{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:47:31Z","timestamp":1793292451227,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol Exp"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Extensive glioblastoma infiltration justifies a 15-mm margin around the gross tumor volume (GTV) to define the radiotherapy clinical target volume (CTV). Amide proton transfer (APT)-weighted imaging could enable visualization of tumor infiltration, allowing more accurate GTV delineation. We quantified the impact of integrating APT-weighted imaging into GTV delineation of glioblastoma and compared two APT-weighted quantification methods\u2014magnetization transfer ratio asymmetry (MTR<jats:sub>asym<\/jats:sub>) and Lorentzian difference (LD) analysis\u2014for target delineation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Nine glioblastoma patients underwent an extended imaging protocol prior to radiotherapy, yielding APT-weighted MTR<jats:sub>asym<\/jats:sub> and LD maps. From both maps, biological tumor volumes were generated (BTV<jats:sub>MTRasym<\/jats:sub> and BTV<jats:sub>LD<\/jats:sub>) and added to the conventional GTV to generate biological GTVs (GTV<jats:sub>bio,MTRasym<\/jats:sub> and GTV<jats:sub>bio,LD<\/jats:sub>). Wilcoxon signed-rank tests were performed for comparisons.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The GTV<jats:sub>bio,MTRasym<\/jats:sub> and GTV<jats:sub>bio,LD<\/jats:sub> were significantly larger than the conventional GTV (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.022), with a median volume increase of 9.3% and 2.1%, respectively. The GTV<jats:sub>bio,MTRasym<\/jats:sub> and GTV<jats:sub>bio,LD<\/jats:sub> were significantly smaller than the CTV (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), with a median volume reduction of 72.1% and 70.9%, respectively. There was no significant volume difference between the BTV<jats:sub>MTRasym<\/jats:sub> and BTV<jats:sub>LD<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009=\u20090.074). In three patients, BTV<jats:sub>MTRasym<\/jats:sub> delineation was affected by elevated signals at the brain periphery due to residual motion artifacts; this elevation was absent on the APT-weighted LD maps.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Larger biological GTVs compared to the conventional GTV highlight the potential of APT-weighted imaging for radiotherapy target delineation of glioblastoma. APT-weighted LD mapping may be advantageous for target delineation as it may be more robust against motion artifacts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Relevance statement<\/jats:title>\n                <jats:p>The introduction of APT-weighted imaging may, ultimately, enhance visualization of tumor infiltration and eliminate the need for the substantial 15-mm safety margin for target delineation of glioblastoma. This could reduce the risk of radiation toxicity while still effectively irradiating the tumor.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT05970757 (ClinicalTrials.gov).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p>Integration of APT-weighted imaging into target delineation for radiotherapy is feasible.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>The integration of APT-weighted imaging yields larger GTVs in glioblastoma.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>APT-weighted LD mapping may be more robust against motion artifacts than APT-weighted MTR<jats:sub>asym<\/jats:sub>.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s41747-024-00523-4","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T17:01:52Z","timestamp":1730307712000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Amide proton transfer-weighted CEST MRI for radiotherapy target delineation of glioblastoma: a prospective pilot study"],"prefix":"10.1186","volume":"8","author":[{"given":"Patrick L. 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