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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StatePublished - Jan 1 2019

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Amides
Glioma
Protons
Mutation
Survival
Disease-Free Survival
Methylation
Proportional Hazards Models
Area Under Curve
Multivariate Analysis
Biomarkers

Keywords

  • Glioma
  • Isocitrate dehydrogenase
  • Magnetic resonance imaging
  • Prognosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Amide proton transfer imaging might predict survival and IDH mutation status in high-grade glioma. / Joo, Bio; Han, Kyunghwa; Ahn, Sung Soo; Choi, Yoon Seong; Chang, Jong Hee; Kang, Seok Gu; Kim, Se Hoon; Zhou, Jinyuan; Lee, Seung Koo.

In: European Radiology, 01.01.2019.

Research output: Contribution to journalArticle

Joo, Bio ; Han, Kyunghwa ; Ahn, Sung Soo ; Choi, Yoon Seong ; Chang, Jong Hee ; Kang, Seok Gu ; Kim, Se Hoon ; Zhou, Jinyuan ; Lee, Seung Koo. / Amide proton transfer imaging might predict survival and IDH mutation status in high-grade glioma. In: European Radiology. 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.",
keywords = "Glioma, Isocitrate dehydrogenase, Magnetic resonance imaging, Prognosis",
author = "Bio Joo and Kyunghwa Han and Ahn, {Sung Soo} and Choi, {Yoon Seong} and Chang, {Jong Hee} and Kang, {Seok Gu} and Kim, {Se Hoon} and Jinyuan Zhou and Lee, {Seung Koo}",
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T1 - Amide proton transfer imaging might predict survival and IDH mutation status in high-grade glioma

AU - Joo, Bio

AU - Han, Kyunghwa

AU - Ahn, Sung Soo

AU - Choi, Yoon Seong

AU - Chang, Jong Hee

AU - Kang, Seok Gu

AU - Kim, Se Hoon

AU - Zhou, Jinyuan

AU - Lee, Seung Koo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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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KW - Prognosis

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