PURPOSE Imaging glioma biology holds great promise to unravel the complex nature of these tumors. Besides well-established imaging techniques such O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET and dynamic susceptibility contrast (DSC) perfusion imaging, amide proton transfer-weighted (APTw) imaging has emerged as a promising novel MR technique. In this study, we aimed to better understand the relation between these imaging biomarkers and how well they capture cellularity and vascularity in newly diagnosed gliomas. METHODS Preoperative MRI and FET-PET data of 46 patients (31 glioblastoma and 15 lower-grade glioma) were segmented into contrast-enhancing and FLAIR-hyperintense areas. Using established cutoffs, we calculated hot-spot volumes (HSV) and their spatial overlap. We further investigated APTw and CBV values in FET-HSV. In a subset of 10 glioblastoma patients, we compared cellularity and vascularization in 34 stereotactically targeted biopsies with imaging. RESULTS In glioblastomas, the largest HSV was found for APTw, followed by PET and CBV (p < 0.05). In lower-grade gliomas, APTw-HSV was clearly lower than in glioblastomas. The spatial overlap of HSV was highest between APTw and FET in both tumor entities and regions. APTw correlated significantly with cellularity, similar to FET, while the association with vascularity was more pronounced in CBV and FET. CONCLUSIONS We found a relevant spatial overlap in glioblastomas between hotspots of APTw and FET both in contrast-enhancing and FLAIR-hyperintense tumor. As suggested by earlier studies, APTw was lower in lower-grade gliomas compared with glioblastomas. APTw meaningfully contributes to biological imaging of gliomas.

中文翻译：

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影像神经胶质瘤生物学：在新诊断的神经胶质瘤中氨基酸PET，酰胺质子转移和灌注加权MRI的空间比较。

目的影像胶质瘤生物学具有广阔的前景，有望揭示这些肿瘤的复杂性质。除了成熟的成像技术，例如O-（2- [18F]氟乙基）-L-酪氨酸（FET）-PET和动态磁化率对比（DSC）灌注成像外，酰胺质子转移加权（APTw）成像也应运而生新颖的MR技术。在这项研究中，我们旨在更好地了解这些成像生物标记物之间的关系，以及它们在新诊断的神经胶质瘤中捕获细胞和血管的能力。方法将46例患者（31例胶质母细胞瘤和15例低级神经胶质瘤）的术前MRI和FET-PET数据分为对比增强和FLAIR高敏区域。使用确定的临界值，我们计算了热点体积（HSV）及其空间重叠。我们进一步研究了FET-HSV中的APTw和CBV值。在10名胶质母细胞瘤患者的子集中，我们比较了34例针对性立体定位的活检组织中的细胞形成和血管形成情况。结果在胶质母细胞瘤中，发现APTw的HSV最大，其次是PET和CBV（p <0.05）。在低级神经胶质瘤中，APTw-HSV明显低于胶质母细胞瘤。在肿瘤实体和区域中，APTw和FET之间HSV的空间重叠最高。与FET相似，APTw与细胞性显着相关，而CBV和FET中与血管性的相关性更为明显。结论我们发现胶质母细胞瘤在增强造影剂和FLAIR-高强度肿瘤中在APTw和FET热点之间存在相关的空间重叠。如较早的研究所提示，低级神经胶质瘤中的APTw低于胶质母细胞瘤。