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  Relaxation-compensated amide proton transfer (APT) MRI signal intensity is associated with survival and progression in high-grade glioma patients

Paech, D., Dreher, C., Regnery, S., Meissner, J., Goerke, S., Windschuh, J., et al. (2019). Relaxation-compensated amide proton transfer (APT) MRI signal intensity is associated with survival and progression in high-grade glioma patients. European Radiology, Epub ahead. doi:10.1007/s00330-019-06066-2.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0003-152D-4 Version Permalink: http://hdl.handle.net/21.11116/0000-0003-152E-3
Genre: Journal Article

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 Creators:
Paech, D, Author
Dreher, C, Author
Regnery, S, Author
Meissner, JE, Author
Goerke, S, Author
Windschuh, J, Author
Oberhollenzer, J, Author
Schultheiss, M, Author
Deike-Hofmann, K, Author
Bickelhaupt, S, Author
Radbruch, A, Author
Zaiss, M1, 2, Author              
Unterberg , A, Author
Wick, W, Author
Bendszus, M, Author
Bachert, P, Author
Ladd, ME, Author
Schlemmer, HP, Author
Affiliations:
1Department High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Max Planck Society, ou_1497796              
2Max Planck Institute for Biological Cybernetics, Max Planck Society, Spemannstrasse 38, 72076 Tübingen, DE, ou_1497794              

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 Abstract: Objectives The purpose of this study was to investigate the association of relaxation-compensated chemical exchange saturation transfer (CEST) MRI with overall survival (OS) and progression-free survival (PFS) in newly diagnosed high-grade glioma (HGG) patients. Methods Twenty-six patients with newly diagnosed high-grade glioma (WHO grades III–IV) were included in this prospective IRB-approved study. CEST MRI was performed on a 7.0-T whole-body scanner. Association of patient OS/PFS with relaxation-compensated CEST MRI (amide proton transfer (APT), relayed nuclear Overhauser effect (rNOE)/NOE, downfield-rNOE-suppressed APT (dns-APT)) and diffusion-weighted imaging (apparent diffusion coefficient) were assessed using the univariate Cox proportional hazards regression model. Hazard ratios (HRs) and corresponding 95% confidence intervals were calculated. Furthermore, OS/PFS association with clinical parameters (age, gender, O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status, and therapy: biopsy + radio-chemotherapy vs. debulking surgery + radio-chemotherapy) were tested accordingly. Results Relaxation-compensated APT MRI was significantly correlated with patient OS (HR = 3.15, p = 0.02) and PFS (HR = 1.83, p = 0.009). The strongest association with PFS was found for the dns-APT metric (HR = 2.61, p = 0.002). These results still stand for the relaxation-compensated APT contrasts in a homogenous subcohort of n = 22 glioblastoma patients with isocitrate dehydrogenase (IDH) wild-type status. Among the tested clinical parameters, patient age (HR = 1.1, p = 0.001) and therapy (HR = 3.68, p = 0.026) were significant for OS; age additionally for PFS (HR = 1.04, p = 0.048). Conclusion Relaxation-compensated APT MRI signal intensity is associated with overall survival and progression-free survival in newly diagnosed, previously untreated glioma patients and may, therefore, help to customize treatment and response monitoring in the future.

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 Dates: 2019-02
 Publication Status: Published online
 Pages: -
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 Rev. Method: -
 Identifiers: DOI: 10.1007/s00330-019-06066-2
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Title: European Radiology
  Other : Eur. Radiol.
Source Genre: Journal
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Publ. Info: Berlin : Springer International
Pages: - Volume / Issue: Epub ahead Sequence Number: - Start / End Page: - Identifier: ISSN: 0938-7994
CoNE: https://pure.mpg.de/cone/journals/resource/954925571877