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• Clinical Article •
Preliminary study of three-dimensions amide proton metastasis imaging in the prediction of pathological grade of hepatocellular carcinoma
QI Xiaohui  WANG Qi  SHEN Zhiwei  DUAN Mengting  LIU Xiang  PAN Jiangyang  WANG Lijia  JIA Litao  WANG Yaning  DU Yu 

Cite this article as: QI X H, WANG Q, SHEN Z W, et al. Preliminary study of three-dimensions amide proton metastasis imaging in the prediction of pathological grade of hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2025, 16(4): 48-53. DOI:10.12015/issn.1674-8034.2025.04.008.


[Abstract] Objective To explore the value of three-dimensional amide proton transfer weighted (3D-APTw) imaging in the assessment of the pathological grade of hepatocellular carcinoma (HCC).Materials and Methods A total of 43 patients with surgical pathology confirmed HCC from October 2020 to April 2023 and underwent Edmondson-Steiner grade (grade Ⅰ to Ⅳ) were prospectively recruited. We classified grade Ⅰ and Ⅱ HCC as low grade HCC and grade Ⅲ and Ⅳ lesions as high grade HCC. A Philips 3.0 T MRI device was scanned before surgery to acquire T1WI, T2WI, diffusion-weighted imaging, amide proton transfer weighted (APTw) and multi-stage enhanced images, respectively. APTw values for HCC and hepatplasm were measured independently by two experienced radiologists. Differences between groups were analyzed by the Mann-Whitney U non-parametric test. The diagnostic efficacy of APTw value was analyzed using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC), threshold, sensitivity and specificity were calculated. A Spearman correlation analysis was used to assess the association between APTw and the histological grade of HCC.Results The APTw value of low grade HCC (2.15% ± 0.13%) was significantly lower than that of high grade HCC (2.63% ± 0.13%), and the difference was statistically significant (P = 0.03). The AUC for identifying high grade and low grade HCC was 0.69 (95% CI: 0.53 to 0.82), and with an optimal threshold of 1.85%, the sensitivity and specificity were 90.00% and 42.31%, respectively. Spearman results of the correlation analysis showed a positive correlation between APTw value and HCC pathological grade, with a correlation coefficient of r = 0.43 (P = 0.003).Conclusions The APTw value can be used to identify high grade and low grade HCC, and the 3D-APTw imaging has some value in predicting the preoperative pathological grade of HCC.
[Keywords] amide proton transfer imaging；hepatocellular carcinoma；histologic grades；functional magnetic resonance imaging

QI Xiaohui1   WANG Qi1*   SHEN Zhiwei2   DUAN Mengting1   LIU Xiang1   PAN Jiangyang1   WANG Lijia1   JIA Litao1   WANG Yaning1   DU Yu1  

1 Department of CT/MRI, No. 4 Hospital of Hebei Medical University, Shijiazhuang 050000, China

2 Philips (China) Investment Co., Ltd., Beijing 100600, China

Corresponding author: WANG Q, E-mail: ja1109w@hebmu.edu.cn

Conflicts of interest   None.

Received  2024-08-28
Accepted  2025-04-02
DOI: 10.12015/issn.1674-8034.2025.04.008
Cite this article as: QI X H, WANG Q, SHEN Z W, et al. Preliminary study of three-dimensions amide proton metastasis imaging in the prediction of pathological grade of hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2025, 16(4): 48-53. DOI:10.12015/issn.1674-8034.2025.04.008.

