TY - JOUR
T1 - Reproducibility of 3 T APT-CEST in Healthy Volunteers and Patients With Brain Glioma
AU - Wamelink, Ivar J. H. G.
AU - Kuijer, Joost P. A.
AU - Padrela, Beatriz E.
AU - Zhang, Yi
AU - Barkhof, Frederik
AU - Mutsaerts, Henk J. M. M.
AU - Petr, Jan
AU - van de Giessen, Elsmarieke
AU - Keil, Vera C.
N1 - Funding Information: The authors thank T. Schweigmann for organizing the scanning of the patients. FB is supported by the NIHR Biomedical Research Center at UCLH. HM is supported by the Dutch Heart Foundation (03‐004‐2020‐T049). The authors thank the COST Action CA 18206 Glimr 2.0 for their networking support. Funding Information: The authors thank T. Schweigmann for organizing the scanning of the patients. FB is supported by the NIHR Biomedical Research Center at UCLH. HM is supported by the Dutch Heart Foundation (03-004-2020-T049). The authors thank the COST Action CA 18206 Glimr 2.0 for their networking support. Publisher Copyright: © 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Amide proton transfer (APT) imaging is a chemical exchange saturation transfer (CEST) technique offering potential clinical applications such as diagnosis, characterization, and treatment planning and monitoring in glioma patients. While APT-CEST has demonstrated high potential, reproducibility remains underexplored. Purpose: To investigate whether cerebral APT-CEST with clinically feasible scan time is reproducible in healthy tissue and glioma for clinical use at 3 T. Study Type: Prospective, longitudinal. Subjects: Twenty-one healthy volunteers (11 females; mean age ± SD: 39 ± 11 years) and 6 glioma patients (3 females; 50 ± 17 years: 4 glioblastomas, 1 oligodendroglioma, 1 radiologically suspected low-grade glioma). Field Strength/Sequence: 3 T, Turbo Spin Echo - ampling perfection with application optimized contrasts using different flip angle evolution - chemical exchange saturation transfer (TSE SPACE-CEST). Assessment: APT-CEST measurement reproducibility was assessed within-session (glioma patients, scan session 1; healthy volunteers scan sessions 1, 2, and 3), between-sessions (healthy volunteers scan sessions 1 and 2), and between-days (healthy volunteers, scan sessions 1 and 3). The mean APTCEST values and standard deviation of the within-subject difference (SDdiff) were calculated in whole tumor enclosed by regions of interest (ROIs) in patients, and eight ROIs in healthy volunteers—whole-brain, cortical gray matter, putamen, thalami, orbitofrontal gyri, occipital lobes, central brain—and compared. Statistical Tests: Brown-Forsythe tests and variance component analysis (VCA) were used to assess the reproducibility of ROIs for the three time intervals. Significance was set at P < 0.003 after Bonferroni correction. Results: Intratumoral mean APTCEST was significantly higher than APTCEST in healthy-appearing tissue in patients (0.5 ± 0.46%). The average within-session, between-sessions, and between-days SDdiff of healthy control brains was 0.2% and did not differ significantly with each other (0.76 > P > 0.22). The within-session SDdiff of whole-brain was 0.2% in both healthy volunteers and patients, and 0.21% in the segmented tumor. VCA showed that within-session factors were the most important (60%) for scanning variance. Data Conclusion: Cerebral APT-CEST imaging may show good scan–rescan reproducibility in healthy tissue and tumors with clinically feasible scan times at 3 T. Short-term measurement effects may be the dominant components for reproducibility. Level of Evidence: 2. Technical Efficacy: Stage 2.
AB - Background: Amide proton transfer (APT) imaging is a chemical exchange saturation transfer (CEST) technique offering potential clinical applications such as diagnosis, characterization, and treatment planning and monitoring in glioma patients. While APT-CEST has demonstrated high potential, reproducibility remains underexplored. Purpose: To investigate whether cerebral APT-CEST with clinically feasible scan time is reproducible in healthy tissue and glioma for clinical use at 3 T. Study Type: Prospective, longitudinal. Subjects: Twenty-one healthy volunteers (11 females; mean age ± SD: 39 ± 11 years) and 6 glioma patients (3 females; 50 ± 17 years: 4 glioblastomas, 1 oligodendroglioma, 1 radiologically suspected low-grade glioma). Field Strength/Sequence: 3 T, Turbo Spin Echo - ampling perfection with application optimized contrasts using different flip angle evolution - chemical exchange saturation transfer (TSE SPACE-CEST). Assessment: APT-CEST measurement reproducibility was assessed within-session (glioma patients, scan session 1; healthy volunteers scan sessions 1, 2, and 3), between-sessions (healthy volunteers scan sessions 1 and 2), and between-days (healthy volunteers, scan sessions 1 and 3). The mean APTCEST values and standard deviation of the within-subject difference (SDdiff) were calculated in whole tumor enclosed by regions of interest (ROIs) in patients, and eight ROIs in healthy volunteers—whole-brain, cortical gray matter, putamen, thalami, orbitofrontal gyri, occipital lobes, central brain—and compared. Statistical Tests: Brown-Forsythe tests and variance component analysis (VCA) were used to assess the reproducibility of ROIs for the three time intervals. Significance was set at P < 0.003 after Bonferroni correction. Results: Intratumoral mean APTCEST was significantly higher than APTCEST in healthy-appearing tissue in patients (0.5 ± 0.46%). The average within-session, between-sessions, and between-days SDdiff of healthy control brains was 0.2% and did not differ significantly with each other (0.76 > P > 0.22). The within-session SDdiff of whole-brain was 0.2% in both healthy volunteers and patients, and 0.21% in the segmented tumor. VCA showed that within-session factors were the most important (60%) for scanning variance. Data Conclusion: Cerebral APT-CEST imaging may show good scan–rescan reproducibility in healthy tissue and tumors with clinically feasible scan times at 3 T. Short-term measurement effects may be the dominant components for reproducibility. Level of Evidence: 2. Technical Efficacy: Stage 2.
KW - APT
KW - CEST
KW - brain
KW - glioma
KW - reproducibility
UR - http://www.scopus.com/inward/record.url?scp=85130691817&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/jmri.28239
DO - https://doi.org/10.1002/jmri.28239
M3 - Article
C2 - 35633282
SN - 1053-1807
VL - 57
SP - 206
EP - 215
JO - Journal of magnetic resonance imaging
JF - Journal of magnetic resonance imaging
IS - 1
ER -