Applying protein-based amide proton transfer MR imaging to distinguish solitary brain metastases from glioblastoma

Abstract

Objectives

To determine the utility of amide proton transfer-weighted (APTw) MR imaging in distinguishing solitary brain metastases (SBMs) from glioblastomas (GBMs).

Methods

Forty-five patients with SBMs and 43 patients with GBMs underwent conventional and APT-weighted sequences before clinical intervention. The APTw parameters and relative APTw (rAPTw) parameters in the tumour core and the peritumoral brain zone (PBZ) were obtained and compared between SBMs and GBMs. The receiver-operating characteristic (ROC) curve was used to assess the best parameter for distinguishing between the two groups.

Results

The APTw_max, APTw_min, APTw_mean, rAPTw_max, rAPTw_min or rAPTw_mean values in the tumour core were not significantly different between the SBM and GBM groups (P = 0.141, 0.361, 0.221, 0.305, 0.578 and 0.448, respectively). However, the APTw_max, APTw_min, APTw_mean, rAPTw_max, rAPTw_min or rAPTw_mean values in the PBZ were significantly lower in the SBM group than in the GBM group (P < 0.001). The APTw_min values had the highest area under the ROC curve 0.905 and accuracy 85.2% in discriminating between the two neoplasms.

Conclusion

As a noninvasive imaging method, APT-weighted MR imaging can be used to distinguish SBMs from GBMs.

Key Points

• APTw values in the tumour core were not different between SBMs and GBMs.

• APTw values in peritumoral brain zone were lower in SBMs than in GBMs.

• The APTw _minwas the best parameter to distinguish SBMs from GBMs.