[1]
KAMIMURA K, NAKAJO M, YONEYAMA T, et al. Amide proton transfer imaging of tumors: theory, clinical applications, pitfalls, and future directions[J]. Jpn J Radiol, 2019, 37(2): 109-116. DOI: 10.1007/s11604-018-0787-3.
[2]
CHOI Y S, AHN S S, LEE S K, et al. Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume[J]. Eur Radiol, 2017, 27(8): 3181-3189. DOI: 10.1007/s00330-017-4732-0.
[3]
ZHANG J X, ZHU W Z, TAIN R, et al. Improved differentiation of low-grade and high-grade gliomas and detection of tumor proliferation using APT contrast fitted from Z-spectrum[J]. Mol Imaging Biol, 2018, 20(4): 623-631. DOI: 10.1007/s11307-017-1154-y.
[4]
KONG Y Q, QU Q Q, MING L, et al. Value of amide proton transfer imaging and intravoxel incoherent motion imaging in estimating histologic grades of endometrial adenocarcinoma[J]. Chin J Magn Reson Imag, 2022, 13(9): 46-52. DOI: 10.12015/issn.1674-8034.2022.09.009.
[5]
TAKAYAMA Y, NISHIE A, TOGAO O, et al. Amide proton transfer MR imaging of endometrioid endometrial adenocarcinoma: association with histologic grade[J]. Radiology, 2018, 286(3): 909-917. DOI: 10.1148/radiol.2017170349.
[6]
LI B B, SUN H Z, ZHANG S Y, et al. Amide proton transfer imaging to evaluate the grading of squamous cell carcinoma of the cervix: a comparative study using 18F FDG PET[J]. J Magn Reson Imaging, 2019, 50(1): 261-268. DOI: 10.1002/jmri.26572.
[7]
NISHIE A, TAKAYAMA Y, ASAYAMA Y, et al. Amide proton transfer imaging can predict tumor grade in rectal cancer[J]. Magn Reson Imaging, 2018, 51: 96-103. DOI: 10.1016/j.mri.2018.04.017.
[8]
NISHIE A, ASAYAMA Y, ISHIGAMI K, et al. Amide proton transfer imaging to predict tumor response to neoadjuvant chemotherapy in locally advanced rectal cancer[J]. J Gastroenterol Hepatol, 2019, 34(1): 140-146. DOI: 10.1111/jgh.14315.
[9]
ZHANG N, SONG Q W, LIANG H B, et al. Early prediction of pathological response to neoadjuvant chemotherapy of breast tumors: a comparative study using amide proton transfer-weighted, diffusion weighted and dynamic contrast enhanced MRI[J/OL]. Front Med, 2024, 11: 1295478 [2025-01-08]. https://doi.org/10.3389/fmed.2024.1295478. DOI: 10.3389/fmed.2024.1295478.
[10]
CHEN S Z, YUAN J, DENG M, et al. Chemical exchange saturation transfer (CEST) MR technique for in-vivo liver imaging at 3.0 tesla[J]. Eur Radiol, 2016, 26(6): 1792-1800. DOI: 10.1007/s00330-015-3972-0.
[11]
LIN Y, LUO X J, YU L, et al. Amide proton transfer-weighted MRI for predicting histological grade of hepatocellular carcinoma: comparison with diffusion-weighted imaging[J]. Quant Imaging Med Surg, 2019, 9(10): 1641-1651. DOI: 10.21037/qims.2019.08.07.
[12]
WU B L, JIA F, LI X K, et al. Comparative study of amide proton transfer imaging and intravoxel incoherent motion imaging for predicting histologic grade of hepatocellular carcinoma[J/OL]. Front Oncol, 2020, 10: 562049 [2025-01-08]. https://doi.org/10.3389/fonc.2020.562049. DOI: 10.3389/fonc.2020.562049.
[13]
SEO N, JEONG H K, CHOI J Y, et al. Liver MRI with amide proton transfer imaging: feasibility and accuracy for the characterization of focal liver lesions[J]. Eur Radiol, 2021, 31(1): 222-231. DOI: 10.1007/s00330-020-07122-y.
[14]
QI X H, WANG Q, SHEN Z W, et al. Preliminary study of 3D-APTw imaging in the evaluation of clinical scanning feasibility and image quality of primary liver cancer[J]. Chin J Magn Reson Imag, 2024, 15(3): 163-169. DOI: 10.12015/issn.1674-8034.2024.03.026.
[15]
