Evidence map›Paper›PMID 41233976›Full record

ArticleNeuro-oncology2026

Amide proton transfer-weighted (APTw) CEST MRI in clinical routine for single time point diagnosis of pseudoprogression in IDH-wildtype glioblastoma.

Thomas Zeyen, Inga Krause, Andreas Decker, Florian Kroh, Sebastian Regnery, Johannes Weller, Niklas Schaefer, Mousa Zidan, Anna-Laura Potthoff, Matthias Schneider and 11 more

Erratum issuedAbstract read
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In one paragraph

Article in Neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Thomas ZeyenDepartment of Neurooncology, Centers for Neurology and Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany (T.Z., J.W., N.S., C.S., U.H.).ORCID 0009-0006-2919-8622
Inga KrauseDepartment of Radiology, Brigham and Womeńs Hospital, Harvard Medical School, Boston, Massachusetts (T.Z., I.K., F.K., D.P.).
Andreas DeckerGerman Center for Neurodegenerative Diseases (DZNE), Bonn, Germany (A.D.).
Florian KrohDepartment of Radiology, Brigham and Womeńs Hospital, Harvard Medical School, Boston, Massachusetts (T.Z., I.K., F.K., D.P.).
Sebastian RegneryDepartment of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany (S.R.).
Johannes WellerDepartment of Neurooncology, Centers for Neurology and Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany (T.Z., J.W., N.S., C.S., U.H.).ORCID 0000-0001-5818-5392
Niklas SchaeferDepartment of Neurooncology, Centers for Neurology and Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany (T.Z., J.W., N.S., C.S., U.H.).
Mousa ZidanDepartment of Neuroradiology, University Hospital Bonn, Bonn, Germany (I.K., M.Z., A.R., D.P.).
Anna-Laura PotthoffDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany (A.P., M.S., H.V.).ORCID 0000-0002-5710-6557
Matthias SchneiderDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany (A.P., M.S., H.V.).ORCID 0000-0002-6025-7479
Lea L FrikerInstitute of Neuropathology, University Hospital Bonn, Bonn, Germany (L.F., T.P.).
Jochen KeuppPhilips Research, Hamburg, Germany (J.K., C.K.).
Christoph KatemannPhilips Research, Hamburg, Germany (J.K., C.K.).
Julian P LayerInstitute of Experimental Oncology, University Hospital Bonn, Bonn, Germany (L.F., J.L.).
Christina SchaubDepartment of Neurooncology, Centers for Neurology and Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany (T.Z., J.W., N.S., C.S., U.H.).
Eleni GkikaDepartment of Radiation Oncology, University Hospital Bonn, Bonn, Germany (J.L., E.G.).
Hartmut VatterDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany (A.P., M.S., H.V.).
Torsten PietschInstitute of Neuropathology, University Hospital Bonn, Bonn, Germany (L.F., T.P.).
Alexander RadbruchDepartment of Neuroradiology, University Hospital Bonn, Bonn, Germany (I.K., M.Z., A.R., D.P.).
Ulrich HerrlingerDepartment of Neurooncology, Centers for Neurology and Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany (T.Z., J.W., N.S., C.S., U.H.).
Daniel PaechDepartment of Radiology, Brigham and Womeńs Hospital, Harvard Medical School, Boston, Massachusetts (T.Z., I.K., F.K., D.P.).ORCID 0000-0001-5755-6833

Funding

Else Kroener Fresenius Stiftung 2022_EKES.33German Research Foundation 2024-12-03Medical -FacultyMedical Faculty of the University of Bonn 2022-1A-09University of Bonn 2024-1A-03
6 · The paper itself

Abstract

backgroundDifferentiating progressive disease (PD) from treatment-related effects (TRE) in glioblastoma remains challenging, particularly at single time point evaluations. TRE can occur at any disease stage, and its underlying biology is poorly understood. This study evaluates the clinical feasibility and diagnostic performance of amide proton transfer-weighted (APTw) MRI in this challenge.

methodsFollowing the integration of APTw MRI into the routine clinical workflow for brain tumor imaging, we screened a total of 870 scans from 626 patients. APTw signal (voxel-based measurement) was automatically quantified in gadolinium-enhanced T1w and FLAIR regions of interest using a deep learning-based approach for 3D tumor segmentations. PD and TRE were compared using unpaired t-tests, and diagnostic accuracy was assessed via ROC- and logistic regression analysis.

resultsAmong 256 MRI scans of 143 patients with glioblastoma, 65 scans showed PD (n = 42) or TRE (n = 23). The median APTw signal was higher in PD (2.23%) vs TRE (1.76%; P = .001). ROC analysis showed an area under the curve (AUC) of 0.82. In patients with early PD or TRE (<6 months post-radiotherapy), the AUC increased to 0.93. Anti-angiogenic therapy decreased APTw signal (P < .01). Combining APTw MRI with DWI and PWI improved diagnostic accuracy (AUC = 0.90).

conclusionsAPTw MRI is a non-invasive imaging tool that is feasible for clinical routine and aids in differentiation of early progression from pseudoprogression in glioblastoma. Its diagnostic accuracy decreases with application of anti-angiogenic treatment and at later follow-up time points. Highest diagnostic accuracy was found in a multimodal approach combining APTw MRI, PWI and DWI.

Indexed as

Brain NeoplasmsGlioblastomaIsocitrate DehydrogenaseMagnetic Resonance ImagingAdultAgedAmidesDisease ProgressionFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProtonsAmidesIsocitrate DehydrogenaseProtonsamide proton transfer-weighted imagingAPTw MRIbiomarkersCESTchemical exchange saturation transferDWIglioblastomaperfusionpseudoprogression

Identifiers

PMID41233976
PMCPMC13070506

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.