酰胺质子转移成像在脑胶质瘤中的应用研究

郑 阳,王晓明

中国临床医学影像杂志 ›› 2017, Vol. 28 ›› Issue (10) : 697-701.

中国临床医学影像杂志 ›› 2017, Vol. 28 ›› Issue (10) : 697-701.
中枢神经影像学

酰胺质子转移成像在脑胶质瘤中的应用研究

  • 郑  阳,王晓明
作者信息 +

Application of amide proton transfer imaging in glioma

  • ZHENG Yang, WANG Xiao-ming
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文章历史 +

摘要

目的:探讨基于蛋白质浓度敏感的酰胺质子转移(Amide proton transfer,APT)成像在脑胶质瘤中的应用价值。方法:收集经穿刺活检或手术切除的脑胶质瘤患者共19例,经病理证实低级别Ⅰ级4例、Ⅱ级7例,高级别Ⅲ级5例、Ⅳ级3例。术前,患者均行常规磁共振序列(T1WI、T2WI、DWI、FLAIR和Gd-T1WI)及APT序列扫描,其中APT成像在增强扫描之前进行。比较APT成像信号在肿瘤实质区(用APTmax表示)、瘤旁区(水肿区或实质区0.5 cm以内为瘤旁区,用APTmin表示)的信号差异。应用独立样本t检验分析低级别肿瘤(Ⅰ、Ⅱ级)及高级别肿瘤(Ⅲ、Ⅳ级)肿瘤APTmin与APTmax值的差异是否有统计学意义。采用方差分析检验各级胶质瘤APTmax与APTmin统计学差异。采用Spearman相关分析统计胶质瘤分级与APTmax、APTmin的相关性。并通过受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线)分析APTmax的诊断效能。取P<0.05为差异有统计学意义。结果:低级别肿瘤APTmax与APTmin值均低于高级别肿瘤。Ⅰ~Ⅳ级肿瘤APTmax与APTmin值均有统计学差异。各级肿瘤APTmax较APTmin值均高。胶质瘤级别与肿瘤APTmax与APTmin呈正相关。结论:作为非侵入性的MR成像技术,APT成像对于脑肿瘤的诊断、分级及鉴别具有重要价值。

Abstract

Objective: To investigate the prospect of amide proton transfer(APT) imaging based on protein concentration in brain gliomas. Methods: A total of 19 patients with brain glioma underwent needle biopsy or surgical resection were collected. They were proved to be low-grade, 4 cases were grade Ⅰ, 7 cases were grade Ⅱ, with high-grade tumors of 5 cases were grade Ⅲ, 3 cases were grade Ⅳ. All patients underwent conventional magnetic resonance sequences(T1WI, T2WI, DWI, FLAIR, and Gd-T1WI) and APT sequence scans, APT imaging was performed prior to enhancement scan. The signal difference of the APT imaging signal was compared between the tumor parenchymal area(represented by APTmax) and the peritumoral region(the edema area or the parenchymal area within 0.5 cm, represented by APTmin). The independent sample t test was used to analyze whether the difference in APTmin and APTmax values between low-grade tumors(grade Ⅰ and Ⅱ) and high-grade tumors(grade Ⅲ and Ⅳ) was statistically significant. ANOVA was used to analyze statistically significant differences in APTmax and APTmin between gliomas. Spearman correlation analysis was used to analyze the correlation between glioma grading and APTmax and APTmin. And through the receiver operating characteristic curve(ROC curve) to analyze the differential diagnosis ability of APTmax. The difference of P<0.05 was statistically significant. Results: The APTmax and APTmin values of low-grade tumors were lower than those of high-grade tumors. There were significant differences in the APTmax and APTmin values from grade Ⅰ to grade Ⅳ. The APTmax of all tumors was higher than APTmin. Glioma grade was positively correlated with tumor APTmax and APTmin. Conclusion: As a non-invasive MR imaging modality, APT imaging plays an important role in the diagnosis, classification and differential diagnosis of brain tumors.

关键词

  / 神经胶质瘤 / 磁共振成像

Key words

Glioma / Magnetic resonance imaging

引用本文

导出引用
郑 阳,王晓明. 酰胺质子转移成像在脑胶质瘤中的应用研究[J]. 中国临床医学影像杂志. 2017, 28(10): 697-701
ZHENG Yang, WANG Xiao-ming. Application of amide proton transfer imaging in glioma[J]. Journal of China Clinic Medical Imaging. 2017, 28(10): 697-701
中图分类号: R730.264    R445.2   

