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European Radiology
Published in: European Radiology 12/2019

01-12-2019 | Glioma | Magnetic Resonance

Amide proton transfer imaging might predict survival and IDH mutation status in high-grade glioma

Authors: Bio Joo, Kyunghwa Han, Sung Soo Ahn, Yoon Seong Choi, Jong Hee Chang, Seok-Gu Kang, Se Hoon Kim, Jinyuan Zhou, Seung-Koo Lee

Published in: European Radiology | Issue 12/2019

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Abstract

Objectives

To assess the utility of amide proton transfer (APT) imaging as an imaging biomarker to predict prognosis and molecular marker status in high-grade glioma (HGG, WHO grade III/IV).

Methods

We included 71 patients with pathologically diagnosed HGG who underwent preoperative MRI with APT imaging. Overall survival (OS) and progression-free survival (PFS) according to APT signal, clinical factors, MGMT methylation status, and IDH mutation status were analyzed. Multivariate Cox regression models with and without APT signal data were constructed. Model performance was compared using the integrated AUC (iAUC). Associations between APT signals and molecular markers were assessed using the Mann-Whitney test.

Results

High APT signal was a significant predictor for poor OS (HR = 3.21, 95% CI = 1.62–6.34) and PFS (HR = 2.22, 95% CI = 1.33–3.72) on univariate analysis. On multivariate analysis, high APT signals were an independent predictor of poor OS and PFS when clinical factors alone (OS: HR = 2.89; PFS: HR = 2.13), or in combination with molecular markers (OS: HR = 2.85; PFS: HR = 2.00), were included as covariates. The incremental prognostic value of APT signals was significant for OS and PFS. IDH-wild type was significantly associated with high APT signals (p = 0.001) when compared to IDH-mutant; however, there was no difference based on MGMT methylation status (p = 0.208).

Conclusion

High APT signal was a significant predictor of poor prognosis in HGG. APT data showed significant incremental prognostic value over clinical prognostic factors and molecular markers and may also predict IDH mutation status.

Key Points

• Amide proton transfer (APT) imaging is a promising prognostic marker of high-grade glioma.
• APT signals were significantly higher in IDH-wild type compared to IDH-mutant high-grade glioma.
• APT imaging may be valuable for preoperative screening and treatment guidance.
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Metadata
Title
Amide proton transfer imaging might predict survival and IDH mutation status in high-grade glioma
Authors
Bio Joo
Kyunghwa Han
Sung Soo Ahn
Yoon Seong Choi
Jong Hee Chang
Seok-Gu Kang
Se Hoon Kim
Jinyuan Zhou
Seung-Koo Lee
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06203-x

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