Fluid-Suppressed APTw is more accurate than Leakage-Corrected rCBV imaging in the distinction between tumor progression and radionecrosis

The distinction between radionecrosis and tumor recurrence is a common diagnostic dilemma, as current advanced multiparametric MRI protocols lack on accuracy. Fluid-Suppressed Amide Proton Transfer weighted (APTw) imaging has strong potentials in brain tumor post-therapeutic assessment. In this study we compare at 3T the diagnostic accuracy of Fluid Suppressed APTw with the most used advanced technique, i.e. the Leakage-Corrected relative Cerebral Blood Volume imaging obtained by DSC perfusion in 22 pre-irradiated metastases. Results show that Fluid-Suppressed APTw metrics can clearly make a distinction between these two pathologies, in contrast to Leakage-Corrected rCBV contrast.