Amide proton transfer-weighted magnetic resonance image-guided stereotactic biopsy in patients with newly diagnosed gliomas.
Amide proton transfer-weighted magnetic resonance image-guided stereotactic biopsy in patients with newly diagnosed gliomas.
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新诊断为神经胶质瘤的患者的酰胺质子转移加权图像引导的立体定向活检。
DOI：
10.1016/j.ejca.2017.06.009
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Jiang S;Eberhart CG;Zhang Y;Heo HY;Wen Z;Blair L;Qin H;Lim M;Quinones-Hinojosa A;Weingart JD;Barker PB;Pomper MG;Laterra J;van Zijl PCM;Blakeley JO;Zhou J
采用WHO标准的病理评估是诊断胶质瘤的金标准。然而，诊断的准确性受到组织取样的限制，特别是对于浸润性异质肿瘤。我们评估了酰胺质子转移加权 (APTw) MRI 引导的组织取样的准确性，以通过新疑似神经胶质瘤患者的放射学-组织病理学相关性来识别高级别神经胶质瘤区域。 24 名先前未诊断出神经胶质瘤的患者在第一次神经外科手术之前接受了体积 APTw MRI。通过 APTw 图像引导立体定向活检总共收集了 70 个标本。对所有样本的细胞结构、坏死、增殖和神经胶质瘤 WHO 等级进行了分析，并与相应的 APTw 信号强度相关。 33 个标本显示 II 级病理，14 个 III 级，15 个 IV 级，8 个标本仅显示瘤周水肿。在六名患者的单个病变内发现了多个神经胶质瘤级别。高等级标本的活检部位的 APTw 信号强度和每位患者所有活检部位的最大 APTw 值显着高于低等级标本。 APTw 信号强度与细胞结构 (R = 0.757) 和增殖 (R = 0.538) 呈显着正相关。多元线性回归分析表明肿瘤细胞结构和增殖指数是 APTw 信号强度的最佳预测因子。 APTw 成像识别出具有较高细胞结构和增殖的肿瘤区域，从而可以识别异质神经胶质瘤内的高级区域。 APTw 成像可以很容易地转化为更广泛的用途，并通过提高浸润性神经胶质瘤患者肿瘤采样的准确性来协助诊断神经外科手术
Pathological assessment using WHO criteria is the gold standard for diagnosis of gliomas. However, the accuracy of diagnosis is limited by tissue sampling, particularly for infiltrating, heterogeneous tumors. We assessed the accuracy of amide proton transfer-weighted (APTw) MRI-guided tissue sampling to identify regions of high-grade glioma via radiographic-histopathologic correlation in patients with newly suspected glioma. Twenty-four patients with previously undiagnosed gliomas underwent a volumetric APTw MRI prior to their first neurosurgical procedure. A total of 70 specimens were collected via APTw image-directed stereotactic biopsy. Cellularity, necrosis, proliferation, and glioma WHO grade were analyzed for all specimens and correlated with corresponding APTw signal intensities. Thirty-three specimens displayed grade-II pathology, 14 grade-III, 15 grade-IV, and eight specimens revealed only peritumoral edema. Multiple glioma grades were found within a single lesion in six patients. APTw signal intensities of the biopsied sites and the maximum APTw values across all biopsied sites in each patient were significantly higher for high-grade versus low-grade specimens. APTw signal intensities were significantly positively correlated with cellularity (R = 0.757) and proliferation (R = 0.538). Multiple linear regression analysis showed that tumor cellularity and proliferation index were the best predictors of APTw signal intensities. APTw imaging identified tumor areas of higher cellularity and proliferation, allowing identification of high-grade regions within heterogeneous gliomas. APTw imaging can be readily translated for more widespread use and assist diagnostic neurosurgical procedures by increasing the accuracy of tumor sampling in patients with infiltrating gliomas
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影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
3.3
作者：
Heo HY;Zhang Y;Jiang S;Lee DH;Zhou J
通讯作者：
Zhou J
影响因子：
2.2
作者：
Ward, KM;Aletras, AH;Balaban, RS
通讯作者：
Balaban, RS
DOI：
10.1093/brain/awu374
发表时间：
2015-01
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Harston GW;Tee YK;Blockley N;Okell TW;Thandeswaran S;Shaya G;Sheerin F;Cellerini M;Payne S;Jezzard P;Chappell M;Kennedy J
通讯作者：
Kennedy J
影响因子：
9.9
作者：
Scott, JN;Brasher, PMA;Forsyth, PA
通讯作者：
Forsyth, PA