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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.
SUBMITTER: Regnery S
PROVIDER: S-EPMC6033360 | biostudies-literature | 2018 Jun
REPOSITORIES: biostudies-literature
Regnery Sebastian S Adeberg Sebastian S Dreher Constantin C Oberhollenzer Johanna J Meissner Jan-Eric JE Goerke Steffen S Windschuh Johannes J Deike-Hofmann Katerina K Bickelhaupt Sebastian S Zaiss Moritz M Radbruch Alexander A Bendszus Martin M Wick Wolfgang W Unterberg Andreas A Rieken Stefan S Debus Jürgen J Bachert Peter P Ladd Mark M Schlemmer Heinz-Peter HP Paech Daniel D
Oncotarget 20180619 47
<h4>Purpose</h4>To prospectively investigate chemical exchange saturation transfer (CEST) MRI in glioblastoma patients as predictor of early tumor progression after first-line treatment.<h4>Experimental design</h4>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 ...[more]