{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:10:20Z","timestamp":1785820220446,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["445704496"],"award-info":[{"award-number":["445704496"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance in Med"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to compare the potential of asymmetry\u2010based (APTw<jats:sub>asym<\/jats:sub>), Lorentzian\u2010fit\u2010based (PeakAreaAPT and MT<jats:sub>const<\/jats:sub>), and relaxation\u2010compensated (MTR<jats:sub>Rex<\/jats:sub>APT and MTR<jats:sub>Rex<\/jats:sub>MT) CEST contrasts of the amide proton transfer (APT) and semi\u2010solid magnetization transfer (ssMT) for early response assessment and prediction of progression\u2010free survival (PFS) in patients with glioma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010two study participants underwent CEST\u2010MRI at 3T from July 2018 to December 2021 in a prospective clinical trial four to 6\u2009wk after the completion of radiotherapy for diffuse glioma. Tumor segmentations were performed on T<jats:sub>2w<\/jats:sub>\u2010FLAIR and contrast\u2010enhanced T<jats:sub>1w<\/jats:sub> images. Therapy response assessment and determination of PFS were performed according to response assessment in neuro oncology (RANO) criteria using clinical follow\u2010up data with a median observation time of 9.2\u2009mo (range, 1.6\u201340.8) and compared to CEST MRI metrics. Statistical testing included receiver operating characteristic analyses, Mann\u2013Whitney\u2010<jats:italic>U<\/jats:italic>\u2010test, Kaplan\u2013Meier analyses, and logrank\u2010test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MT<jats:sub>const<\/jats:sub> (AUC\u2009=\u20090.79, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) showed a stronger association with RANO response assessment compared to PeakAreaAPT (AUC\u2009=\u20090.71, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and MTR<jats:sub>Rex<\/jats:sub>MT (AUC\u2009=\u20090.71, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), and enabled differentiation of participants with pseudoprogression (<jats:italic>n<\/jats:italic>\u2009=\u20098) from those with true progression (AUC\u2009=\u20090.79, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Furthermore, MT<jats:sub>const<\/jats:sub> (HR\u2009=\u20093.04, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), PeakAreaAPT (HR\u2009=\u20090.39, <jats:italic>p<\/jats:italic>\u2009=\u20090.03), and APTw<jats:sub>asym<\/jats:sub> (HR\u2009=\u20092.63, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were associated with PFS. MTR<jats:sub>Rex<\/jats:sub>APT was not associated with any outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MT<jats:sub>const<\/jats:sub>, PeakAreaAPT, and APTw<jats:sub>asym<\/jats:sub> imaging predict clinical outcome by means of progression\u2010free survival. Furthermore, MT<jats:sub>const<\/jats:sub> enables differentiation of radiation\u2010induced pseudoprogression from disease progression. Therefore, the assessed metrics may have synergistic potential for supporting clinical decision making during follow\u2010up of patients with glioma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mrm.29746","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T07:33:48Z","timestamp":1686814428000},"page":"1569-1581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Semi\u2010solid <scp>MT<\/scp> and <scp>APTw CEST\u2010MRI<\/scp> predict clinical outcome of patients with glioma early after radiotherapy"],"prefix":"10.1002","volume":"90","author":[{"given":"Florian","family":"Kroh","sequence":"first","affiliation":[{"name":"Division of Medical Physics in Radiology German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"Department of Physics and Astronomy University of Heidelberg  Heidelberg 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