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Applying Amide Proton Transfer MR Imaging to Hybrid Brain PET/MR: Concordance with Gadolinium Enhancement and Added Value to [18F]FDG PET

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Abstract

Purpose

The purpose of this study is to evaluate the diagnostic concordance and metric correlations of amide proton transfer (APT) imaging with gadolinium-enhanced magnetic resonance imaging (MRI) and 2-deoxy-2-[18F-]fluoro-D-glucose ([18F]FDG) positron emission tomography (PET), using hybrid brain PET/MRI.

Procedures

Twenty-one subjects underwent brain gadolinium-enhanced [18F]FDG PET/MRI prospectively. Imaging accuracy was compared between unenhanced MRI, MRI with enhancement, APT-weighted (APTW) images, and PET based on six diagnostic criteria. Among tumors, the McNemar test was further used for concordance assessment between gadolinium-enhanced imaging, APT imaging, and [18F]FDG PET. As well, the relation of metrics between APT imaging and PET was analyzed by the Pearson correlation analysis.

Results

APT imaging and gadolinium-enhanced MRI showed superior and similar diagnostic accuracy. APTW signal intensity and gadolinium enhancement were concordant in 19 tumors (100 %), while high [18F]FDG avidity was shown in only 12 (63.2 %). For the metrics from APT imaging and PET, there was significant correlation for 13 hypermetabolic tumors (P < 0.05) and no correlation for the remaining six [18F]FDG-avid tumors.

Conclusions

APT imaging can be used to increase diagnostic accuracy with no need to administer gadolinium chelates. APT imaging may provide an added value to [18F]FDG PET in the evaluation of tumor metabolic activity during brain PET/MR studies.

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Acknowledgments

The authors thank Ms. Mary McAllister for her professional editorial assistance.

Funding

This work was supported in part by grants from the National Natural Science Foundation of China (Grant No. 81401438) and from the National Institutes of Health (R01EB009731, R01CA166171, R01NS083435).

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Authors and Affiliations

  1. Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No. 36, Heping District, Shenyang, 110004, Liaoning, People’s Republic of China

    Hongzan Sun, Jun Xin, Zaiming Lu & Qiyong Guo

  2. Division of MR Research, Department of Radiology, Johns Hopkins University, 600 N. Wolfe Street, Park 336, Baltimore, MD, 21287, USA

    Jinyuan Zhou

Authors
  1. Hongzan Sun
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  2. Jun Xin
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  3. Jinyuan Zhou
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  4. Zaiming Lu
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  5. Qiyong Guo
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Corresponding author

Correspondence to Jun Xin.

Ethics declarations

No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Sun, H., Xin, J., Zhou, J. et al. Applying Amide Proton Transfer MR Imaging to Hybrid Brain PET/MR: Concordance with Gadolinium Enhancement and Added Value to [18F]FDG PET. Mol Imaging Biol 20, 473–481 (2018). https://doi.org/10.1007/s11307-017-1136-0

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  • DOI: https://doi.org/10.1007/s11307-017-1136-0

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