Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors
Purpose To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative...
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| Veröffentlicht in: | Journal of magnetic resonance imaging 2017-09, Vol.46 (3), p.732-739 |
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| creator | Sakata, Akihiko Fushimi, Yasutaka Okada, Tomohisa Arakawa, Yoshiki Kunieda, Takeharu Minamiguchi, Sachiko Kido, Aki Sakashita, Naotaka Miyamoto, Susumu Togashi, Kaori |
| description | Purpose
To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative grading in patients with brain tumor.
Materials and Methods
Institutional Review Board approval and written informed consent were obtained. Forty‐one patients with suspected brain tumors were enrolled in the study. Single‐voxel MRS and 2D APT imaging of the same slice level were conducted using a 3T MRI scanner. Positive or negative contrast enhancement on T1‐weighted images was assessed by two neuroradiologists. Correlations among metabolite concentrations, metabolite ratios, and calculated histogram parameters, including mean APT (APTmean) and the 90th percentile of APT (APT90) were assessed using Spearman's correlation coefficient. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis for contrast enhancement and MRS and APT imaging. Values of P |
| doi_str_mv | 10.1002/jmri.25597 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1873721185</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1928329917</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4677-8e90c1daf02046a99e7af770a370b84970a8d7dd78919aeda6d221129b77be063</originalsourceid><addsrcrecordid>eNp9kd9OHCEUh0nTpv7rTR-gIemNMY4CszPApdm2VqMxMXpNGDizstmBKTDZ7Dv40GW76oUXvSCcwHe-HPgh9JWSM0oIO18O0Z2xppH8A9qnDWMVa0T7sdSkqSsqCN9DByktCSFSzprPaI8J1pTF9tHzD6cXPqTsDB4h9iEO2hvAHeQ1gMcm-Bx1yhj80_ZiAJ9P8RhDDh7f3uM0gskxJBPGzSnW3mI9OAuvROn1qYeI3aAXzi-w83jU2RVLwmuXn3AXdTnL0xBiOkKfer1K8OVlP0SPv34-zH9XN3eXV_OLm8rMWs4rAZIYanVPGJm1Wkrguuec6JqTTsxkqYTl1nIhqdRgdWsZo5TJjvMOSFsfouOdt0z5Z4KU1eCSgdVKewhTUlTwmpcO0RT0-zt0Gaboy3SKSiZqJiXlhTrZUaZ8RYrQqzGWF8eNokRtM1LbjNS_jAr87UU5dQPYN_Q1lALQHbB2K9j8R6Wub--vdtK_1D-erA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1928329917</pqid></control><display><type>article</type><title>Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors</title><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>Wiley Online Library All Journals</source><creator>Sakata, Akihiko ; Fushimi, Yasutaka ; Okada, Tomohisa ; Arakawa, Yoshiki ; Kunieda, Takeharu ; Minamiguchi, Sachiko ; Kido, Aki ; Sakashita, Naotaka ; Miyamoto, Susumu ; Togashi, Kaori</creator><creatorcontrib>Sakata, Akihiko ; Fushimi, Yasutaka ; Okada, Tomohisa ; Arakawa, Yoshiki ; Kunieda, Takeharu ; Minamiguchi, Sachiko ; Kido, Aki ; Sakashita, Naotaka ; Miyamoto, Susumu ; Togashi, Kaori</creatorcontrib><description>Purpose
To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative grading in patients with brain tumor.
Materials and Methods
Institutional Review Board approval and written informed consent were obtained. Forty‐one patients with suspected brain tumors were enrolled in the study. Single‐voxel MRS and 2D APT imaging of the same slice level were conducted using a 3T MRI scanner. Positive or negative contrast enhancement on T1‐weighted images was assessed by two neuroradiologists. Correlations among metabolite concentrations, metabolite ratios, and calculated histogram parameters, including mean APT (APTmean) and the 90th percentile of APT (APT90) were assessed using Spearman's correlation coefficient. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis for contrast enhancement and MRS and APT imaging. Values of P < 0.05 were considered statistically significant.
