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European Radiology
Published in: European Radiology 8/2019

01-08-2019 | Magnetic Resonance

Histogram analysis of amide proton transfer–weighted imaging: comparison of glioblastoma and solitary brain metastasis in enhancing tumors and peritumoral regions

Authors: Kiyohisa Kamimura, Masanori Nakajo, Tomohide Yoneyama, Yoshihiko Fukukura, Hirofumi Hirano, Yuko Goto, Masashi Sasaki, Yuta Akamine, Jochen Keupp, Takashi Yoshiura

Published in: European Radiology | Issue 8/2019

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Abstract

Objectives

Differentiation of glioblastomas (GBMs) and solitary brain metastases (SBMs) is an important clinical problem. The aim of this study was to determine whether amide proton transfer–weighted (APTW) imaging is useful for distinguishing GBMs from SBMs.

Methods

We examined 31 patients with GBM and 17 with SBM. For each tumor, enhancing areas (EAs) and surrounding non-enhancing areas with T2-prolongation (peritumoral high signal intensity areas, PHAs) were manually segmented using fusion images of the post-contrast T1-weighted and T2-weighted images. The mean amide proton transfer signal intensities (APTSIs) were compared among the EAs, PHAs, and contralateral normal appearing white matter (NAWM) within each tumor type. Furthermore, we analyzed APTSI histograms to compare the EAs and PHAs of GBMs and SBMs.

Results

In GBMs, the mean APTSI in EAs (2.92 ± 0.74%) was the highest, followed by that in PHAs (1.64 ± 0.83%, p < 0.001) and NAWM (0.43 ± 0.83%, p < 0.001). In SBMs, the mean APTSI in EAs (1.85 ± 0.99%) and PHAs (1.42 ± 0.45%) were significantly higher than that in NAWM (0.42 ± 0.30%, p < 0.001), whereas no significant difference was found between EAs and PHAs. The mean and 10th, 25th, 50th, 75th, and 90th percentiles for APT in EAs of GBMs were significantly higher than those of SBMs. However, no significant difference was found between GBMs and SBMs in any histogram parameters for PHA.

Conclusions

APTSI in EAs, but not PHAs, is useful for differentiation between GBMs and SBMs.

Key Points

• Amide proton transfer–weighted imaging and histogram analysis in the enhancing tumor can provide useful information for differentiation between glioblastomas and solitary brain metastasis.
• Amide proton transfer signal intensity histogram parameters from peritumoral areas showed no significant difference between glioblastomas and solitary brain metastasis.
• Vasogenic edema alone can substantially increase amide proton transfer signal intensity which may mimic tumor invasion.
Appendix
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Metadata
Title
Histogram analysis of amide proton transfer–weighted imaging: comparison of glioblastoma and solitary brain metastasis in enhancing tumors and peritumoral regions
Authors
Kiyohisa Kamimura
Masanori Nakajo
Tomohide Yoneyama
Yoshihiko Fukukura
Hirofumi Hirano
Yuko Goto
Masashi Sasaki
Yuta Akamine
Jochen Keupp
Takashi Yoshiura
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5832-1

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