Comparison of amide proton transfer imaging with perfusion imaging of using arterial spin-labeling for evidence of tumor invasion in glioblastoma

•Amide proton transfer imaging may be superior for predicting tumor invasion than arterial spin-labeling-cerebral blood flow in glioblastoma.•Amide proton transfer signal intensity shows a positive relationship with cell density in glioblastoma. In glioblastoma, differentiation between cerebral edema and tumor infiltration is an important clinical question. Amide proton transfer (APT) and cerebral blood flow (CBF) are useful for evaluating the tumor invasion. In this case series, arterial spin-labeling (ASL)-CBF and APT were compared to determine which method was superior for predicting tumor infiltration in glioblastomas. Twelve specimens from 4 glioblastoma patients with confirmed selective sampling were obtained. APT signal intensity (SI) showed a strong correlation with cell density (R = 0.905; P