Results
Positive correlations with statistical significance were found between total concentration of choline (Cho) and APT90 (r = 0.49), and between Cho/creatine (Cr) and APTmean (r = 0.65) as well as APT90 (r = 0.49). A negative correlation with statistical significance was observed between NAA/Cr and APTmean (r = −0.52). According to ROC curves, Cho/Cr, APTmean, APT90, demonstrated higher area under the curve (AUC) values than that of contrast enhancement in grading gliomas.
Conclusion
Significant correlations were observed between metabolite concentrations and ratios on MRS and APT values. MRS and APT imaging showed comparable diagnostic capability for grading brain tumors, suggesting that both MRS and APT imaging offer potential for quantitatively assessing similar biological characteristics in brain tumors on noncontrast MRI.
Level of Evidence: 2
Technical Efficacy: Stage 2
J. MAGN. RESON. IMAGING 2017;46:732–739</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.25597</identifier><identifier>PMID: 28252822</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; amide proton transfer imaging ; Brain ; Brain - diagnostic imaging ; Brain cancer ; Brain Neoplasms - diagnostic imaging ; Brain tumors ; chemical exchange saturation transfer ; Child ; Choline ; Contrast Media ; Correlation coefficient ; Correlation coefficients ; Creatine ; Diagnostic systems ; Evaluation ; Female ; Glioma ; Grading ; Humans ; Image contrast ; Image enhancement ; Image Enhancement - methods ; Informed consent ; Magnetic resonance imaging ; Magnetic resonance spectroscopy ; Male ; Mathematical analysis ; Middle Aged ; Neuroimaging ; Patients ; Proton Magnetic Resonance Spectroscopy - methods ; Reproducibility of Results ; Sensitivity and Specificity ; Spectroscopic analysis ; Spectroscopy ; Spectrum analysis ; Statistical analysis ; Statistical significance ; Statistics ; Tumors ; Young Adult</subject><ispartof>Journal of magnetic resonance imaging, 2017-09, Vol.46 (3), p.732-739</ispartof><rights>2017 International Society for Magnetic Resonance in Medicine</rights><rights>2017 International Society for Magnetic Resonance in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4677-8e90c1daf02046a99e7af770a370b84970a8d7dd78919aeda6d221129b77be063</citedby><cites>FETCH-LOGICAL-c4677-8e90c1daf02046a99e7af770a370b84970a8d7dd78919aeda6d221129b77be063</cites><orcidid>0000-0002-1982-3168</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmri.25597$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmri.25597$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28252822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sakata, Akihiko</creatorcontrib><creatorcontrib>Fushimi, Yasutaka</creatorcontrib><creatorcontrib>Okada, Tomohisa</creatorcontrib><creatorcontrib>Arakawa, Yoshiki</creatorcontrib><creatorcontrib>Kunieda, Takeharu</creatorcontrib><creatorcontrib>Minamiguchi, Sachiko</creatorcontrib><creatorcontrib>Kido, Aki</creatorcontrib><creatorcontrib>Sakashita, Naotaka</creatorcontrib><creatorcontrib>Miyamoto, Susumu</creatorcontrib><creatorcontrib>Togashi, Kaori</creatorcontrib><title>Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors</title><title>Journal of magnetic resonance imaging</title><addtitle>J Magn Reson Imaging</addtitle><description>Purpose
To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative grading in patients with brain tumor.
Materials and Methods
Institutional Review Board approval and written informed consent were obtained. Forty‐one patients with suspected brain tumors were enrolled in the study. Single‐voxel MRS and 2D APT imaging of the same slice level were conducted using a 3T MRI scanner. Positive or negative contrast enhancement on T1‐weighted images was assessed by two neuroradiologists. Correlations among metabolite concentrations, metabolite ratios, and calculated histogram parameters, including mean APT (APTmean) and the 90th percentile of APT (APT90) were assessed using Spearman's correlation coefficient. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis for contrast enhancement and MRS and APT imaging. Values of P < 0.05 were considered statistically significant.
Results
Positive correlations with statistical significance were found between total concentration of choline (Cho) and APT90 (r = 0.49), and between Cho/creatine (Cr) and APTmean (r = 0.65) as well as APT90 (r = 0.49). A negative correlation with statistical significance was observed between NAA/Cr and APTmean (r = −0.52). According to ROC curves, Cho/Cr, APTmean, APT90, demonstrated higher area under the curve (AUC) values than that of contrast enhancement in grading gliomas.
