The Evaluation Of The Application Of Amide Proton Transfer MR Imaging In Meningiomas And Glioblastomas

BackgroundAmide proton transfer(APTw)imaging is a novel molecular MRI technique based on chemical exchange saturation transfer(CEST),which was designed to detect amide protons of endogenous mobile proteins and peptides in tissue.This technique does not require the use of exogenous contrast agents and is applied to imaging through the exchange between amide protons of endogenous moblie proteins and peptides and protons of bulk water.We tried to evaluation the usefulness of APTw MRI in the study of meningioma and glioblastomas(GBMs and explore the clinical application value of APTw technology.PurposeTo explore the value of APTw technology in the grading,classifying meningiomas and predicting the proliferation index and hardness of meningioma,also in distinguishing GBMs and single brain metastases(SBMs)and assessment of peritumoral edema characteristics of GBMs.Method(1)79 cases of meningiomas patients underwent a preoperative APTw MRI sequence before clinical intervention.The APTw values of tumor core and the Ki-67 index were recorded.Independent sample t test were applied to analysis between the APTw values and tumor grade,and Pearson correlation analysis between the APTw values and Ki-67 Relevance of expression;(2)53 cases of WHO class I meningiomas patients underwent a preoperative APTw MRI sequence before clinical intervention.The APTw values of tumor core were recorded,One way ANOVA were applied to analysis between different subtypes of meningiomas.(3)48 cases of meningiomas patients who underwent APTw preoperatively and obtained tumor hardness determinations intraoperative were followed up.The APTw values of tumor core were recorded.Independent sample t-test were applied to analysis between APTw values of the hard and non-hardened groups.One way ANOVA was applied to analysis the differences in APTw values between the hard,medium,and soft groups.(4)43 patients with GBMs and 45 patients with SBMs underwent a preoperative APTw MRI sequence before clinical intervention.The APTw values and relative APTw values in the core and peritumoral edema area were obtained and compared between GBMs and SBMs.(5)Follow up GBMs and meningiomas APTw images with moderate and severe edema,each group have 12 cases.All cases underwent a preoperative APTw MRI sequence before clinical intervention.APTw and rAPTw values of tumor peritumoral edema were record.One-way ANOVA was applied to analysis the differences in APTw values between different peritumoral edema areas in GBMs,Independent sample t test compares the differences in APTw values of peritumoral edema between GBMs and meningiomas;Result(1)The APTwmax-min value of WHO grade ?meningiomas was significantly higher than that of WHO grade ? meningiomas,and APTwmin value of WHO grade ?meningiomas was significantly lower than that of WHO grade ? meningiomas,and there was a strong correlation between APTwmax and Ki-67 index;(2)The values of APTwmax,APTwmean and APTwmin in microcystic meningiomas were significantly higher than those in Meningothelial,Fibroblastic and Transitional meningiomas,APTwmax-min value was in microcystic meningiomas was significantly lower than that in Meningothelial,Fibroblastic and Transitional meningiomas;(3)The values of APTwmin and APTwmean were significantly lower in the hardness group than in the non-hardness group;when the non-hard group was divided into medium hardness group and the soft group.The APTwmin and APTwmean values in the hard group were significantly lower than those in the medium hardness group and the soft group.But there was no significant difference in the APTwmin and APTwmean values between medium hardness group and the soft group.(4)The APTw parameters in the tumor core were not significantly different between the GBMs and SBMs groups.The APTw parameters in the peritumor edema area of the GBMs were significantly higher than those in SBMs groups.The APTwmin was the best parameter in distinguishing GBMs and SBMs.(5)The APTw parameters in the near peritumoral edema area and the middle peritumoral edema area in the GBMs group was significantly higher than that in the meningioma group,but the APTw values in the far peritumoral edema area was not significantly different between GBMs and SBMs group.Conclusion(1)As a promising supplementary technique,APTw MRI could be used to grading meningiomas and predicting the proliferative activity;(2)APTw technology could be used to distinguish between microcapsular and Meningothelial,Fibroblastic and Transitional meningiomas meningioma;(3)APTw MRI could be used to predict the hardness of meningioma;(4)APTw MRI could be used to distinguish GBMs from SBMs;(5)The APTw MRI could be used to assess the peritumoral edema of GBMs.