Mutlimodality MR imaging for differentiation between brain tumor lesions

• Purpose: Applying diffusion and perfusion metrics for evaluation of low-(LGG), high grade glioma (HGG) and metastases (MET) for differential diagnosis. Materials and Method: 43 patients (18HGG, 10 LGG, and 15MET) were included. MR data for tumour volume, perilesional edema, rCBF-, rCBV-, FLAIR-, FA-, ADC-maps were quantified by regions of interest (ROI). Measures of different parameters, and ratios, using contralateral white matter as denominator, were performed. A binary logistic regression model was constructed for multi-parametric analysis and ROCanalysis. Results: Significant difference was found for nADCt, rCBF, rCBV between LGG and HGG, nADCe between HGG and MET, and Ev, Ev-Tv ratio, nADCt, nADCe, rCBF, rCBV between LGG and MET. ROCanalysis for HGG compared to LGG showed 80 % sensitivity and 81.2 % specificity for nADCt, 100 % sensitivity and 100 % specificity for rCBF and 80 % sensitivity and 90 % specificity for rCBV. ROC-curves betweenMETand LGG showed sensitivity and specificity for Ev 73.3 % and 90 %, Ev-Tv ratio 80 % and 100 %, nADCt 90 % and 86.7 %, nADCe 80 % and 90 %, rCBF 93.3 % and 100 %, and rCBV 60 % and 100 %. Combining Ev, Ev-Tv ratio, nADCt, nADCe and rCBV between METand LGG gave 93.3%sensitivity and 100%specificity. Combining nADCt and rCBV between HGG and LGG 86.7 % sensitivity and 100 % specificity. Conclusion: Multi-parametric imaging protocols is an advantage for preoperative distinction of LGG, HGG and MET.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Nyckelord

brain damage

cancer susceptibility

clinical article

diagnostic test accuracy study

diencephalon

differentiation

edema

female

glioma

human

logistic regression analysis

male

metastasis

nuclear magnetic resonance imaging

quantitative study

receiver operating characteristic

sensitivity and specificity

statistical model

tumor volume

white matter

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kon (ämneskategori)

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