To evaluate the value of amide-proton-transfer weighted (APTw) imaging in differentiating pediatric low-grade gliomas (pLGG) and high-grade gliomas (pHGG). In this retrospective study, APTw imaging from 69 consecutive pediatric patients suspected of brain tumors from April 2021 to March 2024 were reviewed for possible inclusion. Histogram metrics of APTw imaging for the gross tumor core and solid components were extracted. Student's t-test or Mann-Whitney U test was used to compare histogram metrics between pLGG and pHGG. Receiver operating characteristic curve with area under the curve (AUC) was generated for statistically significant histogram metrics. A Bonferroni correction was applied for p value for 10 APTw metrics (p < 0.005 was considered significant). Thirty-two patients (mean age: 68 ± 39 months; 18 males, 16 females) were included in the final analysis. The gross tumor core of pLGG exhibited higher APTmin (p = 0.017), and lower variance (p = 0.041) compared to pHGG. The solid components of pHGG had higher APTmax (p = 0.02), variance (p = 0.02), entropy (p = 0.02) but lower APTmin (p = 0.03) compared to pLGG. For the gross tumor core, pilocytic astrocytoma had significantly higher APT 10th than pHGG (p = 0.003). The AUC for APT 10th to differentiating pilocytic astrocytoma and pHGG was 0.82. Volumetric tumor APT histogram analysis may serve as a potential tool for differentiating pLGG and pHGG, but its application is different from adult population.
Lin et al. (Thu,) studied this question.