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Differentiation between glioblastoma and solitary brain metastases using perfusion and amide proton transfer weighted MRI

Knutsson, Malte ; Salomonsson, Tim LU orcid ; Durmo, Faris LU orcid ; Johansson, Emelie Ryd ; Seidemo, Anina LU orcid ; Lätt, Jimmy LU ; Rydelius, Anna LU ; Kinhult, Sara LU ; Englund, Elisabet LU orcid and Bengzon, Johan LU , et al. (2025) In Frontiers in Neuroscience 19. p.01-09
Abstract

OBJECTIVES: Early diagnostic separation between glioblastoma (GBM) and solitary metastases (MET) is important for patient management but remains challenging when based on imaging only. The objective of this study was to assess whether amide proton transfer weighted (APTw) MRI alone or combined with dynamic susceptibility contrast (DSC) MRI parameters, including cerebral blood volume (CBV), cerebral blood flow (CBF), and leakage parameter (K2) measurements, can differentiate GBM from MET.

METHODS: APTw MRI and DSC-MRI were performed on 18 patients diagnosed with GBM (
N = 10) or MET (
N = 8). Quantitative parameter maps were calculated, and regions-of-interest (ROIs) were placed in whole tumor, contrast-enhanced tumor... (More)

OBJECTIVES: Early diagnostic separation between glioblastoma (GBM) and solitary metastases (MET) is important for patient management but remains challenging when based on imaging only. The objective of this study was to assess whether amide proton transfer weighted (APTw) MRI alone or combined with dynamic susceptibility contrast (DSC) MRI parameters, including cerebral blood volume (CBV), cerebral blood flow (CBF), and leakage parameter (K2) measurements, can differentiate GBM from MET.

METHODS: APTw MRI and DSC-MRI were performed on 18 patients diagnosed with GBM (
N = 10) or MET (
N = 8). Quantitative parameter maps were calculated, and regions-of-interest (ROIs) were placed in whole tumor, contrast-enhanced tumor (ET), edema, necrosis and normal-appearing white matter (NAWM). The mean and max of the APTw signal, CBF, leakage-corrected CBV and K2 were obtained from each ROI. Except for K2, all were normalized to NAWM (nAPTw
mean/max, nCBF
mean/max, ncCBV
mean/max,). Receiver Operating Characteristic (ROC) curves and area-under-the-curve (AUC) were assessed for different parameter combinations. Statistical analyses were performed using Mann-Whitney U test.

RESULTS: When comparing GBM to MET, nAPT
max, nCBF
max, ncCBV
max and ncCBV
mean were significantly increased (
p < 0.05) in ET with AUC being 0.81, 0.83, 0.85, and 0.83, respectively. Combinations of nAPTw
max + ncCBV
max, nAPTw
mean + ncCBV
mean, nAPTw
max + nCBF
max, nAPTw
max + K2
max and nAPTw
max + ncCBV
max + K2
max in ET showed significant prediction in differentiating GBM and MET (AUC = 0.92, 0.82, 0.92, 0.85, and 0.92 respectively).

CONCLUSION: When assessed in Gd-enhanced tumor areas, nAPTw MRI signal intensity alone or combined with DSC-MRI parameters, was an excellent predictor for differentiating GBM and MET. However, the small cohort warrants future studies.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Frontiers in Neuroscience
volume
19
article number
1533799
pages
01 - 09
publisher
Frontiers Media S. A.
external identifiers
  • pmid:39975970
  • scopus:85218195855
ISSN
1662-4548
DOI
10.3389/fnins.2025.1533799
language
English
LU publication?
yes
additional info
Copyright © 2025 Knutsson, Salomonsson, Durmo, Johansson, Seidemo, Lätt, Rydelius, Kinhult, Englund, Bengzon, van Zijl, Knutsson and Sundgren.
id
2483b352-fc43-4588-9dfb-910cf30560a6
date added to LUP
2025-03-16 10:00:07
date last changed
2025-04-14 07:11:57
@article{2483b352-fc43-4588-9dfb-910cf30560a6,
  abstract     = {{<p>OBJECTIVES: Early diagnostic separation between glioblastoma (GBM) and solitary metastases (MET) is important for patient management but remains challenging when based on imaging only. The objective of this study was to assess whether amide proton transfer weighted (APTw) MRI alone or combined with dynamic susceptibility contrast (DSC) MRI parameters, including cerebral blood volume (CBV), cerebral blood flow (CBF), and leakage parameter (K2) measurements, can differentiate GBM from MET.</p><p>METHODS: APTw MRI and DSC-MRI were performed on 18 patients diagnosed with GBM (<br>
 N = 10) or MET (<br>
 N = 8). Quantitative parameter maps were calculated, and regions-of-interest (ROIs) were placed in whole tumor, contrast-enhanced tumor (ET), edema, necrosis and normal-appearing white matter (NAWM). The mean and max of the APTw signal, CBF, leakage-corrected CBV and K2 were obtained from each ROI. Except for K2, all were normalized to NAWM (nAPTw<br>
 mean/max, nCBF<br>
 mean/max, ncCBV<br>
 mean/max,). Receiver Operating Characteristic (ROC) curves and area-under-the-curve (AUC) were assessed for different parameter combinations. Statistical analyses were performed using Mann-Whitney U test.<br>
 </p><p>RESULTS: When comparing GBM to MET, nAPT<br>
 max, nCBF<br>
 max, ncCBV<br>
 max and ncCBV<br>
 mean were significantly increased (<br>
 p &lt; 0.05) in ET with AUC being 0.81, 0.83, 0.85, and 0.83, respectively. Combinations of nAPTw<br>
 max + ncCBV<br>
 max, nAPTw<br>
 mean + ncCBV<br>
 mean, nAPTw<br>
 max + nCBF<br>
 max, nAPTw<br>
 max + K2<br>
 max and nAPTw<br>
 max + ncCBV<br>
 max + K2<br>
 max in ET showed significant prediction in differentiating GBM and MET (AUC = 0.92, 0.82, 0.92, 0.85, and 0.92 respectively).<br>
 </p><p>CONCLUSION: When assessed in Gd-enhanced tumor areas, nAPTw MRI signal intensity alone or combined with DSC-MRI parameters, was an excellent predictor for differentiating GBM and MET. However, the small cohort warrants future studies.</p>}},
  author       = {{Knutsson, Malte and Salomonsson, Tim and Durmo, Faris and Johansson, Emelie Ryd and Seidemo, Anina and Lätt, Jimmy and Rydelius, Anna and Kinhult, Sara and Englund, Elisabet and Bengzon, Johan and van Zijl, Peter C M and Knutsson, Linda and Sundgren, Pia C}},
  issn         = {{1662-4548}},
  language     = {{eng}},
  pages        = {{01--09}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Neuroscience}},
  title        = {{Differentiation between glioblastoma and solitary brain metastases using perfusion and amide proton transfer weighted MRI}},
  url          = {{http://dx.doi.org/10.3389/fnins.2025.1533799}},
  doi          = {{10.3389/fnins.2025.1533799}},
  volume       = {{19}},
  year         = {{2025}},
}