Improved Differentiation of Glioma Grades through Fluid Exponential Suppression in Chemical Exchange Saturation Transfer (CEST) Imaging

Motivation: Fluid-induced artifacts often hamper differentiation between high- and low-grade gliomas in CEST imaging. Goal(s): Our goal was to develop a novel fluid exponential suppression factor to eliminate fluid-related artifacts. Approach: We extended the original linear correction factor into a nonlinear exponential factor. The metrics with and without fluid suppression factors were compared using a dataset of 140 glioma patients. Results: CEST metrics combined with the fluid exponential suppression factor substantially reduced the fluid-related artifacts and yielded higher AUCs for grading gliomas than linear correction and no correlation. Impact: The novel fluid exponential suppression strategy can substantially improve the quality of CEST maps and enhance the performance of diagnosing gliomas. The proposed method is easy to adopt and can be applied to existing data retrospectively.