Original Research

Amide proton transfer-weighted imaging to differentiate malignant from benign pulmonary lesions: Comparison with diffusion-weighted imaging and FDG-PET/CT

Corresponding Author

Yoshiharu Ohno MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Address reprint requests to: Y.O., Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. E-mail: [email protected]; [email protected]; [email protected]Search for more papers by this author

Yuji Kishida MD,

Yuji Kishida MD

Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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Shinichiro Seki MD, PhD,

Shinichiro Seki MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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Masao Yui MS,

Masao Yui MS

Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

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Mitsue Miyazaki PhD,

Mitsue Miyazaki PhD

Toshiba Medical Research Institute USA, Vernon Hills, Illinois, USA

Department of Radiology, University of California San Diego, San Diego, California, USA

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Hisanobu Koyama MD, PhD,

Hisanobu Koyama MD, PhD

Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Department of Radiology, Osaka Police Hospital, Osaka, Japan

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Takeshi Yoshikawa MD, PhD,

Takeshi Yoshikawa MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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Yoshiharu Ohno MD, PhD,

Corresponding Author

Yoshiharu Ohno MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Yuji Kishida MD,

Yuji Kishida MD

Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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Shinichiro Seki MD, PhD,

Shinichiro Seki MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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Masao Yui MS,

Masao Yui MS

Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

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Mitsue Miyazaki PhD,

Mitsue Miyazaki PhD

Toshiba Medical Research Institute USA, Vernon Hills, Illinois, USA

Department of Radiology, University of California San Diego, San Diego, California, USA

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Hisanobu Koyama MD, PhD,

Hisanobu Koyama MD, PhD

Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Department of Radiology, Osaka Police Hospital, Osaka, Japan

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Takeshi Yoshikawa MD, PhD,

Takeshi Yoshikawa MD, PhD

Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

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First published: 11 August 2017

https://doi.org/10.1002/jmri.25832

Citations: 28

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Abstract

Purpose

To compare the capability of amide proton transfer-weighted (APTw) imaging, diffusion-weighted imaging (DWI), and FDG-PET/CT for the differentiation of malignant from benign pulmonary nodules.

Materials and Methods

In all, 82 consecutive patients with pulmonary nodules underwent APTw imaging and DWI with a 3T system, and FDG-PET/CT. All nodules were divided as either malignant (n = 49) or benign (n = 39) groups based on pathological and follow-up examinations. To evaluate the capability for differentiation of malignant from benign nodules, magnetization transfer ratio asymmetry (MTR_asym)(3.5ppm) on APTw imaging, apparent diffusion coefficient (ADC), and maximum value of standard uptake value (SUV_max) were assessed. Receiver operating characteristic (ROC) analyses were performed to computationally determine each feasible threshold value. Next, McNemar's test was used for comparing diagnostic performance with each other as well as with a combination of the significant factors determined by multivariate logistic regression analysis.

Results

Although sensitivity of ADC was significantly higher than that of MTR_asym(3.5 ppm) (P = 0.002) and SUV_max (P = 0.004), specificity of MTR_asym(3.5 ppm) and SUV_max was significantly higher than that of ADC (P < 0.05). Sensitivity of combined MTR_asym(3.5ppm) with SUV_max was significantly higher than that of MTR_asym(3.5ppm) (P = 0.001) and SUV_max (P = 0.002) alone. Moreover, specificity and accuracy of combined MTR_asym(3.5ppm) with SUV_max were significantly higher than that of ADC (specificity: P = 0.002, accuracy: P = 0.008).

Conclusion

APTw imaging appears to be as useful as DWI and FDG-PET/CT for differentiation of malignant from benign nodules.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018;47:1013–1021.

