Amide proton transfer-weighted imaging and derived radiomics in the classification of adult-type diffuse gliomas

Minghao Wu; Tongling Jiang; Min Guo; Yunyun Duan; Zhizheng Zhuo; Jinyuan Weng; Cong Xie; Jun Sun; Junjie Li; Dan Cheng; Xing Liu; Jiang Du; Xianchang Zhang; Yi Zhang; Yaou Liu

doi:10.1007/s00330-023-10343-6

Amide proton transfer-weighted imaging and derived radiomics in the classification of adult-type diffuse gliomas

Eur Radiol. 2023 Oct 19. doi: 10.1007/s00330-023-10343-6. Online ahead of print.

Authors

Minghao Wu¹, Tongling Jiang², Min Guo¹, Yunyun Duan¹, Zhizheng Zhuo¹, Jinyuan Weng³, Cong Xie¹, Jun Sun¹, Junjie Li¹, Dan Cheng¹, Xing Liu⁴, Jiang Du⁴, Xianchang Zhang⁵, Yi Zhang⁶, Yaou Liu⁷

Affiliations

¹ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China.
³ Department of Medical Imaging Product, Neusoft, Group Ltd, Shenyang, 110179, China.
⁴ Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, 10070, China.
⁵ MR Collaboration, Siemens Healthineers Ltd, Beijing, China.
⁶ Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China. yizhangzju@zju.edu.cn.
⁷ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. yaouliu80@163.com.

PMID: 37855851
DOI: 10.1007/s00330-023-10343-6

Abstract

Objectives: To evaluate the utility of amide proton transfer-weighted (APTw) MRI imaging and its derived radiomics in classifying adult-type diffuse glioma.

Materials and methods: In this prospective study, APTw imaging was performed on 129 patients with adult-type diffuse gliomas. The mean APTw-related metrics (chemical exchange saturation transfer ratio (CESTR), CESTR normalized with the reference value (CESTR^nr), and relaxation-compensated inverse magnetization transfer ratio (MTR_Rex)) and radiomic features within 3D tumor masks were extracted. APTw-radiomics models were developed using a support vector machine (SVM) classifier. Sensitivity analysis with tumor area of interest, different histogram cutoff values, and other classifiers were conducted.

Results: CESTR, CESTR^nr, and MTR_Rex in glioblastomas were all significantly higher (p < 0.0003) than those of oligodendrogliomas and astrocytomas, with no significant difference between oligodendrogliomas and astrocytomas. The APTw-related metrics for IDH-wildtype and high-grade gliomas were significantly higher (p < 0.001) than those for the IDH-mutant and low-grade gliomas, with area under the curve (AUCs) of 0.88 for CESTR. The CESTR-radiomics models demonstrated accuracies of 84% (AUC 0.87), 83% (AUC 0.83), 90% (AUC 0.95), and 84% (AUC 0.86) in predicting the IDH mutation status, differentiating glioblastomas from astrocytomas, distinguishing glioblastomas from oligodendrogliomas, and determining high/low grade prediction, respectively, but showed poor performance in distinguishing oligodendrogliomas from astrocytomas (accuracy 63%, AUC 0.63). The sensitivity analysis affirmed the robustness of the APTw signal and APTw-derived radiomics prediction models.

Conclusion: APTw imaging, along with its derived radiomics, presents a promising quantitative approach for prediction IDH mutation and grading adult-type diffuse glioma.

Clinical relevance statement: Amide proton transfer-weighted imaging, a quantitative imaging biomarker, coupled with its derived radiomics, offers a promising non-invasive approach for predicting IDH mutation status and grading adult-type diffuse gliomas, thereby informing individualized clinical diagnostics and treatment strategies.

Key points: • This study evaluates the differences of different amide proton transfer-weighted metrics across three molecular subtypes and their efficacy in classifying adult-type diffuse glioma. • Chemical exchange saturation transfer ratio normalized with the reference value and relaxation-compensated inverse magnetization transfer ratio effectively predicts IDH mutation/grading, notably the first one. • Amide proton transfer-weighted imaging and its derived radiomics holds potential to be used as a diagnostic tool in routine clinical characterizing adult-type diffuse glioma.

Keywords: Amides; Classification; Gliomas; Magnetic resonance imaging; Support vector machine.