Amide proton transfer imaging was investigated for its potential to discriminate tuberculomas from high-grade gliomas. The diagnosis was confirmed by histopathology, CSF examination or response to anti-tubercular therapy. The MTRasym value of the Tuberculomas (mean 2.32± 0.50 s.d.) was significantly lower than high-grade gliomas (mean 4.32±0.84s.d.). Lower MTRasym values in tuberculomas are suggestive of relatively reduced mobile amide protons compared to the tumoral microenvironment. Perilesional elevated APT values in tuberculomas are a unique observation and may reflect a milieu of inflammation.
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