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Object <p>Accurate differentiation between glioblastomas (GBM) and solitary brain metastases (MET) is crucial for treatment planning. This study evaluated the ability of amide proton transfer-weighted (APTw) MRI with and without fluid suppression (FS) to distinguish between GBM and MET.</p> Method <p>Thirty-two patients with histopathologically confirmed GBM (<i>n</i> = 24) or MET (<i>n</i> = 8) were included. Post-processing included creation of APTw maps without FS, with patient-specific FS based on the patient’s white matter values and with a fixed-factor FS. Regions of interest (ROIs) were segmented in the contrast-enhanced tumour, peritumoural oedema, necrosis and the normal-appearing white matter (NAWM). The min, max and mean signals were extracted for each ROI and normalised to NAWM, creating normalised APTw (nAPTw) values. Group differences were determined with <i>t </i>test and Mann–Whitney U test. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.</p> Results <p>Both FS methods significantly reduced nAPTw values in tumour regions. Patient-specific FS showed highest performance in distinguishing GBM from MET in the necrotic (AUC 0.921) and oedematous regions (AUC 0.698). Fixed FS provided minor to intermediate improvements.</p> Conclusion <p>Patient-specific fluid suppression increased the diagnostic performance of APTw imaging in differentiating GBM from MET, particularly in oedematous and necrotic regions.</p>

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Differentiation between glioblastomas and solid brain metastases using amide proton transfer-weighted (APTw) MRI with and without fluid suppression

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Malte Knutsson,
  • Tim Salomonsson,
  • Anina Seidemo,
  • Anna Rydelius,
  • Xavier Saenz Sarda,
  • Patrick Liebig,
  • Mattias Belting,
  • Johan Bengzon,
  • Peter C. M. van Zijl,
  • Linda Knutsson,
  • Pia C. Sundgren

摘要

Object

Accurate differentiation between glioblastomas (GBM) and solitary brain metastases (MET) is crucial for treatment planning. This study evaluated the ability of amide proton transfer-weighted (APTw) MRI with and without fluid suppression (FS) to distinguish between GBM and MET.

Method

Thirty-two patients with histopathologically confirmed GBM (n = 24) or MET (n = 8) were included. Post-processing included creation of APTw maps without FS, with patient-specific FS based on the patient’s white matter values and with a fixed-factor FS. Regions of interest (ROIs) were segmented in the contrast-enhanced tumour, peritumoural oedema, necrosis and the normal-appearing white matter (NAWM). The min, max and mean signals were extracted for each ROI and normalised to NAWM, creating normalised APTw (nAPTw) values. Group differences were determined with t test and Mann–Whitney U test. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.

Results

Both FS methods significantly reduced nAPTw values in tumour regions. Patient-specific FS showed highest performance in distinguishing GBM from MET in the necrotic (AUC 0.921) and oedematous regions (AUC 0.698). Fixed FS provided minor to intermediate improvements.

Conclusion

Patient-specific fluid suppression increased the diagnostic performance of APTw imaging in differentiating GBM from MET, particularly in oedematous and necrotic regions.