• Kiyohisa Kamimura, Masanori Nakajo, Misaki Gohara, Kodai Kawaji, Manisha Bohara, Yoshihiko Fukukura, Hiroyuki Uchida, Kazuhiro Tabata, Takashi Iwanaga, Yuta Akamine, Jochen Keupp, Tomoaki Fukami, and Takashi Yoshiura.
• Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
• J Neuroimaging. 2022 Sep 1; 32 (5): 920929920-929.

Background And PurposeDifferentiation between hemangioblastoma and brain metastasis remains a challenge in neuroradiology using conventional MRI. Amide proton transfer (APT) imaging can provide unique molecular information. This study aimed to evaluate the usefulness of APT imaging in differentiating hemangioblastomas from brain metastases and compare APT imaging with diffusion-weighted imaging and dynamic susceptibility contrast perfusion-weighted imaging.MethodsThis retrospective study included 11 patients with hemangioblastoma and 20 patients with brain metastases. Region-of-interest analyses were employed to obtain the mean, minimum, and maximum values of APT signal intensity, apparent diffusion coefficient (ADC), and relative cerebral blood volume (rCBV), and these indices were compared between hemangioblastomas and brain metastases using the unpaired t-test and Mann-Whitney U test. Their diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and area under the ROC curve (AUC). AUCs were compared using DeLong's method.ResultsAll MRI-derived indices were significantly higher in hemangioblastoma than in brain metastasis. ROC analysis revealed the best performance with APT-related indices (AUC = 1.000), although pairwise comparisons showed no significant difference between the mean ADC and mean rCBV.ConclusionsAPT imaging is a useful and robust imaging tool for differentiating hemangioblastoma from metastasis.© 2022 American Society of Neuroimaging.

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