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  Chemical exchange saturation transfer MRI serves as predictor of early progression in glioblastoma patients

Regnery, S., Adeberg, S., Dreher, C., Oberhollenzer, J., Meissner, J.-E., Goerke, S., et al. (2018). Chemical exchange saturation transfer MRI serves as predictor of early progression in glioblastoma patients. Oncotargert, 9(47), 28772-28783. doi:10.18632/oncotarget.25594.

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https://www.oncotarget.com/article/25594/text/ (Publisher version)
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Regnery, S, Author
Adeberg, S, Author
Dreher, C, Author
Oberhollenzer, J, Author
Meissner, J-E, Author
Goerke, S, Author
Windschuh, J, Author
Deike-Hofmann, K, Author
Bickelhaupt, S, Author
Zaiss, M1, 2, Author           
Radbruch, A, Author
Bendszus, M, Author
Wick, W, Author
Unterberg, A, Author
Rieken, S, Author
Debus, J, Author
Bachert, P, Author
Ladd, M, Author
Schlemmer, H-P, Author
Paech, D, 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: Purpose: To prospectively investigate chemical exchange saturation transfer (CEST) MRI in glioblastoma patients as predictor of early tumor progression after first-line treatment. Experimental Design: Twenty previously untreated glioblastoma patients underwent CEST MRI employing a 7T whole-body scanner. Nuclear Overhauser effect (NOE) as well as amide proton transfer (APT) CEST signals were isolated using Lorentzian difference (LD) analysis and relaxation compensated by the apparent exchange-dependent relaxation rate (AREX) evaluation. Additionally, NOE-weighted asymmetric magnetic transfer ratio (MTRasym) and downfield-NOE-suppressed APT (dns-APT) were calculated. Patient response to consecutive treatment was determined according to the RANO criteria. Mean signal intensities of each contrast in the whole tumor area were compared between early-progressive and stable disease. Results: Pre-treatment tumor signal intensity differed significantly regarding responsiveness to first-line therapy in NOE-LD (p = 0.0001), NOE-weighted MTRasym (p = 0.0186) and dns-APT (p = 0.0328) contrasts. Hence, significant prediction of early progression was possible employing NOE-LD (AUC = 0.98, p = 0.0005), NOE-weighted MTRasym (AUC = 0.83, p = 0.0166) and dns-APT (AUC = 0.80, p = 0.0318). The NOE-LD provided the highest sensitivity (91%) and specificity (100%). Conclusions: CEST derived contrasts, particularly NOE-weighted imaging and dns-APT, yielded significant predictors of early progression after fist-line therapy in glioblastoma. Therefore, CEST MRI might be considered as non-invasive tool for customization of treatment in the future.

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 Dates: 2018-06
 Publication Status: Published in print
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 Identifiers: DOI: 10.18632/oncotarget.25594
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Title: Oncotargert
Source Genre: Journal
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Pages: - Volume / Issue: 9 (47) Sequence Number: - Start / End Page: 28772 - 28783 Identifier: -