Khảo sát sự không đồng nhất của khối u bằng hình ảnh CEST MRI xung 3D ở glioma không tăng cường tại 3T

Esther A. H. Warnert, Tobias Wood1, Fatih Incekara2, Gareth J. Barker1, Arnaud Vincent3, Joost W. Schouten3, Johan M. Kros4, Martin van den Bent5, Marion Smits2, Juan Antonio Hernández Tamames2
1Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
2Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
3Department of Neurosurgery, Erasmus MC, Rotterdam, The Netherlands
4Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
5Department of Neurology, Erasmus MC, Rotterdam, The Netherlands

Tóm tắt

Tóm tắt Mục tiêu Hình ảnh chuyển hóa bão hòa hóa học (CEST) có trọng số proton amide (APT) ngày càng được sử dụng để nghiên cứu các khối u não cấp cao và có tăng cường. Glioma không tăng cường hiện tại chưa được nghiên cứu nhiều, nhưng cho thấy sinh lý bệnh không đồng nhất với các kiểu loại có tiên lượng xấu tương đương như glioma có tăng cường. Ở đây, chúng tôi khảo sát việc sử dụng MRI CEST để phân biệt tốt nhất glioma không tăng cường với mô khỏe mạnh và hình ảnh hóa sự không đồng nhất của khối u. Vật liệu & Phương pháp Một chuỗi CEST xung 3D đã được áp dụng ở 3 Tesla với độ phủ toàn khối u và 31 tần số lệch (+6 đến -6 ppm) trên 18 bệnh nhân bị glioma không tăng cường. Tỷ lệ chuyển giao từ tính không đối xứng (MTRasym) và các bản đồ sai số Lorentz (LD) ở 3.5 ppm đã được so sánh để phân biệt khối u so với chất trắng bình thường. Sự không đồng nhất được bản đồ hóa bằng cách tính toán tỷ lệ thể tích của khối u cho thấy tín hiệu APT có cường độ cao.

Từ khóa

#glioma không tăng cường #hình ảnh CEST #MRI #không đồng nhất khối u #tín hiệu APT.

Tài liệu tham khảo

Choi YS, Ahn SS, Lee S-K, Chang JH, Kang S-G, Kim SH, Zhou J (2017) Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume. Eur Radiol 27:3181–3189

Sakata A, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Dodo T, Arakawa Y, Schmitt B, Miyamoto S, Togashi K (2015) Grading glial tumors with amide proton transfer MR imaging: different analytical approaches. J Neurooncol 122:339–348

Zhou J, Tryggestad E, Wen Z, Lal B, Zhou T, Grossman R, Wang S, Yan K, Fu D-X, Ford E, Tyler B, Blakeley J, Laterra J, van Zijl PCM (2011) Differentiation between glioma and radiation necrosis using molecular magnetic resonance imaging of endogenous proteins and peptides. Nat Med 17:130–134

Zou T, Yu H, Jiang C, Wang X, Jiang S, Rui Q, Mei Y, Zhou J, Wen Z (2018) Differentiating the histologic grades of gliomas preoperatively using amide proton transfer-weighted (APTW) and intravoxel incoherent motion MRI. NMR Biomed. https://doi.org/10.1002/nbm.3850

Aum DJ, Kim DH, Beaumont TL, Leuthardt EC, Dunn GP, Kim AH (2014) Molecular and cellular heterogeneity: the hallmark of glioblastoma. Neurosurg Focus. https://doi.org/10.3171/2014.9.FOCUS14521

Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803–820

Olar A, Wani KM, Alfaro-Munoz KD, Heathcock LE, van Thuijl HF, Gilbert MR, Armstrong TS, Sulman EP, Cahill DP, Vera-Bolanos E, Yuan Y, Reijneveld JC, Ylstra B, Wesseling P, Aldape KD (2015) IDH mutation status and role of WHO grade and mitotic index in overall survival in grade II-III diffuse gliomas. Acta Neuropathol 129:585–596

Togao O, Hiwatashi A, Yamashita K, Kikuchi K, Keupp J, Yoshimoto K, Kuga D, Yoneyama M, Suzuki SO, Iwaki T, Takahashi M, Iihara K, Honda H (2017) Grading diffuse gliomas without intense contrast enhancement by amide proton transfer MR imaging: comparisons with diffusion- and perfusion-weighted imaging. Eur Radiol 27:578–588

Jiang S, Zou T, Eberhart CG, Villalobos MAV, Heo H-Y, Zhang Y, Wang Y, Wang X, Yu H, Du Y, van Zijl PCM, Wen Z, Zhou J (2017) Predicting IDH mutation status in grade II gliomas using amide proton transfer-weighted (APTw) MRI. Magn Reson Med 78:1100–1109

Jones CK, Polders D, Hua J, Zhu H, Hoogduin HJ, Zhou J, Luijten P, Van Zijl PCM (2012) In vivo three-dimensional whole-brain pulsed steady-state chemical exchange saturation transfer at 7 T. Magn Reson Med 67:1579–1589

Deshmane A, Zaiss M, Lindig T, Herz K, Schuppert M, Gandhi C, Bender B, Ernemann U, Scheffler K (2019) 3D gradient echo snapshot CEST MRI with low power saturation for human studies at 3T. Magn Reson Med 81:2412–2423

van Zijl PCM, Lam WW, Xu J, Knutsson L, Stanisz GJ (2018) Magnetization transfer contrast and chemical exchange saturation transfer MRI. Features and analysis of the field-dependent saturation spectrum. Neuroimage 168:222–241

