Abstract #2395

Amide proton transfer weighted (APTw) imaging for identifying treatment-induced MRI changes in IDH-wildtype glioblastoma at 3 Tesla

Inga Krause^1,2, Thomas Zeyen³, Andreas Decker⁴, Florian Kroh², Sebastian Regnery², Niklas Schaefer³, Johannes Weller³, Jochen Keupp⁵, Christoph Katemann⁵, Alexander Radbruch¹, Ulrich Herrlinger³, and Daniel Paech^1,2

¹Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany, ²Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States, ³Department of Neurooncology, Center for Neurology and Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany, ⁴German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany, ⁵Philips Research, Hamburg, Germany

Synopsis

Keywords: Tumors (Post-Treatment), CEST / APT / NOE, Pseudoprogression, Glioblastoma

Motivation: Treatment-induced MRI changes in glioblastoma are common and, using standard techniques, are often difficult to distinguish from true tumor progression.

Goal(s): To evaluate the diagnostic potential of amide proton transfer weighted (APTw) imaging, an FDA-approved and non-invasive tool, to distinguish pseudoprogression from true progression in molecularly defined glioblastomas.

Approach: The mean APTw signal in contrast-enhancing lesions was compared between confirmed progression and treatment-induced MRI changes.

Results: The APTw signal is significantly higher in confirmed progression compared to treatment-induced MRI changes and shows high sensitivity (>90%) in identifying pseudoprogression.

Impact: APTw imaging shows promise for clinical use in glioblastoma assessment, particularly for identifying treatment-induced MRI changes. Future prospective studies should evaluate the combination of APTw imaging with other techniques (e.g., DWI and/or perfusion MRI) to further enhance diagnostic accuracy.

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