TY  - JOUR
AU  - Kroh, Florian
AU  - von Knebel Doeberitz, Nikolaus
AU  - Breitling, Johannes
AU  - Maksimovic, Srdjan
AU  - König, Laila
AU  - Adeberg, Sebastian
AU  - Scherer, Moritz
AU  - Unterberg, Andreas
AU  - Bendszus, Martin
AU  - Wick, Wolfgang
AU  - Bachert, Peter
AU  - Debus, Jürgen
AU  - Ladd, Mark E
AU  - Schlemmer, Heinz-Peter
AU  - Korzowski, Andreas
AU  - Goerke, Steffen
AU  - Paech, Daniel
TI  - Semi-solid MT and APTw CEST-MRI predict clinical outcome of patients with glioma early after radiotherapy.
JO  - Magnetic resonance in medicine
VL  - 90
IS  - 4
SN  - 1522-2594
CY  - New York, NY [u.a.]
PB  - Wiley-Liss
M1  - DKFZ-2023-01178
SP  - 1569-1581
PY  - 2023
N1  - #EA:E010#EA:E020#LA:E010# / 2023 Oct;90(4):1569-1581
AB  - 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.
KW  - amide proton transfer imaging (Other)
KW  - chemical exchange saturation transfer (Other)
KW  - glioma (Other)
KW  - magnetic resonance imaging (Other)
KW  - radiotherapy (Other)
KW  - semisolid magnetization transfer imaging (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:37317562
DO  - DOI:10.1002/mrm.29746
UR  - https://inrepo02.dkfz.de/record/276866
ER  -