多池化学交换和转移MRI用于质瘤分级,分子亚型和评估瘤增殖
Hongquan Zhu1, Yuanhao Li1, Yuejie Ding1
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, PR China.
多池化学交换和转移 (CEST) MRI显示在预测质瘤等级,IDH突变,ATRX损失和Ki-67标记指数方面具有前途. 这种先进的MRI技术有助于非侵入性地评估关键质瘤特征.
科学领域:
- 神经成像是一种神经成像.
- 在瘤学瘤学.
- 生物化学 生化学
背景情况:
- 质瘤是主要的大脑瘤,具有不同等级和分子亚型.
- 准确的分级和分子亚型对治疗计划和预后至关重要.
- 目前的诊断方法可能是侵入性的,可能无法完全捕捉瘤异质性.
研究的目的:
- 评估多池化学交换和转移 (CEST) 磁共振成像 (MRI) 在预测质瘤等级方面的有效性.
- 评估多池CESTMRI在识别异酸脱酶 (IDH) 突变状态方面的性能.
- 确定多池CESTMRI在预测alpha-thalassemia/精神障碍综合征X相关 (ATRX) 损失和Ki-67标记指数 (LI) 的实用性.
主要方法:
- 对95名成人类型扩散性质瘤患者的分析,使用多池CESTMRI.
- 胺的衍生,直接的水和 (DS),核Overhauser增强 (NOE),半固体磁化转移 (MT) 和氨基信号通过洛伦兹拟合.
- 基于不对称的胺质子转移加权 (APTwasym) 信号的计算和瘤区域平均值的评估.
- 使用接收器操作曲线 (ROC) 和曲线下的面积 (AUC) 分析来评估诊断性能.
- 斯皮尔曼相关性分析通过Ki-67 LI评估瘤扩散.
主要成果:
- 胺和DS信号在高度质瘤与低度质瘤 (p < 0.001) 中显著升高.
- 与IDH突变性质瘤相比,IDH野生型质瘤显示出明显更高的胺和DS信号 (p < 0.001).
- DS,MT和氨基信号区分ATRX损失与2/3级IDH突变质瘤的保留 (p <0.05).
- 组合的CEST信号实现了预测等级 (0.857),IDH突变 (0.814) 和ATRX损失 (0.769) 的最高AUC.
- 胺和DS信号与Ki-67 LI (p < 0.001) 呈现出正相关性,表明扩散增加.
结论:
- 多池CESTMRI显示了对预测质瘤等级的非侵入性预测有很大的潜力.
- CEST MRI 参数有效地预测了结质瘤中的 IDH 突变状态和 ATRX 损失.
- 该技术在评估瘤扩散的标志物Ki-67 LI方面表现良好.
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