@article{item_3030374,
  title = {{Relaxation-compensated amide proton transfer (APT) MRI signal intensity is associated with survival and progression in high-grade glioma patients}},
  journal = {{European Radiology}},
  abstract = {{Objectives The purpose of this study was to investigate the association of relaxation-compensated chemical exchange saturation transfer (CEST) MRI with overall survival (OS) and progression-free survival (PFS) in newly diagnosed high-grade glioma (HGG) patients. Methods Twenty-six patients with newly diagnosed high-grade glioma (WHO grades III\textendashIV) were included in this prospective IRB-approved study. CEST MRI was performed on a 7.0-T whole-body scanner. Association of patient OS/PFS with relaxation-compensated CEST MRI (amide proton transfer (APT), relayed nuclear Overhauser effect (rNOE)/NOE, downfield-rNOE-suppressed APT (dns-APT)) and diffusion-weighted imaging (apparent diffusion coefficient) were assessed using the univariate Cox proportional hazards regression model. Hazard ratios (HRs) and corresponding 95\textpercent confidence intervals were calculated. Furthermore, OS/PFS association with clinical parameters (age, gender, O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status, and therapy: biopsy + radio-chemotherapy vs. debulking surgery + radio-chemotherapy) were tested accordingly. Results Relaxation-compensated APT MRI was significantly correlated with patient OS (HR \textequals 3.15, p \textequals 0.02) and PFS (HR \textequals 1.83, p \textequals 0.009). The strongest association with PFS was found for the dns-APT metric (HR \textequals 2.61, p \textequals 0.002). These results still stand for the relaxation-compensated APT contrasts in a homogenous subcohort of n \textequals 22 glioblastoma patients with isocitrate dehydrogenase (IDH) wild-type status. Among the tested clinical parameters, patient age (HR \textequals 1.1, p \textequals 0.001) and therapy (HR \textequals 3.68, p \textequals 0.026) were significant for OS; age additionally for PFS (HR \textequals 1.04, p \textequals 0.048). Conclusion Relaxation-compensated APT MRI signal intensity is associated with overall survival and progression-free survival in newly diagnosed, previously untreated glioma patients and may, therefore, help to customize treatment and response monitoring in the future.}},
  volume = {29},
  number = {9},
  pages = {4957--4967},
  publisher = {Springer International},
  address = {Berlin},
  year = {2019},
  slug = {item_3030374},
  author = {Paech, D and Dreher, C and Regnery, S and Meissner, JE and Goerke, S and Windschuh, J and Oberhollenzer, J and Schultheiss, M and Deike-Hofmann, K and Bickelhaupt, S and Radbruch, A and Zaiss, M and Unterberg, A and Wick, W and Bendszus, M and Bachert, P and Ladd, ME and Schlemmer, HP}
}