The Role of Amide Proton Transfer (APT)-Weighted Imaging in Glioma: Assessment of Tumor Grading, Molecular Profile and Survival in Different Tumor Components
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Molecular Analysis
2.2.1. MGMT
2.2.2. IDH
2.3. MRI Acquisition
- 3D T1-weighted sequence after administration of contrast medium (Gadovist, gadobutrol 1 mmol/mL, Bayer AG®, Leverkusen, Germany) fast-field-echo (FFE): Repetition time/echo time (TR/TE) = 9.93 ms/4.5 ms; flip angle (FA) = 8°; slice thickness = 1 mm; no gap = 1 mm; matrix = 240 × 240 mm; field of view (FOV) = 240 × 240 mm;
- 3D FLAIR sequence: TR/TE = 4800 ms/333 ms; TI = 1650 ms; slice thickness = 1 mm; no gaps; matrix = 240 × 240 mm; FOV = 240 × 240 mm;
- APT: 3D TSE DIXON sequence, saturation radiofrequency (RF) pulse duration 2.0 s; B1 power 2.0 µT; 40 sync Gaussian pulses each of 50 ms; 7 off-resonance saturation pulses: ±3.1, ±3.5, ±3.9 and −1560 ppm (S0); 9 slices; FOV 212 × 183 × 40 mm; matrix = 116 × 116 reconstructed 224 × 224; voxel size 1.8 × 1.8 × 4.4 mm; TR = 3825 ms; TE = 6.2 ms; FA = 90°; refocusing angle 120°; Echo train length (ETL) 181; Spectral presaturation with inversion recovery (SPIR) fat suppression. Total acquisition time was 4 min and 30 s.
2.4. Image Procesing and Analysis
2.5. Statistical Analysis
3. Results
3.1. Between-Subject Variability of Mean APT Values in Tumor Compartments and Other Tissues
3.2. Correlation of APT-Derived Statistical Parameters with Tumor and Patient Characteristics
3.2.1. “Lesion” ROI
3.2.2. “Necrosis” ROI
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Value |
---|---|
Age, median (range) years | 56 (23–76) |
Sex (M/F) | 45/16 |
WHO grade (2/3/4) | 3/10/48 |
Tumor volume, median (range) mm3 | 30, 187 (67–167, 636) |
IDH mutation (Yes/No) | 15/46 |
MGMT promoter methylation (Yes/No) 1 | 34/25 |
Survival status after 1 year (Alive/Dead) | 39/22 |
Survival status after 2 years (Alive/Dead) 2 | 19/38 |
APT Parameter | WHO Grade | IDH Status | MGMT Promoter Status | |||
---|---|---|---|---|---|---|
2–3 (n = 13) | 4 (n = 48) | Mutant (n = 15) | Wildtype (n = 46) | Methylated (n = 34) | Unmethylated (n = 25) | |
Mean | 1.58 * (0.50) | 2.04 * (0.56) | 1.69 (0.55) | 2.02 (0.57) | 1.91 (0.53) | 1.93 (0.63) |
Median | 1.55 * (0.52) | 1.99 * (0.57) | 1.65 (0.54) | 1.98 (0.58) | 1.85 (0.53) | 1.90 (0.64) |
10th percentile | 0.74 * (0.29) | 1.08 * (0.42) | 0.79 (0.31) | 1.08 (0.43) | 0.99 (0.39) | 1.01 (0.45) |
90th percentile | 2.41 * (0.72) | 3.07 * (0.84) | 2.64 (0.89) | 3.03 (0.83) | 2.91 (0.84) | 2.88 (0.87) |
Skewness | 0.35 (0.46) | 0.27 (0.46) | 0.41 (0.49) | 0.25 (0.44) | 0.37 (0.48) | 0.20 (0.43) |
Kurtosis | 3.45 (1.17) | 3.03 (0.63) | 3.43 (1.16) | 3.01 (0.60) | 3.21 (0.90) | 3.03 (0.61) |
APT Parameter | Survival Status after 1 Year | Survival Status after 2 Years | Overall Survival | |||
---|---|---|---|---|---|---|
Alive (n = 39) | Dead (n = 22) | Alive (n = 19) | Dead (n = 38) | HR (95% CI) | p-Value | |
Mean | 1.81 * (0.58) | 2.17 * (0.51) | 1.78 (0.61) | 2.01 (0.54) | 1.55 (0.95–2.54) | 0.081 |
Median | 1.76 * (0.58) | 2.13 * (0.51) | 1.74 (0.63) | 1.96 (0.54) | 1.55 (0.94–2.54) | 0.085 |
10th percentile | 0.93 (0.44) | 1.15 (0.34) | 0.89 (0.42) | 1.04 (0.38) | 1.54 (0.76–3.11) | 0.227 |
90th percentile | 2.74 * (0.84) | 3.27 * (0.79) | 2.73 (0.92) | 3.04 (0.79) | 1.33 (0.98–1.82) | 0.070 |
