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

摘要

ObjectivesDifferentiation 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.MethodsWe 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.ResultsIn GBMs, the mean APTSI in EAs (2.920.74%) was the highest, followed by that in PHAs (1.640.83%, p<0.001) and NAWM (0.430.83%, p<0.001). In SBMs, the mean APTSI in EAs (1.850.99%) 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.ConclusionsAPTSI in EAs, but not PHAs, is useful for differentiation between GBMs and SBMs.