation of radiation‐induced pseudoprogression from disease progression. Therefore, the assessed metrics may have synergistic potential for supporting clinical decision making during follow‐up of patients with glioma.
Type of Medium:
Online Resource
ISSN:
0740-3194
,
1522-2594
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
1493786-4
