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@ARTICLE{Paech:142103,
author = {D. Paech$^*$ and J. Windschuh$^*$ and J. Oberhollenzer$^*$
and C. Dreher$^*$ and F. Sahm$^*$ and J.-E. Meissner$^*$ and
S. Goerke$^*$ and P. Schuenke$^*$ and M. Zaiss and S.
Regnery$^*$ and S. Bickelhaupt$^*$ and P. Bäumer$^*$ and M.
Bendszus and W. Wick$^*$ and A. Unterberg and P. Bachert$^*$
and M. Ladd$^*$ and H.-P. Schlemmer$^*$ and A. Radbruch$^*$},
title = {{A}ssessing the predictability of {IDH} mutation and {MGMT}
methylation status in glioma patients using
relaxation-compensated multipool {CEST} {MRI} at 7.0 {T}.},
journal = {Neuro-Oncology},
volume = {20},
number = {12},
issn = {1523-5866},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2018-02333},
pages = {1661 - 1671},
year = {2018},
abstract = {Early identification of prognostic superior characteristics
in glioma patients such as isocitrate dehydrogenase (IDH)
mutation and O6-methylguanine-DNA-methyltransferase (MGMT)
promoter methylation status is of great clinical importance.
The study purpose was to investigate the non-invasive
predictability of IDH mutation status, MGMT promoter
methylation, and differentiation of low-grade versus
high-grade glioma (LGG vs HGG) in newly diagnosed patients
employing relaxation-compensated multipool chemical exchange
saturation transfer (CEST) MRI at 7.0 Tesla.Thirty-one
patients with newly diagnosed glioma were included in this
prospective study. CEST MRI was performed at a 7T whole-body
scanner. Nuclear Overhauser effect (NOE) and isolated amide
proton transfer (APT; downfield NOE-suppressed APT =
dns-APT) CEST signals (mean value and 90th signal
percentile) were quantitatively investigated in the whole
tumor area with regard to predictability of IDH mutation,
MGMT promoter methylation status, and differentiation of LGG
versus HGG. Statistics were performed using receiver
operating characteristic (ROC) and area under the curve
(AUC) analysis. Results were compared with advanced MRI
methods (apparent diffusion coefficient and relative
cerebral blood volume ROC/AUC analysis) obtained at
3T.dns-APT CEST yielded highest AUCs in IDH mutation status
prediction (dns-APTmean = $91.84\%,$ P < 0.01; dns-APT90 =
$97.96\%,$ P < 0.001). Furthermore, dns-APT metrics enabled
significant differentiation of LGG versus HGG (AUC:
dns-APTmean = 0.78, P < 0.05; dns-APT90 = 0.83, P < 0.05).
There was no significant difference regarding MGMT promoter
methylation status at any contrast (P >
0.05).Relaxation-compensated multipool CEST MRI,
particularly dns-APT imaging, enabled prediction of IDH
mutation status and differentiation of LGG versus HGG and
should therefore be considered as a non-invasive MR
biomarker in the diagnostic workup.},
cin = {E010 / G380 / E020 / G370 / E012 / L101},
ddc = {610},
cid = {I:(DE-He78)E010-20160331 / I:(DE-He78)G380-20160331 /
I:(DE-He78)E020-20160331 / I:(DE-He78)G370-20160331 /
I:(DE-He78)E012-20160331 / I:(DE-He78)L101-20160331},
pnm = {315 - Imaging and radiooncology (POF3-315)},
pid = {G:(DE-HGF)POF3-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29733378},
pmc = {pmc:PMC6231210},
doi = {10.1093/neuonc/noy073},
url = {https://inrepo02.dkfz.de/record/142103},
}