Conclusion
Significant correlations were observed between metabolite concentrations and ratios on MRS and APT values. MRS and APT imaging showed comparable diagnostic capability for grading brain tumors, suggesting that both MRS and APT imaging offer potential for quantitatively assessing similar biological characteristics in brain tumors on noncontrast MRI.
Level of Evidence: 2
Technical Efficacy: Stage 2
J. MAGN. RESON. IMAGING 2017;46:732–739</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>amide proton transfer imaging</subject><subject>Brain</subject><subject>Brain - diagnostic imaging</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain tumors</subject><subject>chemical exchange saturation transfer</subject><subject>Child</subject><subject>Choline</subject><subject>Contrast Media</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Creatine</subject><subject>Diagnostic systems</subject><subject>Evaluation</subject><subject>Female</subject><subject>Glioma</subject><subject>Grading</subject><subject>Humans</subject><subject>Image contrast</subject><subject>Image enhancement</subject><subject>Image Enhancement - methods</subject><subject>Informed consent</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic resonance spectroscopy</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Middle Aged</subject><subject>Neuroimaging</subject><subject>Patients</subject><subject>Proton Magnetic Resonance Spectroscopy - methods</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Spectroscopic analysis</subject><subject>Spectroscopy</subject><subject>Spectrum analysis</subject><subject>Statistical analysis</subject><subject>Statistical significance</subject><subject>Statistics</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd9OHCEUh0nTpv7rTR-gIemNMY4CszPApdm2VqMxMXpNGDizstmBKTDZ7Dv40GW76oUXvSCcwHe-HPgh9JWSM0oIO18O0Z2xppH8A9qnDWMVa0T7sdSkqSsqCN9DByktCSFSzprPaI8J1pTF9tHzD6cXPqTsDB4h9iEO2hvAHeQ1gMcm-Bx1yhj80_ZiAJ9P8RhDDh7f3uM0gskxJBPGzSnW3mI9OAuvROn1qYeI3aAXzi-w83jU2RVLwmuXn3AXdTnL0xBiOkKfer1K8OVlP0SPv34-zH9XN3eXV_OLm8rMWs4rAZIYanVPGJm1Wkrguuec6JqTTsxkqYTl1nIhqdRgdWsZo5TJjvMOSFsfouOdt0z5Z4KU1eCSgdVKewhTUlTwmpcO0RT0-zt0Gaboy3SKSiZqJiXlhTrZUaZ8RYrQqzGWF8eNokRtM1LbjNS_jAr87UU5dQPYN_Q1lALQHbB2K9j8R6Wub--vdtK_1D-erA</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Sakata, Akihiko</creator><creator>Fushimi, Yasutaka</creator><creator>Okada, Tomohisa</creator><creator>Arakawa, Yoshiki</creator><creator>Kunieda, Takeharu</creator><creator>Minamiguchi, Sachiko</creator><creator>Kido, Aki</creator><creator>Sakashita, Naotaka</creator><creator>Miyamoto, Susumu</creator><creator>Togashi, Kaori</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1982-3168</orcidid></search><sort><creationdate>201709</creationdate><title>Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors</title><author>Sakata, Akihiko ; Fushimi, Yasutaka ; Okada, Tomohisa ; Arakawa, Yoshiki ; Kunieda, Takeharu ; Minamiguchi, Sachiko ; Kido, Aki ; Sakashita, Naotaka ; Miyamoto, Susumu ; Togashi, Kaori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4677-8e90c1daf02046a99e7af770a370b84970a8d7dd78919aeda6d221129b77be063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>amide proton transfer imaging</topic><topic>Brain</topic><topic>Brain - diagnostic imaging</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain tumors</topic><topic>chemical exchange saturation transfer</topic><topic>Child</topic><topic>Choline</topic><topic>Contrast Media</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Creatine</topic><topic>Diagnostic systems</topic><topic>Evaluation</topic><topic>Female</topic><topic>Glioma</topic><topic>Grading</topic><topic>Humans</topic><topic>Image contrast</topic><topic>Image enhancement</topic><topic>Image Enhancement - methods</topic><topic>Informed consent</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic resonance spectroscopy</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Middle Aged</topic><topic>Neuroimaging</topic><topic>Patients</topic><topic>Proton Magnetic Resonance Spectroscopy - methods</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Spectroscopic analysis</topic><topic>Spectroscopy</topic><topic>Spectrum analysis</topic><topic>Statistical