Original Research

Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Jie Liu PhD

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

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Cong Li MS,

Cong Li MS

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Yinsheng Chen MD,

Yinsheng Chen MD

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Xiaofei Lv MD,

Xiaofei Lv MD

orcid.org/0000-0002-1712-630X

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Yanchun Lv MD,

Yanchun Lv MD

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Jian Zhou MD,

Jian Zhou MD

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Shaoyan Xi MD,

Shaoyan Xi MD

Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Weiqiang Dou PhD,

Weiqiang Dou PhD

GE Healthcare, Beijing, China

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Long Qian PhD,

Long Qian PhD

GE Healthcare, Beijing, China

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Hairong Zheng PhD,

Hairong Zheng PhD

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

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Yin Wu PhD,

Corresponding Author

Yin Wu PhD

[email protected]

orcid.org/0000-0002-4323-5083

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

Address reprint requests to: Y.W., Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Boulevard, Xili, Nanshan, Shenzhen, Guangdong 518055, China. E-mail: [email protected] or Z.C., Department of Neurosurgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu, Guangzhou, Guangdong 510060, China. E-mail: [email protected]Search for more papers by this author

Zhongping Chen MD,

Corresponding Author

Zhongping Chen MD

[email protected]

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

Jie Liu PhD,

Jie Liu PhD

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

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Cong Li MS,

Cong Li MS

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Yinsheng Chen MD,

Yinsheng Chen MD

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Xiaofei Lv MD,

Xiaofei Lv MD

orcid.org/0000-0002-1712-630X

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Yanchun Lv MD,

Yanchun Lv MD

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Jian Zhou MD,

Jian Zhou MD

Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Shaoyan Xi MD,

Shaoyan Xi MD

Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

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Weiqiang Dou PhD,

Weiqiang Dou PhD

GE Healthcare, Beijing, China

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Long Qian PhD,

Long Qian PhD

GE Healthcare, Beijing, China

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Hairong Zheng PhD,

Hairong Zheng PhD

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

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Yin Wu PhD,

Corresponding Author

Yin Wu PhD

[email protected]

orcid.org/0000-0002-4323-5083

Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China

Zhongping Chen MD,

Corresponding Author

Zhongping Chen MD

[email protected]

Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

First published: 20 August 2019

https://doi.org/10.1002/jmri.26900

Citations: 42

The first two authors contributed equally to this work.

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Abstract

Background

MRI is one of the most important techniques to assess the treatment response of gliomas. However, differentiating tumor recurrence (TuR) from treatment effects (TrE) remains challenging.

Purpose

To compare the diagnostic performance of MR diffusion-weighted imaging (DWI), arterial spin labeling (ASL), proton MR spectroscopy (MRS), and amide proton transfer (APT) imaging in differentiating between TuR and TrE in posttreatment glioma patients.

Study Type

Prospective.

Population

Thirty patients with suspected tumor progression.

Field Strength/Sequence

DWI, ASL, proton MRS, and APT imaging were performed at 3T MR.

Assessment

MR indices, including ADC, relative cerebral blood flow (rCBF), ratios of Cho/Cr, Cho/NAA, and NAA/Cr and APT-weighted (APTw) effect were obtained from DWI, ASL, proton MRS, and APT imaging, respectively. Indices were measured in the contralateral normal-appearing white matter and lesions defined on the Gd-enhanced T₁w image. TuR or TrE was either determined histologically or clinically from longitudinal MRI follow-up for at least 6 months.

Statistical Tests

The diagnostic performance of the indices was evaluated using Student's t-test, receiver operating characteristic (ROC) curve, and multivariate logistic regression analyses.

Results

Among the 30 patients, 16 were diagnosed as having TuR and the rest having TrE. The recurrent tumors showed a significantly higher APTw effect (1.56 ± 1.14%) and rCBF (1.44 ± 0.61) compared with lesions representing treatment effects (–0.44 ± 1.34% and 0.72 ± 0.25, respectively, with P < 0.001). The areas under the curve (AUCs) were 0.87 and 0.90 for APTw and rCBF, respectively, in differentiating between TuR and TrE. Combining APTw and rCBF achieved a higher AUC of 0.93. MRS index ratios of Cho/Cr (P = 0.25), Cho/NAA (P = 0.16), and NAA/Cr (P = 0.86) and ADC (P = 0.37) showed no significant differences between TuR and TrE lesions, with AUCs lower than 0.70.

Data Conclusion

Compared with DWI and MRS, ASL and APT imaging techniques showed better diagnostic capability in distinguishing TuR from TrE.

Level of Evidence: 1

Technical Efficacy: Stage 4

J. Magn. Reson. Imaging 2020;51:1154–1161.

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Citing Literature

Volume51, Issue4

April 2020

Pages 1154-1161

Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Information

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Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Related

Information