Three-Dimensional Gradient-Echo–Based Amide Proton Transfer-Weighted Imaging of Brain Tumors: Comparison With Two-Dimensional Spin-Echo–Based Amide Proton Transfer-Weighted Imaging

Abstract

Objective 

Although amide proton transfer–weighted (APTw) imaging is reported by 2-dimensional (2D) spin-echo–based sequencing, 3-dimensional (3D) APTw imaging can be obtained by gradient-echo–based sequencing. The purpose of this study was to compare the efficacy of APTw imaging between 2D and 3D imaging in patients with various brain tumors.

Methods 

A total of 49 patients who had undergone 53 examinations [5 low-grade gliomas (LGG), 16 high-grade gliomas (HGG), 6 malignant lymphomas, 4 metastases, and 22 meningiomas] underwent APTw imaging using 2D and 3D sequences. The magnetization transfer ratio asymmetry (MTR_asym) was assessed by means of region of interest measurements. Pearson correlation was performed to determine the relationship between MTR_asym for the 2 methods, and Student's t test to compare MTR_asym for LGG and HGG. The diagnostic accuracy to differentiate HGG from LGG of the 2 methods was compared by means of the McNemar test.

Results 

Three-dimensional APTw imaging showed a significant correlation with 2D APTw imaging (r = 0.79, P < 0.0001). The limits of agreement between the 2 methods were −0.021 ± 1.42%. The MTR_asym of HGG (2D: 1.97 ± 0.96, 3D: 2.11 ± 0.95) was significantly higher than those of LGG (2D: 0.46 ± 0.89%, P < 0.01; 3D: 0.15 ± 1.09%, P < 0.001). The diagnostic performance of the 2 methods to differentiate HGG from LGG was not significantly different (P = 1).

Conclusions 

The potential capability of 3D APTw imaging is equal to or greater than that of 2D APTw imaging and is considered at least as valuable in patients with brain tumors.