Clinical translation of amide proton transfer (APT) MRI for ischemic stroke: A systematic review (2003-2020)

Foo, Lee Sze and Harston, George and Mehndiratta, Amit and Yap, Wun-She and Hum, Yan Chai and Lai, Khin Wee and Mukari, Shahizon Azura Mohamed and Zaki, Faizah Mohd and Tee, Yee Kai (2021) Clinical translation of amide proton transfer (APT) MRI for ischemic stroke: A systematic review (2003-2020). Quantitative Imaging in Medicine and Surgery, 11 (8). pp. 3797-3811. ISSN 2223-4292, DOI

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Amide proton transfer (APT) magnetic resonance imaging (MRI) is a pH-sensitive imaging technique that can potentially complement existing clinical imaging protocol for the assessment of ischemic stroke. This review aims to summarize the developments in the clinical research of APT imaging of ischemic stroke after 17 years of progress since its first preclinical study in 2003. Three electronic databases: PubMed, Scopus, and Cochrane Library were systematically searched for articles reporting clinical studies on APT imaging of ischemic stroke. Only articles in English published between 2003 to 2020 that involved patients presenting ischemic stroke-like symptoms that underwent APT MRI were included. Of 1,093 articles screened, 14 articles met the inclusion criteria with a total of 282 patients that had been scanned using APT imaging. Generally, the clinical studies agreed APT effect to be hypointense in ischemic tissue compared to healthy tissue, allowing for the detection of ischemic stroke. Other uses of APT imaging have also been investigated in the studies, including penumbra identification, predicting long term clinical outcome, and serving as a biomarker for supportive treatment monitoring. The published results demonstrated the potential of APT imaging in these applications, but further investigations and larger trials are needed for conclusive evidence. Future studies are recommended to report the result of asymmetry analysis at 3.5 ppm along with the findings of the study to reduce this contribution to the heterogeneity of experimental methods observed and to facilitate effective comparison of results between studies and centers. In addition, it is important to focus on the development of fast 3D imaging for full volumetric ischemic tissue assessment for clinical translation.

Item Type: Article
Funders: National Cancer Council Malaysia (MAKNA) Cancer Research Award 2018, UTAR Research Fund[IPSR/RMC/UTARRF/2018-C1/T04], UTAR Research Fund[IPSR/RMC/UTARRF/2020-C1/T02], NVIDIA Corporation
Uncontrolled Keywords: Amide proton transfer (APT);Chemical exchange saturation transfer (CEST);Magnetic resonance imaging;Ischemic stroke
Subjects: R Medicine
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Engineering
Depositing User: Ms Zaharah Ramly
Date Deposited: 20 Jun 2022 02:15
Last Modified: 20 Jun 2022 02:15

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