Differentiation of true progression from treatment response in high‐grade glioma treated with chemoradiation: a comparison study of 3D‐APTW and 3D‐PcASL imaging and DWI. (17th September 2022)

• Record Type: Journal Article
• Authors: Hou, Huimin; Diao, Yanzhao; Yu, Jinchao; Xu, Min; Wang, Liming; Li, Zhenzhi; Song, Tao; Liu, Yu; Yuan, Zhenguo
• Is Part Of: NMR in biomedicine. Volume 36:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-09-17
• Subjects: amide proton transfer imaging -- biomarkers -- brain -- diffusion -- glioma -- MRI -- perfusion -- tumor recurrence; Nuclear magnetic resonance -- Periodicals; Magnetic Resonance Spectroscopy -- Periodicals; 574
• DOI: 10.1002/nbm.4821
• Languages: English
• ISSNs: 0952-3480

Abstract

Abstract : Purpose: To assess and compare the diagnostic performance of 3D amide proton‐transfer‐weighted (3D‐APTW) imaging, 3D pseudocontinuous arterial spin‐labeling (3D‐PcASL) imaging, and diffusion‐weighted imaging in distinguishing true progression (TP) from treatment response (TR) in posttreatment malignant glioma patients. Materials and methods: Forty‐eight patients with suspected tumor recurrence were prospectively enrolled. Histological or longitudinal routine MRI follow‐up over six months was assessed to confirm lesion type. The apparent diffusion coefficient (ADC), relative APTWmax (rAPTW), and relative CBFmax values (rCBF) were measured in lesions with enhancing regions on post‐gadolinium T 1 ‐weighted MRI. MRI parameters between the TP and TR groups were compared using Student's t tests. In addition, a receiver operating characteristic (ROC) curve was constructed, and the area under the ROC curve (AUC) was calculated to assess the differentiation diagnostic performance of each parameter. Results: The TP group showed a significantly higher rAPTW and rCBF than the TR group; the AUCs of rAPTW and rCBF to distinguish between TP and TR were 0.911 (with sensitivity of 90.3% and specificity of 82.4%) and 0.852 (with sensitivity of 80.6% and specificity of 82.4%), respectively. By adding the rAPTW values to rCBF values, the diagnostic ability was improved from 0.852 to 0.951. ADC showed no significant differences between the TP and TR groups, with an AUC lower than 0.70. Conclusion: Both 3D‐PcASL and 3D‐APTW imaging could distinguish TP from TR, and 3D‐APTW had a better diagnostic performance. Combining the rAPTW values and rCBF values achieved a better diagnostic performance. Abstract : Both 3D amide proton‐transfer‐weighted (3D‐APTW) imaging and 3D pseudocontinuous arterial spin‐labelling (3D‐PcASL) imaging could distinguish true progression from treatment response significantly, while the apparent diffusion coefficient values derived from diffusion‐weighted imaging showed no statistical difference. Moreover, the diagnostic performance of distinguishing true progression from treatment response could be improved by combining 3D‐APTW imaging and 3D‐PcASL imaging.