Magnetization Transfer Ratio based Metric for APTw or CESTw MRI Suppressing Signal from Fluid Compartments - Initial Application to Glioblastoma Assessment

Amide proton transfer weighted (APTw) MRI has been shown to allow assessment of the tumor aggressiveness/tumor grade with high sensitivity and specificity. Compartments with significant fluid content, like cysts, haemorrhage or necrosis may complicate reading. A metric for APTw MRI is developed, applicable for chemical exchange saturation transfer (CEST) MRI in general, which suppresses fluids based on the spectral shape of the background magnetization transfer ratio (MTR). It is shown to essentially conserve numerical values of APTw MRI in solid tissues. Furthermore, no extra acquisition time is needed, because the metric can be computed from the minimum Z-spectral data also required for standard CEST MRI. The novel metric is explored in an intial study on N=12 gliobastoma cases.