{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:51:44Z","timestamp":1793213504856,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000015","name":"Canadian Cancer Society Research Institute","doi-asserted-by":"publisher","award":["701640"],"award-info":[{"award-number":["701640"]}],"id":[{"id":"10.13039\/501100000015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009408","name":"Fondation Brain Canada","doi-asserted-by":"publisher","award":["705083"],"award-info":[{"award-number":["705083"]}],"id":[{"id":"10.13039\/100009408","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004376","name":"Terry Fox Research Institute","doi-asserted-by":"publisher","award":["1034"],"award-info":[{"award-number":["1034"]}],"id":[{"id":"10.13039\/501100004376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2023,6]]},"abstract":"\n Background<\/jats:title>\n High radiation doses of stereotactic radiosurgery (SRS) for brain metastases (BM) can increase the likelihood of radiation necrosis (RN). Advanced MRI sequences can improve the differentiation between RN and tumor progression (TP).<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To use saturation transfer MRI methods including chemical exchange saturation transfer (CEST) and magnetization transfer (MT) to distinguish RN from TP.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Subjects<\/jats:title>\n Seventy patients (median age 60; 73% females) with BM (75 lesions) post\u2010SRS.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n \n 3\u2010T, CEST imaging using low\/high\u2010power (saturation B\n 1<\/jats:sub>\n \u00a0=\u00a00.52 and 2.0\u2009\u03bcT), quantitative MT imaging using B\n 1<\/jats:sub>\n \u00a0=\u00a01.5, 3.0, and 5.0\u2009\u03bcT, WAter Saturation Shift Referencing (WASSR), WAter Shift And B\n 1<\/jats:sub>\n (WASABI), T\n 1<\/jats:sub>\n , and T\n 2<\/jats:sub>\n mapping. All used gradient echoes except T\n 2<\/jats:sub>\n mapping (gradient and spin echo).\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n Voxel\u2010wise metrics included: magnetization transfer ratio (MTR); apparent exchange\u2010dependent relaxation (AREX); MTR asymmetry; normalized MT exchange rate and pool size product; direct water saturation peak width; and the observed T\n 1<\/jats:sub>\n and T\n 2<\/jats:sub>\n . Regions of interests (ROIs) were manually contoured on the post\u2010Gd T\n 1<\/jats:sub>\n w. The mean (of median ROI values) was compared between groups. Clinical outcomes were determined by clinical and radiologic follow\u2010up or histopathology.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n t<\/jats:italic>\n \u2010Test, univariable and multivariable logistic regression, receiver operating characteristic, and area under the curve (AUC) with sensitivity\/specificity values with the optimal cut point using the Youden index, Akaike information criterion (AIC), Cohen's\n d<\/jats:italic>\n .\n P<\/jats:italic>\n \u2009<\u20090.05 with Bonferroni correction was considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seven metrics showed significant differences between RN and TP. The high\u2010power MTR showed the highest AUC of 0.88, followed by low\u2010power MTR (AUC\u00a0=\u00a00.87). The combination of low\u2010power CEST scans improved the separation compared to individual parameters (with an AIC of 70.3 for low\u2010power MTR\/AREX). Cohen's\n d<\/jats:italic>\n effect size showed that the MTR provided the largest effect sizes among all metrics.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Significant differences between RN and TP were observed based on saturation transfer MRI.<\/jats:p>\n Evidence Level: 3<\/jats:p>\n Technical Efficacy: Stage 2<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.28440","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T12:10:51Z","timestamp":1665490251000},"page":"1713-1725","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Chemical Exchange Saturation Transfer\n MRI<\/scp>\n for Differentiating Radiation Necrosis From Tumor Progression in Brain Metastasis\u2014Application in a Clinical Setting"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3409-9948","authenticated-orcid":false,"given":"Hatef","family":"Mehrabian","sequence":"first","affiliation":[{"name":"Physical Sciences Platform Sunnybrook Research Institute Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-1111","authenticated-orcid":false,"given":"Rachel W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Physical Sciences Platform Sunnybrook Research Institute Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Sahgal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"Theriault","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9883-6142","authenticated-orcid":false,"given":"Wilfred W.","family":"Lam","sequence":"additional","affiliation":[{"name":"Physical Sciences Platform Sunnybrook Research Institute Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sten","family":"Myrehaug","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Lin","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Detsky","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg J.","family":"Stanisz","sequence":"additional","affiliation":[{"name":"Physical Sciences Platform Sunnybrook Research Institute Toronto Ontario Canada"},{"name":"Department of Medical Biophysics University of Toronto Toronto Ontario Canada"},{"name":"Department of Neurosurgery and Pediatric Neurosurgery Medical University of Lublin Lublin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.08.041"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-811161-1.00002-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000493055"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.26.4749"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5034-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1014571900854"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1006\/jmre.1999.1956"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm907"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.24822"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2268"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.1910100113"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.683"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-16-2265"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.26470"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)70057-4"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21873"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.26133"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2009.2035616"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.02.040"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-20624-6"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-018-2846-0"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.25795"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-64912-6"},{"key":"e_1_2_7_25_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.29241"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.10395"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.tn.2016-0069"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4789"},{"key":"e_1_2_7_30_1","first-page":"901","article-title":"Posttherapeutic intraaxial brain tumor: The value of perfusion\u2010sensitive contrast\u2010enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast\u2010enhancing tissue","volume":"21","author":"Sugahara T","year":"2000","journal-title":"Am J Neuroradiol"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2011.04.004"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18890"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-018-0866-7"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141438"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.04.0933"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08204-1"},{"key":"e_1_2_7_37_1","first-page":"201","article-title":"Diffusion\u2010weighted imaging in the follow\u2010up of treated high\u2010grade gliomas: Tumor recurrence versus radiation injury","volume":"25","author":"Hein PA","year":"2004","journal-title":"Am J Neuroradiol"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-017-2545-2"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-019-03379-6"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5958"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1159\/000514297"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.28440","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmri.28440","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.28440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T04:50:16Z","timestamp":1692420616000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.28440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/jmri.28440"],"URL":"https:\/\/doi.org\/10.1002\/jmri.28440","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]},"assertion":[{"value":"2022-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}