Paech D, Windschuh J, Oberhollenzer J, Dreher C, Sahm F, Meissner JE, Goerke S, Schuenke P, Zaiss M, Regnery S, Bickelhaupt S, Bäumer P, Bendszus M, Wick W, Unterberg A, Bachert P, Ladd ME, Schlemmer HP, Radbruch A (2018) Assessing the predictability of IDH mutation and MGMT methylation status in glioma patients using relaxation-compensated multipool CEST MRI at 7.0 T. Neuro Oncol 20:1661–1671

Regnery S, Adeberg S, Dreher C, Oberhollenzer J, Meissner JE, Goerke S, Windschuh J, Deike-Hofmann K, Bickelhaupt S, Zaiss M, Radbruch A, Bendszus M, Wick W, Unterberg A, Rieken S, Debus J, Bachert P, Ladd M, Schlemmer HP, Paech D (2018) Chemical exchange saturation transfer MRI serves as predictor of early progression in glioblastoma patients. Oncotarget 9:28772–28783

Heo HY, Jones CK, Hua J, Yadav N, Agarwal S, Zhou J, van Zijl PCM, Pillai JJ (2016) Whole-brain amide proton transfer (APT) and nuclear overhauser enhancement (NOE) imaging in glioma patients using low-power steady-state pulsed chemical exchange saturation transfer (CEST) imaging at 7T. J Magn Reson Imaging 44:41–50

Block W, Pauly J, Kerr A, Nishimura D (1997) Consistent fat suppression with compensated spectral-spatial pulses. Magn Reson Med 38:198–206

Zhou J (2011) Amide proton transfer imaging of the human brain. Methods Mol Biol 711:227–237

Scheidegger R, Wong ET, Alsop DC (2014) Contributors to contrast between glioma and brain tissue in chemical exchange saturation transfer sensitive imaging at 3 Tesla. Neuroimage 99:256–268

Jones CK, Huang A, Xu J, Edden RAE, Schär M, Hua J, Oskolkov N, Zacà D, Zhou J, McMahon MT, Pillai JJ, van Zijl PCM (2013) Nuclear Overhauser enhancement (NOE) imaging in the human brain at 7T. Neuroimage 77:114–124

Kuroda J, Kinoshita M, Tanaka H, Nishida T, Nakamura H, Watanabe Y, Tomiyama N, Fujinaka T, Yoshimine T (2012) Cardiac cycle-related volume change in unruptured cerebral aneurysms: a detailed volume quantification study using 4-dimensional CT angiography. Stroke 43:61–66

Windschuh J, Zaiss M, Meissner JE, Paech D, Radbruch A, Ladd ME, Bachert P (2015) Correction of B1-inhomogeneities for relaxation-compensated CEST imaging at 7T. NMR Biomed 28:529–537

Yushkevich PA, Piven J, Hazlett HC, Smith RG, Ho S, Gee JC, Gerig G (2006) User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability. Neuroimage 31:1116–1128

Jiang S, Eberhart CG, Zhang Y, Heo H-Y, Wen Z, Blair L, Qin H, Lim M, Quinones-Hinojosa A, Weingart JD, Barker PB, Pomper MG, Laterra J, van Zijl PCM, Blakeley JO, Zhou J (2017) Amide proton transfer-weighted magnetic resonance image-guided stereotactic biopsy in patients with newly diagnosed gliomas. Eur J Cancer 83:9–18

Jiang S, Eberhart CG, Lim M, Heo H-Y, Zhang Y, Blair L, Wen Z, Holdhoff M, Lin D, Huang P, Qin H, Quinones-Hinojosa A, Weingart JD, Barker PB, Pomper MG, Laterra J, van Zijl PCM, Blakeley JO, Zhou J (2019) Identifying recurrent malignant glioma after treatment using amide proton transfer-weighted MR imaging: a validation study with image-guided stereotactic biopsy. Clin cancer Res an Off J Am Assoc Cancer Res 25:552–561

Yan K, Fu Z, Yang C, Zhang K, Jiang S, Lee DH, Heo HY, Zhang Y, Cole RN, Van Eyk JE, Zhou J (2015) Assessing amide proton transfer (APT) MRI contrast origins in 9 L gliosarcoma in the rat brain using proteomic analysis. Mol Imaging Biol 17:479–487

Zaiss M, Schuppert M, Deshmane A, Herz K, Ehses P, Füllbier L, Lindig T, Bender B, Ernemann U, Scheffler K (2018) Chemical exchange saturation transfer MRI contrast in the human brain at 9.4 T. Neuroimage 179:144–155

Harris RJ, Cloughesy TF, Liau LM, Prins RM, Antonios JP, Li D, Yong WH, Pope WB, Lai A, Nghiemphu PL, Ellingson BM (2015) PH-weighted molecular imaging of gliomas using amine chemical exchange saturation transfer MRI. Neuro Oncol 17:1514–1524

Xu J, Zaiss M, Zu Z, Li H, Xie J, Gochberg DF, Bachert P, Gore JC (2014) On the origins of chemical exchange saturation transfer (CEST) contrast in tumors at 9.4T. NMR Biomed 27:406–416

Heo HY, Zhang Y, Lee DH, Hong X, Zhou J (2016) Quantitative assessment of amide proton transfer (APT) and nuclear overhauser enhancement (NOE) imaging with extrapolated semi-solid magnetization transfer reference (EMR) signals: application to a rat glioma model at 4.7 tesla. Magn Reson Med 75:137–149

Zhou J, Heo HY, Knutsson L, van Zijl PCM, Jiang S (2019) APT-weighted MRI: Techniques, current neuro applications, and challenging issues. J Magn Reson Imaging. https://doi.org/10.1002/jmri.26645

Kim M, Gillen J, Landman BA, Zhou J, Van Zijl PCM (2009) Water saturation shift referencing (WASSR) for chemical exchange saturation transfer (CEST) experiments. Magn Reson Med. https://doi.org/10.1002/mrm.21873