References

1Gupta NC, Frank AR, Dewan NA, et al. Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology 1992; 184: 441–444.
10.1148/radiology.184.2.1620844
CAS PubMed Web of Science® Google Scholar
2Fletcher JW. PET scanning and the solitary pulmonary nodule. Semin Thorac Cardiovasc Surg 2002; 14: 268–274.
10.1053/stcs.2002.33429
PubMed Google Scholar
3Zhang M, Kono M. Solitary pulmonary nodules: evaluation of blood flow patterns with dynamic CT. Radiology 1997; 205: 471–478.
10.1148/radiology.205.2.9356631
CAS PubMed Web of Science® Google Scholar
4Swensen SJ, Viggiano RW, Midthun DE, et al. Lung nodule enhancement at CT: multicenter study. Radiology 2000; 214: 73–80.
10.1148/radiology.214.1.r00ja1473
CAS PubMed Web of Science® Google Scholar
5Ohno Y, Hatabu H, Takenaka D, Adachi S, Kono M, Sugimura K. Solitary pulmonary nodules: potential role of dynamic MR imaging in management initial experience. Radiology 2002; 224: 503–511.
10.1148/radiol.2242010992
PubMed Web of Science® Google Scholar
6Demura Y, Tsuchida T, Ishizaki T, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med 2003; 44: 540–548.
CAS PubMed Web of Science® Google Scholar
7Yi CA, Lee KS, Kim EA, et al. Solitary pulmonary nodules: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology 2004; 233: 191–199.
10.1148/radiol.2331031535
PubMed Web of Science® Google Scholar
8Ohno Y, Hatabu H, Takenaka D, et al. Dynamic MR imaging: value of differentiating subtypes of peripheral small adenocarcinoma of the lung. Eur J Radiol 2004; 52: 144–1450.
10.1016/j.ejrad.2004.01.015
PubMed Web of Science® Google Scholar
9Cronin P, Dwamena BA, Kelly AM, Carlos RC. Solitary pulmonary nodules: meta-analytic comparison of cross-sectional imaging modalities for diagnosis of malignancy. Radiology 2008; 246: 772–782.
10.1148/radiol.2463062148
PubMed Web of Science® Google Scholar
10Koyama H, Ohno Y, Kono A, et al. Quantitative and qualitative assessment of non-contrast-enhanced pulmonary MR imaging for management of pulmonary nodules in 161 subjects. Eur Radiol 2008; 18: 2120–2131.
10.1007/s00330-008-1001-2
PubMed Web of Science® Google Scholar
11Razek AA, Elmorsy A, Elshafey M, Elhadedy T, Hamza O. Assessment of mediastinal tumors with diffusion-weighted single-shot echo-planar MRI. J Magn Reson Imaging 2009; 30: 535–540.
10.1002/jmri.21871
CAS PubMed Web of Science® Google Scholar
12Uto T, Takehara Y, Nakamura Y, et al. Higher sensitivity and specificity for diffusion-weighted imaging of malignant lung lesions without apparent diffusion coefficient quantification. Radiology 2009; 252: 247–254.
10.1148/radiol.2521081195
PubMed Web of Science® Google Scholar
13Koyama H, Ohno Y, Aoyama N, et al. Comparison of STIR turbo SE imaging and diffusion-weighted imaging of the lung: capability for detection and subtype classification of pulmonary adenocarcinomas. Eur Radiol 2010; 20: 790–800.
10.1007/s00330-009-1615-z
PubMed Web of Science® Google Scholar
14Ohno Y, Koyama H, Matsumoto K, et al. Differentiation of malignant and benign pulmonary nodules with quantitative first-pass 320-detector row perfusion CT versus FDG PET/CT. Radiology 2011; 258: 599–609.
10.1148/radiol.10100245
PubMed Web of Science® Google Scholar
15Ohno Y, Nishio M, Koyama H, et al. Comparison of quantitatively analyzed dynamic area-detector CT using various mathematic methods with FDG PET/CT in management of solitary pulmonary nodules. AJR Am J Roentgenol 2013; 200: W593–W602.
10.2214/AJR.12.9197
PubMed Web of Science® Google Scholar
16Ohno Y, Nishio M, Koyama H, et al. Dynamic contrast-enhanced CT and MRI for pulmonary nodule assessment. AJR Am J Roentgenol 2014; 202: 515–529.
10.2214/AJR.13.11888
PubMed Web of Science® Google Scholar
17Ohno Y, Nishio M, Koyama H, et al. Solitary pulmonary nodules: comparison of dynamic first-pass contrast-enhanced perfusion area-detector CT, dynamic first-pass contrast-enhanced MR imaging, and FDG PET/CT. Radiology 2015; 274: 563–575.
10.1148/radiol.14132289
PubMed Web of Science® Google Scholar
