Differentiation of Malignant and Benign Head and Neck Tumors with Amide Proton Transfer-Weighted MR Imaging

Lu Yu, Chunmei Li, Xiaojie Luo, Jinyuan Zhou, Chen Zhang, Yi Zhang, Min Chen

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose: To prospectively evaluate the feasibility and capability of amide proton transfer-weighted (APTw) imaging for the characterization of head and neck tumors. Procedures: Twenty-nine consecutive patients with suspected head and neck tumors were enrolled in this study and underwent APTw magnetic resonance imaging (MRI) on a 3.0-T MRI scanner. The patients were divided into malignant (n = 16) and benign (n = 13) groups, based on pathological results. A map of magnetization transfer ratio asymmetry at 3.5 ppm [MTRasym (3.5 ppm)] was generated for each patient. Interobserver agreement was evaluated and comparisons of MTRasym (3.5 ppm) were made between the malignant and benign groups. Receiver operating characteristic analysis was used to determine the appropriate threshold value of MTRasym (3.5 ppm) for the differentiation of malignant from benign tumors. Results: The intraclass correlation coefficients of the malignant and benign groups were 0.96 and 0.90, respectively, which indicated a good interobserver agreement. MTRasym (3.5 ppm) was significantly higher for the malignant group (3.66 ± 1.15 %) than for the benign group (1.94 ± 0.93 %, P < 0.001). APTw MRI revealed an area under the curve of 0.904 in discriminating these two groups, with a sensitivity of 81.3 %, a specificity of 92.3 %, and an accuracy of 86.2 %, at the threshold of 2.62 % of MTRasym (3.5 ppm). Conclusions: APTw MRI is feasible for use in the head and neck tumors and is a valuable imaging biomarker for distinguishing malignant from benign lesions.

Original languageEnglish (US)
Pages (from-to)348-355
Number of pages8
JournalMolecular Imaging and Biology
Issue number2
StatePublished - Apr 15 2019


  • APTw imaging
  • CEST imaging
  • Head and neck tumors
  • MRI

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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