Amide proton transfer MRI differentiates between progressive multifocal leukoencephalopathy and malignant brain tumors: a pilot study

• DOI: 10.1186/s12880-022-00959-3
• Publication Date: 2022-12-26T14:06:44Z
• Authors: Hirofumi Koike; Minoru Morikawa; Hideki Ishimaru; Reiko Ideguchi; Masataka Uetani; Takeshi Hiu; Takayuki Matsuo; Mitsuharu Miyoshi
• Keywords: Male; Pilot Projects; Glioblastoma multiforme; 03 medical and health sciences; Magnetic resonance imaging; 0302 clinical medicine; Progressive multifocal leukoencephalopathy; Medical technology; Humans; R855-855.5; Primary central nervous system lymphoma; Aged; Retrospective Studies; Aged, 80 and over; Brain Neoplasms; Research; Leukoencephalopathy, Progressive Multifocal; Middle Aged; Amides; Magnetic Resonance Imaging; 3. Good health; Amide proton transfer imaging; Female; Protons; Glioblastoma

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nerve system caused by John Cunningham virus. On MRI, PML may sometimes appear similar to primary nervous lymphoma (PCNSL) and glioblastoma multiforme (GBM). The purpose this pilot study was evaluate potential amide proton transfer (APT) imaging for differentiating from PCNSL GBM.Patients with (n = 4; two men; mean age 52.3 ± 6.1 years), 7; four women; 74.4 5.8 or GBM 11; 6 65.0 15.2 years) who underwent APT-CEST MRI between January 2021 September 2022 were retrospectively evaluated. Magnetization ratio asymmetry (MTRasym) values measured on APT using region interest within lesion. Receiver operating characteristics curve analysis used determine diagnostic cutoffs MTRasym.The MTRasym 0.005 in group, 0.025 0.009 group. There significant differences (P 0.023), 0.015). For PCNSL, an threshold 0.0165 gave sensitivity, specificity, positive predictive value, negative value 100% (all). GBM, 0.015 100%, 90.9%, 80.0%, respectively.MTRasym obtained allowed patients be clearly discriminated GBM.