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Amid proton transfer (APT) and magnetization transfer (MT) MRI contrasts provide complimentary assessment of brain tumors similarly to proton magnetic resonance spectroscopy imaging (MRSI)

  • Oncology
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Abstract

Objectives

Using MRSI as comparison, we aimed to explore the difference between amide proton transfer (APT) MRI and conventional semi-solid magnetization transfer ratio (MTR) MRI, and to investigate if molecular APT and structural MTR can provide complimentary information in assessing brain tumors.

Methods

Seventeen brain tumor patients and 17 age- and gender-matched volunteers were included and scanned with anatomical MRI, APT and MT-weighted MRI, and MRSI. Multi-voxel choline (Cho) and N-acetylaspartic acid (NAA) signals were quantified from MRSI and compared with MTR and MTRasym(3.5ppm) contrasts averaged from corresponding voxels. Correlations between contrasts were explored voxel-by-voxel by pooling values from all voxels into Pearson’s correlation analysis. Differences in correlation coefficients were tested with the Z-test (set at p<0.05).

Results

APT and MT provide good contrast and quantitative parameters in tumor imaging, as do the metabolite (Cho and NAA) maps. MTRasym(3.5ppm) significantly correlated with MTR (R=-0.61, p<0.0001), Cho (R=0.568, p<0.0001) and NAA (R=-0.619, p<0.0001) in tumors, and MTR also significantly correlated with Cho (R=-0.346, p<0.0001) and NAA (R=0.624, p<0.0001). In healthy volunteers, MTRasym(3.5ppm) was non-significantly correlated with MTR (R=-0.049, p=0.239), Cho (R=0.030, p=0.478) and NAA (R=-0.083, p=0.046). Significant correlations were found among MTR with Cho (R=0.199, p<0.0001) and NAA (R=0.263, p<0.0001) in the group of healthy volunteers with lower correlation R values than those in tumor patients.

Conclusions

APT and MT could provide independent and supplementary information for the comprehensive assessment of molecular and structural changes due to brain tumor cancerogenesis.

Key Points

• MTR asym(3.5ppm) positively correlated with Cho while negatively with NAA in tumors.

• MTR positively correlated with NAA while negatively with Cho in tumors.

• Combining APT/MT provides molecular and structural information similarly to MRSI.

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Abbreviations

APT:

Amide proton transfer

MRSI:

Magnetic resonance spectroscopy imaging

MT:

Magnetization transfer

MTR:

Conventional magnetization transfer ratio

MTRasym(3.5ppm) :

Asymmetrical magnetization transfer ratio at 3.5 ppm

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Acknowledgements

We thank Bing Wu from GE health for his generous help in data post-processing and advice on the manuscript. We also acknowledge Dr. Yang Fan from General Electric Company (China) for his generous contributions to manuscript revision.

Funding

This study has received funding by grants from the National Program of the Ministry of Science and Technology of China during the “12th Five-Year Plan” (ID: 2011BAI08B10) and the National Natural Science Foundation of China (No. 81171308, No. 81570462, No. 81730049 and No. 81401389). This work is also partially supported by NIH NIBIB grant R21-EB023516-02 (Cai).

Author information

Authors and Affiliations

  1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 JieFang Avenue, Hankou, Wuhan, 430030, People’s Republic of China

    Changliang Su, Lingyun Zhao, Shihui Li, Jingjing Jiang, Jingjing Shi, Yihao Yao, Guiling Zhang, Nanxi Shen, Shan Hu, Jiaxuan Zhang, Yuanyuan Qin & Wenzhen Zhu

  2. The Department of Radiology and Bioengineering, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Kejia Cai

  3. Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 JieFang Avenue, Hankou, Wuhan, 430030, People’s Republic of China

    Qilin Ao

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  1. Changliang Su
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  2. Lingyun Zhao
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  14. Wenzhen Zhu
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Correspondence to Wenzhen Zhu.

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The scientific guarantor of this publication is Wenzhen Zhu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

• Prospective

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• Performed at one institution

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Su, C., Zhao, L., Li, S. et al. Amid proton transfer (APT) and magnetization transfer (MT) MRI contrasts provide complimentary assessment of brain tumors similarly to proton magnetic resonance spectroscopy imaging (MRSI). Eur Radiol 29, 1203–1210 (2019). https://doi.org/10.1007/s00330-018-5615-8

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  • DOI: https://doi.org/10.1007/s00330-018-5615-8

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