%0 Journal Article
%A Kroh, Florian
%A von Knebel Doeberitz, Nikolaus
%A Breitling, Johannes
%A Maksimovic, Srdjan
%A König, Laila
%A Adeberg, Sebastian
%A Scherer, Moritz
%A Unterberg, Andreas
%A Bendszus, Martin
%A Wick, Wolfgang
%A Bachert, Peter
%A Debus, Jürgen
%A Ladd, Mark E
%A Schlemmer, Heinz-Peter
%A Korzowski, Andreas
%A Goerke, Steffen
%A Paech, Daniel
%T Semi-solid MT and APTw CEST-MRI predict clinical outcome of patients with glioma early after radiotherapy.
%J Magnetic resonance in medicine
%V 90
%N 4
%@ 1522-2594
%C New York, NY [u.a.]
%I Wiley-Liss
%M DKFZ-2023-01178
%P 1569-1581
%D 2023
%Z #EA:E010#EA:E020#LA:E010# / 2023 Oct;90(4):1569-1581
%X 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.
%K amide proton transfer imaging (Other)
%K chemical exchange saturation transfer (Other)
%K glioma (Other)
%K magnetic resonance imaging (Other)
%K radiotherapy (Other)
%K semisolid magnetization transfer imaging (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:37317562
%R 10.1002/mrm.29746
%U https://inrepo02.dkfz.de/record/276866