BACKGROUND Lung cancer brain metastases are very common and one of the common causes of treatment failure. We aimed to examine the clinical use of chemical exchange saturation transfer (CEST) technology in the evaluation of brain metastases for lung cancer diagnosis and prognosis. METHODS We included26 cases of lung cancer brain metastases, 15 cases of gliomas, and 20 cases with normal tests. The magnetization transfer ratio (MTR;3.5 ppm) image from the GRE-EPI-CEST sequence was analyzed using the ASSET technique and APT technology. The MTR values were measured in the lesion-parenchymal, edema, and non-focus regions, and the MTR image was compared with the conventional MRI. ANOVA and t-test were used for statistical analysis. RESULTS The lesion-parenchymal, edema, and non-focus areas in the metastatic-tumor-group were red-yellow, yellow-green, and green-blue, and the MTR values were 3.29 ± 1.14%,1.28 ± 0.36%,and 1.26 ± 0.31%, respectively. However, in the glioma-group, the corresponding areas were red, red-yellow, and green-blue, and the MTR values were 6.29 ± 1.58%, 2.87 ± 0.65%, and 1.03 ± 0.30%, respectively. The MTR values of the corresponding areas in the normal-group were 1.07 ± 0.22%,1.04 ± 0.23%, and 1.06 ± 0.24%, respectively. Traditional MR images are in black-white contrast and no metabolic information is displayed. The MTRvalues of the three regions were significantly different among the three groups. The values were also significantly different between the parenchymal and edema areas in the metastatic-tumor-group. There were significant differences in the MTR values between the non-lesion and edema regions, but there was no significant difference between the edema and non-focus areas. In the glioma-group, there were significant differences in the MTR values between the parenchymal and edema areas, between the parenchymal and non-focus areas, and between the edema and non-focus areas. CONCLUSIONS CEST reflects the protein metabolism; therefore, early diagnosis of brain metastases and assessment of the prognosis can be achieved using molecular imaging.

中文翻译：

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3.0 T磁共振化学交换饱和转移成像在肺癌脑转移中的初步应用。

背景技术肺癌脑转移是非常普遍的，并且是治疗失败的常见原因之一。我们旨在检查化学交换饱和转移（CEST）技术在评估脑转移是否可用于肺癌诊断和预后方面的临床应用。方法我们纳入了26例肺癌脑转移瘤，15例脑胶质瘤和20例正常检查的病例。使用ASSET技术和APT技术分析了GRE-EPI-CEST序列的磁化传递比率（MTR; 3.5 ppm）图像。在病变实质，水肿和非聚焦区域测量MTR值，并将MTR图像与常规MRI进行比较。方差分析和t检验用于统计分析。结果转移性肿瘤组的病变实质，水肿和非灶性区域为红黄色，黄绿色，MTR值分别为3.29±1.14％，1.28±0.36％和1.26±0.31％。然而，在神经胶质瘤组中，相应的区域为红色，红黄色和绿蓝色，MTR值分别为6.29±1.58％，2.87±0.65％和1.03±0.30％。正常组相应区域的MTR值分别为1.07±0.22％，1.04±0.23％和1.06±0.24％。传统的MR图像具有黑白对比，并且不会显示任何代谢信息。三组之间三个区域的MTR值显着不同。在转移性肿瘤组的实质和水肿区域之间，该值也显着不同。非病变部位和水肿部位的MTR值存在显着差异，但是水肿和非聚焦区域之间没有显着差异。在神经胶质瘤组中，实质和水肿区域之间，实质和非聚焦区域之间以及水肿和非聚焦区域之间的MTR值存在显着差异。结论CEST反映了蛋白质的代谢。因此，可以使用分子成像技术对脑转移进行早期诊断并评估预后。