优化单体素点分辨波谱在体靶向检测胶质瘤特异性代谢物胱硫醚的研究  

Optimization of Single-Voxel PRESS Spectroscopy for In Vivo Detection of Glioma-Specific Metabolite Cystathionine

作　　者：聂壮 周敏[1] 赵洁[1] 肖瑶[1] 颜冰清 雷子乔[1] NIE Zhuang;ZHOU Min;ZHAO Jie(Department of Radiology,Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,Hubei Provincial Clinical Research Center for Precision Radiology&Interventional Medicine,Hubei Province Key Laboratory of Molecular Imaging,Wuhan,Hubei Province 430022,P.R.China)

机构地区：[1]华中科技大学同济医学院附属协和医院放射科、湖北省精准智能放射诊断与介入治疗临床医学研究中心、分子影像湖北省重点实验室,武汉430022

出　　处：《临床放射学杂志》2025年第3期522-528,共7页Journal of Clinical Radiology

摘　　要：目的优化点分辨波谱(PRESS)的回波时间(TE),以检测胶质瘤中的胱硫醚,并评估PRESS波谱在识别1p/19q共缺失分子分型方面的诊断准确性。方法通过计算机模拟激发和模体实验优化PRESS的TE,以更好地区分胱硫醚和重叠的天冬氨酸多重峰。随后,将优化后的PRESS序列和97 ms TE PRESS序列应用于前瞻性纳入的84例疑似胶质瘤或胶质瘤复发的患者。通过拟合包含和不包含天冬氨酸的基组集来研究天冬氨酸对胱硫醚量化的影响,并评估PRESS对1p/19q共缺失胶质瘤的诊断表现。结果PRESS的TE优化为TE=45 ms,胱硫醚和天冬氨酸的谱峰模式在模拟激发和模体实验中一致。在临床实验中,97 ms TE PRESS中不包含天冬氨酸拟合得到的胱硫醚平均浓度显著高于使用完整基组集拟合的浓度[(1.97±2.01)mM vs.(1.55±1.95)mM,P<0.01],而45 ms TE PRESS方法则无显著差异[(0.801±1.217)mM vs.(0.796±1.217)mM,P=0.494]。45 ms方法的胱硫醚浓度与编辑MRS的相关性优于97 ms方法(r=0.68 vs.0.49,P<0.01)。在鉴别1p/19q共缺失胶质瘤方面,45 ms TE PRESS的敏感度和特异度分别为66.7%和73.7%,97 ms TE PRESS的敏感度和特异度分别为44.4%和52.5%。结论45 ms TE PRESS较97 ms方法提供了更精确的胱硫醚检测,将有助于1p/19q共缺失胶质瘤的无创诊断和患者的治疗反应监测。PRESS在1p/19q共缺失胶质瘤中表现出中等诊断性能,表明需要进一步研究。Objective Cystathionine accumulates selectively in 1p/19q-codeleted gliomas and can serve as a potential noninvasive biomarker.This study aims to optimize the echo time(TE)of point-resolved spectroscopy(PRESS)for cystathionine detection in gliomas and to evaluate the diagnostic accuracy of PRESS for identifying 1p/19q codeletion.Methods The TE of PRESS was optimized using numerical simulations and phantom experiments to better resolve the cystathionine signal from the overlapping aspartate multiplets at 2.72 ppm.The optimized PRESS sequence,as well as the 97 ms TE PRESS sequence,was then applied to 84 prospectively enrolled patients suspected of having glioma or glioma recurrence.Fitting analyses for PRESS data were performed with and without aspartate to examine the influence of aspartate on cystathionine quantification.The diagnostic performance of PRESS sequences for identifying 1p/19q codeletion was assessed.Results The echo time of the PRESS sequence was optimized to TE=45 ms.The spectral patterns of cystathionine and aspartate were consistent between simulation and phantom experiments.In clinical experiments,the mean concentration of cystathionine fitted without aspartate was significantly higher than that fitted with a full basis set for the 97 ms TE PRESS[(1.97±2.01)mM vs.(1.55±1.95)mM,P<0.01],but not significantly different for the 45 ms TE PRESS[(0.801±1.217)mM vs.(0.796±1.217)mM,P=0.494].The cystathionine concentrations obtained using the 45 ms TE PRESS were better correlated with those obtained using MEGA-editing MRS than those obtained using the 97 ms TE PRESS(r=0.68 vs.0.49,P<0.01).The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7%and 73.7%for the 45 ms TE PRESS,and 44.4%and 52.5%for the 97 ms TE PRESS,respectively.Conclusion The 45 ms TE PRESS provides more precise cystathionine detection than the 97 ms method and is expected to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas and treatment response monitoring in those patients.The moderate diagno

关 键 词：磁共振波谱 点分辨波谱 1p/19q共缺失 胶质瘤 胱硫醚 

分 类 号：R73[医药卫生—肿瘤]