Glutamate-glutathione-weighted chemical exchange saturation transfer 3-T magnetic resonance imaging for identifying malignant uterine tumors
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Uterine tumors are a prevalent gynecological condition among women worldwide, and distinguishing malignant from benign uterine tumors is crucial for clinical decision-making. This study aimed to investigate the utility of Glutamate-glutathione-weighted chemical exchange saturation transfer (Glu-GSHw-CEST) imaging for differentiating malignant from benign uterine tumors. Methods: In this prospective study, participants were enrolled between April 2023 and February 2025. Ultimately, 57 patients, including 33 with benign tumors (33 uterine leiomyomas) and 24 with malignant tumors (15 cervical cancers and 9 endometrial cancers), were evaluated.T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging (DWI), and Glu-GSHw-CEST magnetic resonance imaging (MRI) were performed with a 3-T clinical MRI scanner. Following B1 amplitude optimization at 3-T, a four-pool Lorentzian fitting model was used to extract the Glu-GSHw-CEST value from participants at 3 parts per million. The apparent diffusion coefficient (ADC) was calculated, and diagnostic efficacies were assessed via receiver operating characteristic curves analysis. The significance threshold was set at P<0.05. Results: 6.773% (5.013%, 7.795%); U=234; P<0.001]. In distinguishing between malignant and benign uterine tumors, Glu-GSHw-CEST imaging [area under the receiver operating characteristic curve (AUC) =0.750; 95% confidence interval (CI): 0.631-0.869] and DWI (AUC =0.754; 95% CI: 0.619-0.890) showed comparable performance (P=0.966). Combining both methods further improved performance (AUC =0.868; 95%CI: 0.777-0.958) compared with Glu-GSHw-CEST (P=0.027) and DWI (P=0.048). Conclusions: Glu-GSHw-CEST is a promising noninvasive molecular imaging technique for differentiating malignant from benign uterine tumors at 3 T. Combining it with DWI can further enhance diagnostic performance.
Institutions: Shantou University, Shantou University Medical College, Second Affiliated Hospital of Shantou University Medical College, The Second Affiliated Hospital of Xiamen Medical College, Hanshan Normal University, Wuxi Fourth People's Hospital, Sir Run Run Shaw Hospital, Zhejiang University, Xiamen University, Xiamen Medical College, Kyungpook National University
Language: English
Topic: MRI in cancer diagnosis
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223251999