QI X H, WANG Q, SHEN Z W, et al. Image quality assessment and feasibility of three-dimensional amide proton transfer-weighted imaging for hepatocellular carcinoma[J]. Quant Imaging Med Surg, 2024, 14(2): 1778-1790. DOI: 10.21037/qims-23-767.
[16]
LIU N. Application progress of amide proton transfer imaging in tumor imaging[J]. J Pract Med Imag, 2020, 21(1): 50-52. DOI: 10.16106/j.cnki.cn14-1281/r.2020.01.019.
[17]
XU X H, CHANG L Y, WU G T, et al. Application of MR amide proton transfer imaging and apparent diffusion coefficient in preoperative pathological grade assessment of bladder cancer[J]. Chin J Magn Reson Imag, 2023, 14(11): 97-102. DOI: 10.12015/issn.1674-8034.2023.11.016.
[18]
HOU G R, WANG C, LI L L, et al. Comparison of 3D amide proton transfer imaging and intravoxel incoherent motion imaging in the diagnosis of prostate cancer[J]. Chin J Magn Reson Imag, 2023, 14(5): 139-144. DOI: 10.12015/issn.1674-8034.2023.05.024.
[19]
WANG H J, CAI Q, HUANG Y P, et al. Amide proton transfer-weighted MRI in predicting histologic grade of bladder cancer[J]. Radiology, 2022, 305(1): 127-134. DOI: 10.1148/radiol.211804.
[20]
CHEN Y Q, LI X B, SONG Y K, et al. The diagnostic efficacy of amide proton transfer imaging in grading gliomas and predicting tumor proliferation[J]. Neuroreport, 2019, 30(2): 139-144. DOI: 10.1097/WNR.0000000000001174.
[21]
CHEN W C, LI L, YAN Z X, et al. Three-dimension amide proton transfer MRI of rectal adenocarcinoma: correlation with pathologic prognostic factors and comparison with diffusion kurtosis imaging[J]. Eur Radiol, 2021, 31(5): 3286-3296. DOI: 10.1007/s00330-020-07397-1.
[22]
LI S J, LIU J, ZHANG Z X, et al. Added-value of 3D amide proton transfer MRI in assessing prognostic factors of cervical cancer: a comparative study with multiple model diffusion-weighted imaging[J]. Quant Imaging Med Surg, 2023, 13(12): 8157-8172. DOI: 10.21037/qims-23-324.
[23]
LI L, CHEN W C, YAN Z X, et al. Comparative analysis of amide proton transfer MRI and diffusion-weighted imaging in assessing p53 and Ki-67 expression of rectal adenocarcinoma[J]. J Magn Reson Imaging, 2020, 52(5): 1487-1496. DOI: 10.1002/jmri.27212.
[24]
WANG X, CAO Y Y, JIANG Y, et al. Effects of breathing patterns on amide proton transfer MRI in the kidney: a preliminary comparative study in healthy volunteers and patients with tumors[J]. J Magn Reson Imaging, 2024, 60(1): 222-230. DOI: 10.1002/jmri.29099.
[25]
MENG N, WANG X J, SUN J, et al. Evaluation of amide proton transfer-weighted imaging for endometrial carcinoma histological features: a comparative study with diffusion kurtosis imaging[J]. Eur Radiol, 2021, 31(11): 8388-8398. DOI: 10.1007/s00330-021-07966-y.
[26]
TOGAO O, YOSHIURA T, KEUPP J, et al. Amide proton transfer imaging of adult diffuse gliomas: correlation with histopathological grades[J]. Neuro Oncol, 2014, 16(3): 441-448. DOI: 10.1093/neuonc/not158.
[27]
LI G M, JIANG G H, MEI Y J, et al. Applying amide proton transfer-weighted imaging (APTWI) to distinguish papillary thyroid carcinomas and predominantly solid adenomatous nodules: comparison with diffusion-weighted imaging[J/OL]. Front Oncol, 2020, 10: 918 [2025-01-08]. https://doi.org/10.3389/fonc.2020.00918. DOI: 10.3389/fonc.2020.00918.
[28]
KAMITANI T, SAGIYAMA K, YAMASAKI Y, et al. Amide proton transfer (APT) imaging of breast cancers and its correlation with biological status[J]. Clin Imaging, 2023, 96: 38-43. DOI: 10.1016/j.clinimag.2023.02.002.

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