Amide proton transfer imaging for differentiating benign ovarian cystic lesions: Potential of first time right

•APT imaging reflects mobile protein and peptide in the ovarian cystic lesions.•APT imaging can be useful for noninvasive diagnosis of benign ovarian cystic lesions with and without malignant potential.•The diagnostic ability of APT imaging can be improved with the use of the longer presaturation pu...

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Published in:European journal of radiology 2019-11, Vol.120, p.108656, Article 108656
Main Authors: Ishimatsu, Keisuke, Nishie, Akihiro, Takayama, Yukihisa, Asayama, Yoshiki, Ushijima, Yasuhiro, Kakihara, Daisuke, Morita, Koichiro, Takao, Seiichiro, Sonoda, Kenzo, Ohishi, Yoshihiro, Honda, Hiroshi
Format: Article
Language:English
Subjects:
ADC
Adult
Aged
Algorithms
Amide proton transfer imaging
Amides - metabolism
CEST
Cyst
Cystadenoma, Mucinous - diagnosis
Cystadenoma, Serous - diagnosis
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging - methods
Middle Aged
Ovarian Cysts - diagnosis
Ovarian Neoplasms - diagnosis
Ovary
Prospective Studies
Protons
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Summary:•APT imaging reflects mobile protein and peptide in the ovarian cystic lesions.•APT imaging can be useful for noninvasive diagnosis of benign ovarian cystic lesions with and without malignant potential.•The diagnostic ability of APT imaging can be improved with the use of the longer presaturation pulse. To investigate whether amide proton transfer (APT) imaging is useful to differentiate benign ovarian cystic lesions. This prospective study enrolled a total of 19 lesions in 18 patients with benign ovarian cystic lesion: serous cystadenoma (SCA), n = 4; mucinous cystadenoma (MCA), n = 9; or functional cyst (FC), n = 6. APT imaging was performed with three different presaturation pulse durations: 0.5, 1.0 and 2.0 s. APT signal was defined as magnetization transfer ratio asymmetry at 3.5 ppm. The SI ratios of cyst to muscle calculated on T1- and T2-weighted images were defined as T1- and T2-ratios. Apparent diffusion coefficient (ADC) maps were also generated. We compared the three cystic lesion groups’ APT signals, T1-ratio, T2-ratio, and ADC. When using 2.0 s of presaturation, the APT signals were 1.41 ± 0.71% in SCA, 5.15 ± 1.92% in MCA and 8.52 ± 1.17% in FC. Significant differences were observed between SCA and MCA (p 
ISSN:0720-048X
1872-7727
1872-7727
DOI:10.1016/j.ejrad.2019.108656