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Peer-reviewedCC BY-NC-NDQuantitative imaging in medicine and surgery

Glutamate-glutathione-weighted chemical exchange saturation transfer 3-T magnetic resonance imaging for identifying malignant uterine tumors.

  • Yumeng Mao1,2
  • Gang Xiao3
  • Huige Zhai1
  • Dafa Shi1,2
  • Yuxi Ge4
  • Nannan Zhao1
  • Junhu Tai5
  • Qianqi Wang1,6
  • Guangsong Wang1,7
  • Hongying Huang1,2
  • Shuohua Wu1,2
  • Yongmin Chang8
2 more authors
  • Gen Yan1
  • Renhua Wu2
8 affiliations
  1. 1Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
  2. 2Department of Radiology, Second Affiliated Hospital, Shantou University Medical College, Shantou, China.
  3. 3School of Mathematics and Statistics, Hanshan Normal University, Chaozhou, China.
  4. 4Department of Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China.
  5. 5Department of Medical Research Center, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
  6. 6Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  7. 7Department of Radiology, Xiamen University Medical College, Xiamen, China.
  8. 8Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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Abstract

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. 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. Malignant uterine tumors had a significantly higher Glu-GSHw-CEST effect than did benign tumors [7.942% (7.247%, 9.232%) vs. 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). 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.

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Cite

BibTeXRIS
BibTeX
@article{mao2026glutamateglutathioneweighted,
  title = {{Glutamate-glutathione-weighted chemical exchange saturation transfer 3-T magnetic resonance imaging for identifying malignant uterine tumors.}},
  author = {Yumeng Mao and Gang Xiao and Huige Zhai and Dafa Shi and Yuxi Ge and Nannan Zhao and Junhu Tai and Qianqi Wang and Guangsong Wang and Hongying Huang and Shuohua Wu and Yongmin Chang and Gen Yan and Renhua Wu},
  journal = {Quantitative imaging in medicine and surgery},
  year = {2026},
  month = sep,
  doi = {10.21037/qims-2026-0802},
  url = {https://europepmc.org/article/MED/42997784},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Glutamate-glutathione-weighted chemical exchange saturation transfer 3-T magnetic resonance imaging for identifying malignant uterine tumors.
AU  - Yumeng Mao
AU  - Gang Xiao
AU  - Huige Zhai
AU  - Dafa Shi
AU  - Yuxi Ge
AU  - Nannan Zhao
AU  - Junhu Tai
AU  - Qianqi Wang
AU  - Guangsong Wang
AU  - Hongying Huang
AU  - Shuohua Wu
AU  - Yongmin Chang
AU  - Gen Yan
AU  - Renhua Wu
PY  - 2026
DA  - 2026/09/29
JO  - Quantitative imaging in medicine and surgery
DO  - 10.21037/qims-2026-0802
UR  - https://europepmc.org/article/MED/42997784
AB  - 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. 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. Malignant uterine tumors had a significantly higher Glu-GSHw-CEST effect than did benign tumors [7.942% (7.247%, 9.232%) vs. 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). 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.
SN  - 2223-4292
SN  - 2223-4306
ER  -