Journal Article

DKFZ-2023-01178

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Semi-solid MT and APTw CEST-MRI predict clinical outcome of patients with glioma early after radiotherapy.

Kroh, F. (First author)DKFZ* ; von Knebel Doeberitz, N. (First author)DKFZ* ; Breitling, J.DKFZ* ; Maksimovic, S.DKFZ* ; König, L. ; Adeberg, S. ; Scherer, M. ; Unterberg, A. ; Bendszus, M. ; Wick, W. ; Bachert, P.DKFZ* ; Debus, J.DKFZ* ; Ladd, M. E.DKFZ* ; Schlemmer, H.-P.DKFZ* ; Korzowski, A.DKFZ* ; Goerke, S.DKFZ* ; Paech, D. (Last author)DKFZ*

2023
Wiley-Liss New York, NY [u.a.]

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Please use a persistent id in citations: doi:10.1002/mrm.29746

Abstract: The purpose of this study was to compare the potential of asymmetry-based (APTwasym ), Lorentzian-fit-based (PeakAreaAPT and MTconst ), and relaxation-compensated (MTRRex APT and MTRRex 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.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 T2w -FLAIR and contrast-enhanced T1w 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.MTconst (AUC = 0.79, p < 0.01) showed a stronger association with RANO response assessment compared to PeakAreaAPT (AUC = 0.71, p = 0.02) and MTRRex 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, MTconst (HR = 3.04, p = 0.01), PeakAreaAPT (HR = 0.39, p = 0.03), and APTwasym (HR = 2.63, p = 0.02) were associated with PFS. MTRRex APT was not associated with any outcome.MTconst , PeakAreaAPT, and APTwasym imaging predict clinical outcome by means of progression-free survival. Furthermore, MTconst 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.

Keyword(s): amide proton transfer imaging ; chemical exchange saturation transfer ; glioma ; magnetic resonance imaging ; radiotherapy ; semisolid magnetization transfer imaging

Note: #EA:E010#EA:E020#LA:E010# / 2023 Oct;90(4):1569-1581

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Contributing Institute(s):

1. E020 Med. Physik in der Radiologie (E020)
2. E010 Radiologie (E010)
3. E050 KKE Strahlentherapie (E050)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2023

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Wiley ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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