18Ward KM, Aletras AH, Balaban RS. A new class of contrast agents for MRI based on proton chemical exchange dependent saturation transfer (CEST). J Magn Reson 2000; 143: 79–87.
10.1006/jmre.1999.1956
CAS PubMed Web of Science® Google Scholar
19Zhou J, Lal B, Wilson DA, Laterra J, van Zijl PC. Amide proton transfer (APT) contrast for imaging of brain tumors. Magn Reson Med 2003; 50: 1120–1126.
10.1002/mrm.10651
CAS PubMed Web of Science® Google Scholar
20Jones CK, Schlosser MJ, van Zijl PC, Pomper MG, Golay X, Zhou J. Amide proton transfer imaging of human brain tumors at 3T. Magn Reson Med 2006; 56: 585–592.
10.1002/mrm.20989
PubMed Web of Science® Google Scholar
21van Zijl PC, Jones CK, Ren J, Malloy CR, Sherry AD. MRI detection of glycogen in vivo by using chemical exchange saturation transfer imaging (glycoCEST). Proc Natl Acad Sci U S A 2007; 104: 4359–4364.
10.1073/pnas.0700281104
CAS PubMed Web of Science® Google Scholar
22van Zijl PC, Yadav NN. Chemical exchange saturation transfer (CEST): what is in a name and what isn't? Magn Reson Med 2011; 65: 927–948.
10.1002/mrm.22761
CAS PubMed Web of Science® Google Scholar
23Vinogradov E, Sherry AD, Lenkinski RE. CEST: from basic principles to applications, challenges and opportunities. J Magn Reson 2013; 29: 155–172.
10.1016/j.jmr.2012.11.024
Web of Science® Google Scholar
24Togao O, Kessinger CW, Huang G, et al. Characterization of lung cancer by amide proton transfer (APT) imaging: an in vivo study in an orthotopic mouse model. PLoS One 2013; 8: e77019.
10.1371/journal.pone.0077019
CAS PubMed Web of Science® Google Scholar
25Togao O, Yoshiura T, Keupp J, et al. Amide proton transfer imaging of adult diffuse gliomas: correlation with histopathological grades. Neuro Oncol 2014; 16: 441–448.
10.1093/neuonc/not158
CAS PubMed Web of Science® Google Scholar
26Ohno Y, Yui M, Koyama H, et al. Chemical exchange saturation transfer MR imaging: preliminary results for differentiation of malignant and benign thoracic lesions. Radiology 2016; 279: 578–589.
10.1148/radiol.2015151161
PubMed Web of Science® Google Scholar
27Ohno Y, Koyama H, Yoshikawa T, et al. Diffusion-weighted MR imaging using FASE sequence for 3T MR system: Preliminary comparison of capability for N-stage assessment by means of diffusion-weighted MR imaging using EPI sequence, STIR FASE imaging and FDG PET/CT for non-small cell lung cancer patients. Eur J Radiol 2015; 84: 2321–2331.
10.1016/j.ejrad.2015.07.019
PubMed Web of Science® Google Scholar
28Zhao X, Wen Z, Huang F, et al. Saturation power dependence of amide proton transfer image contrasts in human brain tumors and strokes at 3 T. Magn Reson Med 2011; 66: 1033–1041.
10.1002/mrm.22891
PubMed Web of Science® Google Scholar
29Jia G, Abaza R, Williams JD, et al. Amide proton transfer MR imaging of prostate cancer: a preliminary study. J Magn Reson Imaging 2011; 33: 647–654.
10.1002/jmri.22480
PubMed Web of Science® Google Scholar
30Zhou J, Zhu H, Lim M, et al. Three-dimensional amide proton transfer MR imaging of gliomas: Initial experience and comparison with gadolinium enhancement. J Magn Reson Imaging 2013; 38: 1119–1128.
10.1002/jmri.24067
CAS PubMed Web of Science® Google Scholar

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Volume47, Issue4

April 2018

Pages 1013-1021

Amide proton transfer-weighted imaging to differentiate malignant from benign pulmonary lesions: Comparison with diffusion-weighted imaging and FDG-PET/CT

Abstract

Purpose

Materials and Methods

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Conclusion

References

Citing Literature

References

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Amide proton transfer-weighted imaging to differentiate malignant from benign pulmonary lesions: Comparison with diffusion-weighted imaging and FDG-PET/CT

Abstract

Purpose

Materials and Methods

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Citing Literature

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