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Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

 Yoon Seong Choi  ;  Sung Soo Ahn  ;  Seung-Koo Lee  ;  Jong Hee Chang  ;  Seok-Gu Kang  ;  Se Hoon Kim  ;  Jinyuan Zhou 
 EUROPEAN RADIOLOGY, Vol.27(8) : 3181-3189, 2017 
Journal Title
Issue Date
Adult ; Aged ; Amides ; Brain Neoplasms/diagnostic imaging* ; Brain Neoplasms/pathology ; Cerebral Blood Volume* ; Diffusion Tensor Imaging* ; Female ; Glioma/diagnostic imaging* ; Glioma/pathology ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Neoplasm Grading/methods ; Neuroimaging/methods ; Protons ; ROC Curve ; Sensitivity and Specificity
Amide proton transfer imaging ; Brain tumour ; Chemical exchange saturation transfer ; Glioma ; Magnetic resonance imaging
OBJECTIVES: To evaluate the added value of amide proton transfer (APT) imaging to the apparent diffusion coefficient (ADC) from diffusion tensor imaging (DTI) and the relative cerebral blood volume (rCBV) from perfusion magnetic resonance imaging (MRI) for discriminating between high- and low-grade gliomas. METHODS: Forty-six consecutive adult patients with diffuse gliomas who underwent preoperative APT imaging, DTI and perfusion MRI were enrolled. APT signals were compared according to the World Health Organization grade. The diagnostic ability and added value of the APT signal to the ADC and rCBV for discriminating between low- and high-grade gliomas were evaluated using receiver operating characteristic (ROC) analyses and integrated discrimination improvement. RESULTS: The APT signal increased as the glioma grade increased. The discrimination abilities of the APT, ADC and rCBV values were not significantly different. Using both the APT signal and ADC significantly improved discrimination vs. the ADC alone (area under the ROC curve [AUC], 0.888 vs. 0.910; P = 0.007), whereas using both the APT signal and rCBV did not improve discrimination vs. the rCBV alone (AUC, 0.927 vs. 0.923; P = 0.222). CONCLUSIONS: APT imaging may be a useful imaging biomarker that adds value to the ADC for discriminating between low- and high-grade gliomas. KEY POINTS: • Higher APT values were correlated with higher glioma grades. • Adding the APT signal to the ADC improved glioma grading. • Adding the APT signal to rCBV did not improve glioma grading. • APT is a useful adjunct to the ADC for glioma grading.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Chang, Jong Hee(장종희)
Choi, Yoon Seong(최윤성)
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