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Abstract
Amide proton transfer (APT) imaging is a magnetic resonance (MR) molecular imaging technique that is sensitive to mobile proteins and peptides in living tissue. Studies have shown that APT-related signal intensity (APTSI) parallels with the malignancy grade of gliomas, allowing the preoperative assessment of tumor grades. An increased APTSI in malignant gliomas has been attributed to cytosolic proteins and peptides in proliferating tumor cells; however, the exact underlying mechanism is poorly understood. To get an insight into the mechanism of high APTSI in malignant gliomas, we investigated the correlations between APTSI and several MR imaging parameters including apparent diffusion coefficient (ADC), relative cerebral blood volume and pharmacokinetic parameters obtained in the same regions-of-interest in 22 high-grade gliomas. We found a significant positive correlation between APTSI and ADC (ρ = 0.625 and 0.490 for observers 1 and 2, respectively; p < 0.001 for both), which is known to be inversely correlated with cell density. Multiple regression analysis revealed that ADC was significantly associated with APTSI (p < 0.001 for both observers). Our results suggest possible roles of extracellular proteins and peptides in high APTSI in malignant gliomas.
Highlights
Amide proton transfer (APT) imaging is a magnetic resonance (MR) molecular imaging technique that is sensitive to mobile proteins and peptides in living tissue
The most widely accepted hypothesis for higher APT-related signal intensity (APTSI) in malignant gliomas is that APTSI reflects cytosolic protein that would increase in malignant gliomas with a higher proliferative activity
The inclusion criteria were (1) magnetic resonance imaging (MRI) examination including APT-weighted imaging (APTWI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) imaging, and dynamic susceptibility contrast (DSC) perfusion imaging on the same day within 14 days before surgery and (2) pathological confirmation of high-grade diffuse glioma
Summary
Amide proton transfer (APT) imaging is a magnetic resonance (MR) molecular imaging technique that is sensitive to mobile proteins and peptides in living tissue. Studies have shown that APT-related signal intensity (APTSI) parallels with the malignancy grade of gliomas, allowing the preoperative assessment of tumor grades. An increased APTSI in malignant gliomas has been attributed to cytosolic proteins and peptides in proliferating tumor cells; the exact underlying mechanism is poorly understood. Our results suggest possible roles of extracellular proteins and peptides in high APTSI in malignant gliomas. Several studies have shown that APT-related signal intensity (APTSI) increases with increasing malignancy grades as defined by the World Health Organization (WHO)[3,4,5,6]. This study correlates APTSI with diffusion and perfusion MRI parameters in malignant gliomas
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