analysis</topic><topic>Statistical significance</topic><topic>Statistics</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sakata, Akihiko</creatorcontrib><creatorcontrib>Fushimi, Yasutaka</creatorcontrib><creatorcontrib>Okada, Tomohisa</creatorcontrib><creatorcontrib>Arakawa, Yoshiki</creatorcontrib><creatorcontrib>Kunieda, Takeharu</creatorcontrib><creatorcontrib>Minamiguchi, Sachiko</creatorcontrib><creatorcontrib>Kido, Aki</creatorcontrib><creatorcontrib>Sakashita, Naotaka</creatorcontrib><creatorcontrib>Miyamoto, Susumu</creatorcontrib><creatorcontrib>Togashi, Kaori</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sakata, Akihiko</au><au>Fushimi, Yasutaka</au><au>Okada, Tomohisa</au><au>Arakawa, Yoshiki</au><au>Kunieda, Takeharu</au><au>Minamiguchi, Sachiko</au><au>Kido, Aki</au><au>Sakashita, Naotaka</au><au>Miyamoto, Susumu</au><au>Togashi, Kaori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J Magn Reson Imaging</addtitle><date>2017-09</date><risdate>2017</risdate><volume>46</volume><issue>3</issue><spage>732</spage><epage>739</epage><pages>732-739</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>Purpose
To explore the relationship among parameters of magnetic resonance spectroscopy (MRS) and amide proton transfer (APT) imaging, and to assess the diagnostic performance of MRS and APT imaging for grading brain tumors in comparison with contrast enhancement of conventional MRI for preoperative grading in patients with brain tumor.
Materials and Methods
Institutional Review Board approval and written informed consent were obtained. Forty‐one patients with suspected brain tumors were enrolled in the study. Single‐voxel MRS and 2D APT imaging of the same slice level were conducted using a 3T MRI scanner. Positive or negative contrast enhancement on T1‐weighted images was assessed by two neuroradiologists. Correlations among metabolite concentrations, metabolite ratios, and calculated histogram parameters, including mean APT (APTmean) and the 90th percentile of APT (APT90) were assessed using Spearman's correlation coefficient. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis for contrast enhancement and MRS and APT imaging. Values of P < 0.05 were considered statistically significant.
Results
Positive correlations with statistical significance were found between total concentration of choline (Cho) and APT90 (r = 0.49), and between Cho/creatine (Cr) and APTmean (r = 0.65) as well as APT90 (r = 0.49). A negative correlation with statistical significance was observed between NAA/Cr and APTmean (r = −0.52). According to ROC curves, Cho/Cr, APTmean, APT90, demonstrated higher area under the curve (AUC) values than that of contrast enhancement in grading gliomas.
Conclusion
Significant correlations were observed between metabolite concentrations and ratios on MRS and APT values. MRS and APT imaging showed comparable diagnostic capability for grading brain tumors, suggesting that both MRS and APT imaging offer potential for quantitatively assessing similar biological characteristics in brain tumors on noncontrast MRI.
Level of Evidence: 2
Technical Efficacy: Stage 2
J. MAGN. RESON. IMAGING 2017;46:732–739</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28252822</pmid><doi>10.1002/jmri.25597</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1982-3168</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over amide proton transfer imaging Brain Brain - diagnostic imaging Brain cancer Brain Neoplasms - diagnostic imaging Brain tumors chemical exchange saturation transfer Child Choline Contrast Media Correlation coefficient Correlation coefficients Creatine Diagnostic systems Evaluation Female Glioma Grading Humans Image contrast Image enhancement Image Enhancement - methods Informed consent Magnetic resonance imaging Magnetic resonance spectroscopy Male Mathematical analysis Middle Aged Neuroimaging Patients Proton Magnetic Resonance Spectroscopy - methods Reproducibility of Results Sensitivity and Specificity Spectroscopic analysis Spectroscopy Spectrum analysis Statistical analysis Statistical significance Statistics Tumors Young Adult |
| title | Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors |
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