Molecular Imaging and Biology

, Volume 21, Issue 2, pp 348–355 | Cite as

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 ChenEmail author
Research Article



To prospectively evaluate the feasibility and capability of amide proton transfer-weighted (APTw) imaging for the characterization of head and neck tumors.


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.


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).


APTw MRI is feasible for use in the head and neck tumors and is a valuable imaging biomarker for distinguishing malignant from benign lesions.

Key words

APTw imaging CEST imaging Head and neck tumors MRI 



This study was supported by grants from the National Natural Science Foundation of China (81361120392, 81401404, and 81771826), Beijing Municipal Natural Science Foundation (7154235), and the National Institutes of Health (R01CA166171, R01CA228188).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© World Molecular Imaging Society 2018

Authors and Affiliations

  • Lu Yu
    • 1
    • 2
  • Chunmei Li
    • 1
  • Xiaojie Luo
    • 1
  • Jinyuan Zhou
    • 3
  • Chen Zhang
    • 1
  • Yi Zhang
    • 4
  • Min Chen
    • 1
    • 2
    Email author
  1. 1.Department of Radiology, Beijing HospitalNational Center of GerontologyBeijingChina
  2. 2.Graduate School of Peking Union Medical CollegeBeijingChina
  3. 3.Department of RadiologyJohns Hopkins UniversityBaltimoreUSA
  4. 4.Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument ScienceZhejiang UniversityHangzhouChina

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