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

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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Abbreviations

APTSI:

Amide proton transfer signal intensity

APTW:

Amide proton transfer–weighted

EA:

Enhancing area

GBM:

Glioblastoma

ICC:

Intraclass correlation coefficient

NAWM:

Normal appearing white matter

PHA:

Peritumoral high signal intensity area

SBM:

Solitary brain metastasis

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Acknowledgments

The authors thank Dr. Hajime Yonezawa, MD, PhD, Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, for providing the clinical information for this article.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Kiyohisa Kamimura, Masanori Nakajo, Tomohide Yoneyama, Yoshihiko Fukukura & Takashi Yoshiura

  2. Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Hirofumi Hirano

  3. Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Yuko Goto

  4. Department of Radiological Technology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Masashi Sasaki

  5. Philips Japan, 13-37, Kohnan 2-chome Minato-ku, Tokyo, 108-8507, Japan

    Yuta Akamine

  6. Philips Research, Röntgenstraße 24-26, 22335, Hamburg, Germany

    Jochen Keupp

Authors
  1. Kiyohisa Kamimura
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  2. Masanori Nakajo
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  4. Yoshihiko Fukukura
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  5. Hirofumi Hirano
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  7. Masashi Sasaki
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  8. Yuta Akamine
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  9. Jochen Keupp
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  10. Takashi Yoshiura
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Corresponding author

Correspondence to Takashi Yoshiura.

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Guarantor

The scientific guarantor of this publication is Takashi Yoshiura.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Jochen Keupp is an employee of Philips Research, and Yuta Akamine is an employee of Philips Japan.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Diagnostic study

• Performed at one institution

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Kamimura, K., Nakajo, M., Yoneyama, T. et al. Histogram analysis of amide proton transfer–weighted imaging: comparison of glioblastoma and solitary brain metastasis in enhancing tumors and peritumoral regions. Eur Radiol 29, 4133–4140 (2019). https://doi.org/10.1007/s00330-018-5832-1

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  • DOI: https://doi.org/10.1007/s00330-018-5832-1

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