Predicting radionecrosis and recurrent disease through Amide Proton Transfer weighted imaging in brain metastases

Distinguishing tumor recurrence from radionecrotic injury of pre-irradiated brain metastases is fundamental to provide optimal patient care. Unfortunately, this distinction is often hard to make even with advanced MRI multimodal protocols. This study aims to evaluate APTw imaging in predicting the differentiation between radio-induced tissue changes from tumor progression at 3T in 20 pre-irradiated metastases. Results show that APTw metrics can significantly separate these two common radiological entities (p<0.0001) and suggest the use of fluid-suppressed APTw to reach higher discriminating values.