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. 2024 Sep;169(2):287-297.
doi: 10.1007/s11060-024-04729-9. Epub 2024 Jun 14.

Multi-pool chemical exchange saturation transfer MRI in glioma grading, molecular subtyping and evaluating tumor proliferation

Hongquan Zhu  1 , Yuanhao Li  1 , Yuejie Ding  1 , Yufei Liu  1 , Nanxi Shen  1 , Yan Xie  1 , Su Yan  1 , Dong Liu  1 , Xiaoxiao Zhang  2 , Li Li  3 , Wenzhen Zhu  4
Affiliations

Multi-pool chemical exchange saturation transfer MRI in glioma grading, molecular subtyping and evaluating tumor proliferation

Hongquan Zhu et al. J Neurooncol. 2024 Sep.

Abstract

Purpose: To evaluate the performance of multi-pool Chemical exchange saturation transfer (CEST) MRI in prediction of glioma grade, isocitrate dehydrogenase (IDH) mutation, alpha-thalassemia/mental retardation syndrome X-linked (ATRX) loss and Ki-67 labeling index (LI), based on the fifth edition of the World Health Organization classification of central nervous system tumors (WHO CNS5).

Methods: 95 patients with adult-type diffuse gliomas were analyzed. The amide, direct water saturation (DS), nuclear Overhauser enhancement (NOE), semi-solid magnetization transfer (MT) and amine signals were derived using Lorentzian fitting, and asymmetry-based amide proton transfer-weighted (APTwasym) signal was calculated. The mean value of tumor region was measured and intergroup differences were estimated using student-t test. The receiver operating curve (ROC) and area under the curve (AUC) analysis were used to evaluate the diagnostic performance of signals and their combinations. Spearman correlation analysis was performed to evaluate tumor proliferation.

Results: The amide and DS signals were significantly higher in high-grade gliomas compared to low-grade gliomas, as well as in IDH-wildtype gliomas compared to IDH-mutant gliomas (all p < 0.001). The DS, MT and amine signals showed significantly differences between ATRX loss and retention in grade 2/3 IDH-mutant gliomas (all p < 0.05). The combination of signals showed the highest AUC in prediction of grade (0.857), IDH mutation (0.814) and ATRX loss (0.769). Additionally, the amide and DS signals were positively correlated with Ki-67 LI (both p < 0.001).

Conclusion: Multi-pool CEST MRI demonstrated good potential to predict glioma grade, IDH mutation, ATRX loss and Ki-67 LI.

Keywords: Central nervous system; Chemical exchange saturation transfer; Genotype; Glioma; Magnetic resonance imaging.

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References

    1. Louis DN, Perry A, Wesseling P et al (2021) The 2021 WHO classification of tumors of the Central Nervous System: a summary. Neuro Oncol 23:1231–1251. https://doi.org/10.1093/neuonc/noab106 - DOI - PubMed - PMC
    1. Hartmann C, Hentschel B, Wick W et al (2010) Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 120:707–718. https://doi.org/10.1007/s00401-010-0781-z - DOI - PubMed
    1. Brendle C, Hempel JM, Schittenhelm J et al (2018) Glioma grading and determination of IDH Mutation Status and ATRX loss by DCE and ASL Perfusion. Clin Neuroradiol 28:421–428. https://doi.org/10.1007/s00062-017-0590-z - DOI - PubMed
    1. Venneti S, Huse JT (2015) The evolving molecular genetics of low-grade glioma. Adv Anat Pathol 22:94–101. https://doi.org/10.1097/PAP.0000000000000049 - DOI - PubMed - PMC
    1. Ogishima T, Tamura K, Kobayashi D et al (2017) ATRX status correlates with 11 C-methionine uptake in WHO grade II and III gliomas with IDH1 mutations. Brain Tumor Pathol 34:20–27. https://doi.org/10.1007/s10014-017-0280-1 - DOI - PubMed

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