Comparison of amide proton transfer imaging with perfusion imaging of using arterial spin-labeling for evidence of tumor invasion in glioblastoma

Abstract

In glioblastoma, differentiation between cerebral edema and tumor infiltration is an important clinical question. Amide proton transfer (APT) and cerebral blood flow (CBF) are useful for evaluating the tumor invasion. In this case series, arterial spin-labeling (ASL)-CBF and APT were compared to determine which method was superior for predicting tumor infiltration in glioblastomas. Twelve specimens from 4 glioblastoma patients with confirmed selective sampling were obtained. APT signal intensity (SI) showed a strong correlation with cell density (R = 0.905; P < 0.0001). ASL-CBF showed no correlation with cell density (R = 0.373; P = 0.2319) but a correlation with vessel density (R = 0.724; P = 0.0077). In linear regression analysis, APT SI showed a positive relationship with cell density (R2 = 0.819, P < 0.0001, linear regression; y = 30.70 + 6.24E-3*x). In glioblastoma, APT imaging may be superior for predicting tumor invasion than ASL-CBF.

Keywords

• Amide proton transfer
• Arterial spin-labeling
• Glioblastoma
• Tumor invasion