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; Windschuh, J; Deike-Hofmann, K; Bickelhaupt, S; Zaiss, M; Radbruch, A; Bendszus, M; Wick, W; Unterberg, A; Rieken, S; Debus, J; Bachert, P; Ladd, M; Schlemmer, H-P; Paech, D

doi:10.18632/oncotarget.25594

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

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Zaiss, M
Department High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Max Planck Society;
Max Planck Institute for Biological Cybernetics, Max Planck Society;

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https://www.oncotarget.com/article/25594/text/
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Zitation

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.

Zitierlink: https://hdl.handle.net/21.11116/0000-0009-A400-D

Zusammenfassung

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.