参考文献

[1]Zhou J. Amide proton transfer imaging of the human brain[J]. Methods Mol Biol, 2011, 711: 227-237.
[2]Kogan F, Hariharan H, Reddy R. Chemical Exchange Saturation Transfer(CEST) Imaging: Description of Technique and Potential Clinical Applications[J]. Curr Radiol Rep, 2013, 1(2): 102-114.
[3]Jokivarsi KT, Grohn HI, Grohn OH, et al. Proton transfer ratio, lactate, and intracellular pH in acute cerebral ischemia[J]. Magn Reson Med, 2007, 57(4): 647-653.
[4]Zhou J, Payen JF, Wilson DA, et al. Using the amide proton signals of intracellular proteins and peptides to detect pH effects in MRI[J]. Nat Med, 2003, 9(8): 1085-1090.
[5]Zhou J, Tryggestad E, Wen Z, et al. Differentiation between glioma and radiation necrosis using molecular magnetic resonance imaging of endogenous proteins and peptides[J]. Nat Med, 2011, 17(1): 130-134.
[6]Zhou J, Yan K, Zhu H. A simple model for understanding the origin of the amide proton transfer MRI signal in tissue[J]. Appl Magn Reson, 2012, 42(3): 393-402.
[7]Sun PZ, Benner T, Copen WA, et al. Early experience of translating pH-weighted MRI to image human subjects at 3 Tesla[J]. Stroke, 2010, 41(10 Suppl): S147-151.
[8]Zhou J, Wilson DA, Sun PZ, et al. Quantitative description of proton exchange processes between water and endogenous and exogenous agents for WEX, CEST, and APT experiments[J]. Magn Reson Med, 2004, 51(5): 945-952.
[9]Howe FA, Barton SJ, Cudlip SA, et al. Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy[J]. Magn Reson Med, 2003, 49(2): 223-232.
[10]Yu H, Lou H, Zou T, et al. Applying protein-based amide proton transfer MR imaging to distinguish solitary brain metastases from glioblastoma[J]. Eur Radiol, 2017. [Epub ahead of print].
[11]Gillies RJ, Raghunand N, Garcia-Martin ML, et al. A review of pH measurement methods and applications in cancers[J]. IEEE Eng Med Biol Mag, 2004, 23(5): 57-64.
[12]Law M, Yang S, Wang H, et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging[J]. Am J Neuroradiol, 2003, 24(10): 1989-1998.
[13]Schafer ML, Maurer MH, Synowitz M, et al. Low-grade(WHO Ⅱ) and anaplastic(WHO Ⅲ) gliomas: differences in morphology and MRI signal intensities[J]. Eur Radiol, 2013, 23(10): 2846-2853.
[14]Sakata A, Fushimi Y, Okada T, et al. Diagnostic performance between contrast enhancement, proton MR spectroscopy, and amide proton transfer imaging in patients with brain tumors[J]. J Magn Reson Imaging, 2017. [Epub ahead of print].
[15]McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial Gadolinium Deposition after Contrast-enhanced MR Imaging[J]. Radiology, 2015, 275(3): 772-782.
[16]Kanda T, Matsuda M, Oba H, et al. Gadolinium Deposition after Contrast-enhanced MR Imaging[J]. Radiology, 2015, 277(3): 924-925.
[17]McDonald RJ, McDonald JS, Kallmes DF, et al. Gadolinium Deposition in Human Brain Tissues after Contrast-enhanced MR Imaging in Adult Patients without Intracranial Abnormalities[J]. Radiology, 2017. [Epub ahead of print].
[18]Ward KM, Aletras AH, Balaban RS. A new class of contrast agents for MRI based on proton chemical exchange dependent saturation transfer(CEST)[J]. J Magn Reson, 2000, 143(1): 79-87.
[19]Li J, Zhuang Z, Okamoto H, et al. Proteomic profiling distinguishes astrocytomas and identifies differential tumor markers[J]. Neurology, 2006, 66(5): 733-736.
[20]Hobbs SK, Shi G, Homer R, et al. Magnetic resonance image-guided proteomics of human glioblastoma multiforme[J]. J Magn Reson Imaging, 2003, 18(5): 530-536.
[21]Choi YS, Ahn SS, Lee SK, et al. Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume[J]. Eur Radiol, 2017, 27(8): 3181-3189.
[22]Yu Y, Lee DH, Peng SL, et al. Assessment of Glioma Response to Radiotherapy Using Multiple MRI Biomarkers with Manual and Semiautomated Segmentation Algorithms[J]. J Neuroimaging, 2016, 26(6): 626-634.
[23]Park KJ, Kim HS, Park JE, et al. Added value of amide proton transfer imaging to conventional and perfusion MR imaging for evaluating the treatment response of newly diagnosed glioblastoma[J]. Eur Radiol, 2016, 26(12): 4390-4403.
[24]Mehrabian H, Desmond KL, Soliman H, et al. Differentiation between Radiation Necrosis and Tumor Progression Using Chemical Exchange Saturation Transfer[J]. Clin Cancer Res, 2017, 23(14): 3667-3675.
[25]Sakata A, Okada T, Yamamoto A, et al. Grading glial tumors with amide proton transfer MR imaging: different analytical approaches[J]. J Neurooncol, 2015, 122(2): 339-348.
[26]Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system[J]. Acta Neuropathol, 2007, 114(2): 97-109.
[27]Heo HY, Zhang Y, Burton TM, et al. Improving the detection sensitivity of pH-weighted amide proton transfer MRI in acute stroke patients using extrapolated semisolid magnetization transfer reference signals[J]. Magn Reson Med, 2017. [Epub ahead of print].
[28]Song G, Li C, Luo X, et al. Evolution of Cerebral Ischemia Assessed by Amide Proton Transfer-Weighted MRI[J]. Front Neurol, 2017, 8: 67.
[29]Zheng Y, Wang XM. Measurement of Lactate Content and Amide Proton Transfer Values in the Basal Ganglia of a Neonatal Piglet Hypoxic-Ischemic Brain Injury Model Using MRI[J]. Am J Neuroradiol, 2017, 38(4): 827-834.
[30]Wells JA, O’Callaghan JM, Holmes HE, et al. In vivo imaging of tau pathology using multi-parametric quantitative MRI[J]. NeuroImage, 2015, 111: 369-378.
[31]Wang R, Li SY, Chen M, et al. Amide proton transfer magnetic resonance imaging of Alzheimer’s disease at 3.0 Tesla: a preliminary study[J]. Chin Med J(Engl), 2015, 128(5): 615-619.
[32]Ling W, Regatte RR, Navon G, et al. Assessment of glycosaminoglycan concentration in vivo by chemical exchange-dependent saturation transfer(gagCEST)[J]. Proc Natl Acad Sci USA, 2008, 105(7): 2266-2270.

基金

国家自然科学基金(No.30570541,30770632,81271631);盛京医院自由研究者基金(No.2014-02);
 辽宁省临床能力建设项目(LNCCC-B06-2014)。

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