What question did this study set out to answer?

This research aims to evaluate the performance of 5T GLU‐CEST imaging for diagnosing and stratifying diffuse gliomas based on histological grade and IDH mutation status.

April 22, 2026

5T‐Based Glutamate Chemical Exchange Saturation Transfer Imaging for Adult Diffuse Glioma Stratification

Key Points

This research aims to evaluate the performance of 5T GLU‐CEST imaging for diagnosing and stratifying diffuse gliomas based on histological grade and IDH mutation status.
Conducted MRI scans using 5T GLU‐CEST and APT‐CEST on phantom models and 40 adult glioma patients.
Measured and compared GLU‐CEST and APT‐CEST values across different glioma grades and IDH statuses using statistical tests.
Analyzed correlations between GLU‐CEST signals, glutamate concentration, and pH levels.
GLU‐CEST signals showed a strong positive correlation with glutamate levels and a negative correlation with pH.
Significant differences in ΔGLU‐CEST and GLU‐CEST were found between glioma grades, particularly between grades 2 and 4 and grades 3 and 4.
GLU‐CEST demonstrated higher diagnostic efficacy compared to APT‐CEST in classifying IDH status in gliomas.

Abstract

ABSTRACT Background Glutamate chemical exchange saturation transfer (GLU‐CEST) is a non‐invasive in vivo approach for glutamate detection, but its performance for glioma evaluation at 5T remains incompletely defined. Purpose To investigate factors influencing 5T GLU‐CEST and its diagnostic value in glioma stratification. Study Type Prospective. Phantom and Population Five phantom series (pH 6.2–7.4; glutamate 8–20 mM) and 40 adult‐type diffuse glioma patients (49.00 ± 12.26 years; 23 males). Fieldstrength/Sequence 5 T, fast spin‐echo GLU‐CEST and amide proton transfer (APT)‐CEST. Assessment Phantoms and patients underwent MRI scans; GLU‐CEST, APT‐CEST, and normalized values (ΔGLU‐CEST, ΔAPT‐CEST) were quantified. Gliomas were graded by WHO 2–4; IDH status was determined. Statistical Tests Spearman correlation, Kruskal–Wallis tests, Mann–Whitney U tests, and weighted DeLong tests; two‐sided p < 0.05 was significant. Results GLU‐CEST signals positively correlated with glutamate and negatively with pH ( ρ ≥ 0.893). Significant differences were found in all effects between WHO Grade 2 and 4 gliomas (ΔGLU‐CEST: 2.006 1.143, 2.799 vs. 4.365 2.974, 5.299; GLU‐CEST: 7.424 6.679, 7.649 vs. 10.155 8.098, 11.550; ΔAPT‐CEST: 1.918 1.258, 2.461 vs. 3.386 2.682, 4.805; APT‐CEST: 1.961 1.425, 2.715 vs. 3.333 2.478, 4.632), whereas only ΔGLU‐CEST and GLU‐CEST exhibited significant disparities between Grade 3 and 4 gliomas (ΔGLU‐CEST: 2.171 1.895, 2.862 vs. 4.365 2.974, 5.299; GLU‐CEST: 7.102 6.475, 7.259 vs. 10.155 8.098, 11.550). In the solid tumor region, all effects demonstrated significant differences between IDH‐mutant and IDH wild‐type gliomas (ΔGLU‐CEST: 2.111 1.614, 3.110 vs. 4.333 2.964, 5.405; GLU‐CEST: 7.259 6.577, 7.726 vs. 10.291 8.097, 11.634; ΔAPT‐CEST: 2.017 1.355, 2.718 vs. 3.235 2.670, 4.735; APT‐CEST: 2.122 1.680, 2.889 vs. 3.270 2.450, 4.262), whereas GLU‐CEST outperformed APT‐CEST and ΔAPT‐CEST in diagnostic efficacy (AUC difference = 0.073 and 0.101). Data Conclusion 5 T GLU‐CEST is capable of differentiating between grade 2 and grade 4, as well as grade 3 and grade 4 adult diffuse gliomas, and demonstrates superior performance to APT‐CEST in the classification of IDH status. Evidence Level 2. Technical Efficacy Stage 2.

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Cite This Study

Ying et al. (Sun,) studied this question.

synapsesocial.com/papers/69e8661d6e0dea528ddea993 https://doi.org/https://doi.org/10.1002/jmri.70340

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