Multicenter Validation of Amide Proton Transfer Imaging for Molecular and Grade Classification of Adult-Type Diffuse Gliomas

Motivation: Precise glioma classification is essential for personalized treatment, but non-invasive tools struggle with molecular differentiation. APT imaging shows promise, yet multicenter validation is lacking. Goal(s): This prospective study evaluates APT imaging's ability to classify adult-type diffuse gliomas by grade, subtype, and IDH status across multiple centers. Approach: Using standardized MRI protocols, 123 patients from three centers were analyzed. APT metrics were assessed for consistency and diagnostic performance. Results: APT imaging reliably distinguished glioma grades and IDH mutations across centers, though some challenges remain in differentiating certain subtypes. Impact: This study demonstrates that APT imaging reliably differentiates adult-type gliomas across centers, enabling more precise, non-invasive tumor characterization. It promotes earlier, molecularly informed diagnoses, guiding personalized treatment strategies and fostering research on APT imaging's prognostic and therapeutic potential.