The Application of Quasi‐Steady‐State Chemical Exchange Saturation Transfer Imaging in the Visualization of Glioma Infiltration and the Optimal Extent of Resection Establishment

作者：Yinwei Ying, Dongdong Wang, Yajing Zhao, Kai Quan, Xuanxuan Li, Yuxi Xie, Nan Mei, Jie Chen, Zhuoying Ruan, Rong Xu, Guoqiang Ren, Ruibin Liu, Yin Wu, Yiping Lu, Bo Yin · 发表于：Journal of Magnetic Resonance Imaging · 年份：2025 · DOI：10.1002/jmri.29786 · 被引用次数：4 · 研究领域：Lanthanide and Transition Metal Complexes、Magnetism in coordination complexes、Advanced MRI Techniques and Applications

BACKGROUND: The quasi-steady-state (QUASS) algorithm improves chemical exchange saturation transfer (CEST) reliability, but its efficacy in detecting glioma infiltration is unclear. PURPOSE: To assess apparent and QUASS CEST in visualizing glioma infiltration and predicting optimal extent-of-resection (EOR). STUDY TYPE: Prospective. POPULATION: 72 adult-type diffuse glioma patients (37 males, 49.57 ± 14.76 years) and 24 healthy volunteers (12 males, 48.71 ± 14.23 years). FIELDSTRENGTH/SEQUENCE: 3 T, fast spin-echo CEST. ASSESSMENT: Apparent and QUASS CEST effects (amide proton transfer [APT], combined magnetization transfer and nuclear overhauser enhancement and the 2-ppm chemical exchange saturation transfer peak) were calculated in solid tumor, edema, contralateral normal apparent white matter (CNAWM) in glioma patients, and white matter in healthy individuals (WMH). Comparisons were made between these four regions, high-/low-grade gliomas (HGGs/LGGs), and isocitrate dehydrogenase (IDH)-mutant/wild-type gliomas. Twenty-seven biopsy samples from glioblastomas and peritumoral regions were selected and traced back to the original images. Then, correlations between CEST effects, cellularity, and Ki-67 labeling index (LI) were assessed. An optimal cutoff value for the normalized ratios of QUASS APT (QUASS_rAPT) was generated. STATISTICAL TESTS: Linear mixed models, t-test, receiver-operating characteristic analysis, and Pearson's correlation tests were used. The statistical sign...