Amide proton transfer (APT) imaging was applied to the grading of pediatric brain tumors for the first time with its performance evaluated by the Receiver Operating Characteristic (ROC) curve. Ninety-two patients were enrolled in this study, of whom 48 cases were high-grade tumors and 44 cases were low-grade tumors. An experienced radiologist delineated the initial ROIs, which were then automatically masked and shrunk to avoid artifacts and subjective bias. APT MRI was able to differentiate low-grade pediatric brain tumors from high-grade ones, with a maximum area under the ROC curve of 0.95 in conjunction with quantitative T1 and T2.
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