Skewness | 0.31 (0.42) | 0.25 (0.53) | 0.31 (0.43) | 0.26 (0.48) | 0.90 (0.44–1.84) | 0.768 |
Kurtosis | 3.02 (0.84) | 3.29 (0.66) | 3.10 (1.05) | 3.14 (0.66) | 1.13 (0.83–1.53) | 0.444 |
Factor | Overall Survival (Univariate) | Overall Survival (Multivariate) | |||
---|---|---|---|---|---|
HR (95% CI) | p-Value | HR (95% CI) | p-Value | ||
APT Mean | 0.86 (0.51–1.46) | 0.576 | - | - | |
APT Median | 0.89 (0.53–1.48) | 0.640 | - | - | |
APT 10th percentile | 0.71 (0.35–1.43) | 0.335 | - | - | |
APT 90th percentile | 0.94 (0.66–1.33) | 0.709 | - | - | |
APT Skewness | 0.99 (0.46–2.11) | 0.977 | - | - | |
APT Kurtosis | 1.66 (1.07–2.56) | 0.023 * | 1.60 (1.02–2.52) | 0.040 * | |
Surgery type | Biopsy (n = 11) | ref | - | ref | - |
GTR (n = 23) | 0.31 (0.13–0.72) | 0.006 * | 0.29 (0.12–0.68) | 0.005 * | |
Partial (n = 13) | 0.90 (0.39–2.08) | 0.810 | 0.76 (0.32–1.81) | 0.536 | |
Age at surgery | 1.02 (0.99–1.05) | 0.256 | - | - |
APT Parameter | MGMT Promoter Status | Survival Status after 1 Year | Survival Status after 2 Years | |||
---|---|---|---|---|---|---|
Methylated (n = 19) | Unmethylated (n = 18) | Alive (n = 21) | Dead (n = 18) | Alive (n = 9) | Dead (n = 28) | |
Mean | 3.69 (1.89) | 3.13 (1.67) | 3.05 (1.79) | 3.72 (1.73) | 3.63 (2.38) | 3.28 (1.56) |
Median | 3.72 (1.92) | 3.13 (1.69) | 3.06 (1.81) | 3.74 (1.77) | 3.64 (2.39) | 3.29 (1.59) |
10th percentile | 3.20 (1.85) | 2.75 (1.65) | 2.70 (1.79) | 3.19 (1.70) | 3.30 (2.38) | 2.81 (1.51) |
90th percentile | 4.15 (1.97) | 3.51 (1.67) | 3.41 (1.81) | 4.22 (1.74) | 3.95 (2.36) | 3.75 (1.61) |
Skewness | −0.24 (0.54) | 0.01 (0.42) | −0.10 (0.47) | −0.12 (0.52) | −0.08 (0.53) | −0.12 (0.50) |
Kurtosis | 2.55 (0.62) | 2.40 (0.75) | 2.48 (0.71) | 2.41 (0.65) | 2.41 (0.57) | 2.51 (0.71) |
APT Parameter | Overall Survival | |
---|---|---|
HR (95% CI) | p-Value | |
Mean | 0.98 (0.81–1.19) | 0.828 |
Median | 0.98 (0.81–1.18) | 0.823 |
10th percentile | 0.95 (0.77–1.16) | 0.600 |
90th percentile | 1.01 (0.84–1.21) | 0.932 |
Skewness | 0.90 (0.44–1.83) | 0.768 |
Kurtosis | 1.14 (0.71–1.83) | 0.578 |
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Borges de Almeida, G.; Pascuzzo, R.; Mambrin, F.; Aquino, D.; Verri, M.; Moscatelli, M.; Del Bene, M.; DiMeco, F.; Silvani, A.; Pollo, B.; et al. The Role of Amide Proton Transfer (APT)-Weighted Imaging in Glioma: Assessment of Tumor Grading, Molecular Profile and Survival in Different Tumor Components. Cancers 2024, 16, 3014. https://doi.org/10.3390/cancers16173014
Borges de Almeida G, Pascuzzo R, Mambrin F, Aquino D, Verri M, Moscatelli M, Del Bene M, DiMeco F, Silvani A, Pollo B, et al. The Role of Amide Proton Transfer (APT)-Weighted Imaging in Glioma: Assessment of Tumor Grading, Molecular Profile and Survival in Different Tumor Components. Cancers. 2024; 16(17):3014. https://doi.org/10.3390/cancers16173014
Chicago/Turabian StyleBorges de Almeida, Gonçalo, Riccardo Pascuzzo, Francesca Mambrin, Domenico Aquino, Mattia Verri, Marco Moscatelli, Massimiliano Del Bene, Francesco DiMeco, Antonio Silvani, Bianca Pollo, and et al. 2024. "The Role of Amide Proton Transfer (APT)-Weighted Imaging in Glioma: Assessment of Tumor Grading, Molecular Profile and Survival in Different Tumor Components" Cancers 16, no. 17: 3014. https://doi.org/10.3390/cancers16173014