Journal Article

DKFZ-2023-01963

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Post-Surgical Depositions of Blood Products Are No Major Confounder for the Diagnostic and Prognostic Performance of CEST MRI in Patients with Glioma.

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

2023
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/biomedicines11092348

Abstract: Amide proton transfer (APT) and semi-solid magnetization transfer (ssMT) imaging can predict clinical outcomes in patients with glioma. However, the treatment of brain tumors is accompanied by the deposition of blood products within the tumor area in most cases. For this reason, the objective was to assess whether the diagnostic interpretation of the APT and ssMT is affected by methemoglobin (mHb) and hemosiderin (Hs) depositions at the first follow-up MRI 4 to 6 weeks after the completion of radiotherapy. A total of 34 participants underwent APT and ssMT imaging by applying reconstruction methods described by Zhou et al. (APTwasym), Goerke et al. (MTRRexAPT and MTRRexMT) and Mehrabian et al. (MTconst). Contrast-enhancing tumor (CE), whole tumor (WT), mHb and Hs were segmented on contrast-enhanced T1wCE, T2w-FLAIR, T1w and T2*w images. ROC-analysis, Kaplan-Meier analysis and the log rank test were used to test for the association of mean contrast values with therapy response and overall survival (OS) before (WT and CE) and after correcting tumor volumes for mHb and Hs (CEC and WTC). CEC showed higher associations of the MTRRexMT with therapy response (CE: AUC = 0.677, p = 0.081; CEC: AUC = 0.705, p = 0.044) and of the APTwasym with OS (CE: HR = 2.634, p = 0.040; CEC: HR = 2.240, p = 0.095). In contrast, WTC showed a lower association of the APTwasym with survival (WT: HR = 2.304, p = 0.0849; WTC: HR = 2.990, p = 0.020). Overall, a sophisticated correction for blood products did not substantially influence the clinical performance of APT and ssMT imaging in patients with glioma early after radiotherapy.

Keyword(s): amide proton transfer ; blood ; chemical exchange saturation transfer MRI ; correction ; glioma ; hemosiderin ; methemoglobin ; overall survival ; radiotherapy ; semi-solid magnetization transfer ; therapy response

Note: #EA:E010#LA:E010#

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Contributing Institute(s):

1. E010 Radiologie (E010)
2. E020 Med. Physik in der Radiologie (E020)
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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