Grading diffuse gliomas without intense contrast enhancement by amide proton transfer MR imaging: comparisons with diffusion- and perfusion-weighted imaging

Abstract

• Amide proton transfer (APT) imaging helps in grading non-enhancing gliomas • High-grade gliomas showed higher APT signal than low-grade gliomas • APT imaging showed better diagnostic performance than diffusion- and perfusion-weighted imaging.

Addition of Amide Proton Transfer Imaging to FDG-PET/CT Improves Diagnostic Accuracy in Glioma Grading: A Preliminary Study Using the Continuous Net Reclassification Analysis

“…This study confirmed that APT imaging can be used for grading glial tumors, with a diagnostic accuracy comparable with that of other imaging biomarkers derived from DWI and FDG-PET. Previous studies have shown the diagnostic accuracy of APT imaging to be comparable with DSC-PWI, 13,16 and better than contrastenhanced T1-weighted imaging. 22 As in previous studies, our results also demonstrated excellent interrater reproducibility in the measurement of APT.…”

“…3,[11][12][13][14][15][16][17][18] However, details of the relationships between APT imaging and other clinical imaging parameters of malignancy have yet to be fully elucidated. This study confirmed that APT imaging can be used for grading glial tumors, with a diagnostic accuracy comparable with that of other imaging biomarkers derived from DWI and FDG-PET.…”

“…22 As in previous studies, our results also demonstrated excellent interrater reproducibility in the measurement of APT. 3,[11][12][13][14][15][16] We believe that for the preoperative grading of brain tumors, APT can be considered an alternative approach to PET and other MR imaging methods such as DWI.…”

“…9 This technique has been successfully applied to human brain tumors. 3,[10][11][12][13][14][15][16] Some reports have shown that the APT asymmetry value is useful in tumor grading, allowing differentiation of pseudoprogression from recurrence 17 and the assessment of treatment response. 18,19 However, the relationship between APT and other quantitative imaging values has yet to be investigated.…”

Magnetization Transfer and Amide Proton Transfer MRI of Neonatal Brain Development

“…Relatively higher APT signals generally indicate elevated exchange rates resulting from increased protein concentration [16, 17]. Although the clinical applications of APT imaging remain in their investigative stages, this modality has demonstrated promise for the evaluation of brain development [18] and the characterization and grading of brain tumors [19–23]. …”