Abstract
This study sought to determine the diagnostic utility of perfusion parameters derived from dynamic contrast-enhanced (DCE) perfusion MRI with a short acquisition time (approximately 3.5 min) in patients with glioma, brain metastasis, and primary CNS lymphoma (PCNSL).Twenty-six patients with 29 lesions (4 low-grade glioma, 13 high-grade glioma, 7 metastasis, and 5 PCNSL) underwent DCE-MRI in a 3 T scanner. A ROI was placed on the hotspot of each tumor in maps for volume transfer contrast Ktrans, extravascular extracellular volume Ve, and fractional plasma volume Vp. We analyzed differences in parameters between tumors using the Mann–Whitney U test. We calculated sensitivity and specificity using receiver operating characteristics analysis.Mean Ktrans values of LGG, HGG, metastasis and PCNSL were 0.034, 0.31, 0.38, 0.44, respectively. Mean Ve values of each tumors was 0.036, 0.57, 0.47, 0.96, and mean Vp value of each tumors was 0.070, 0.086, 0.26, 0.17, respectively. Compared with other tumor types, low-grade glioma showed lower Ktrans (P < 0.01, sensitivity = 88%, specificity = 100%) and lower Ve (P < 0.01, sensitivity = 96%, specificity = 100%). PCNSL showed higher Ve (P < 0.01, sensitivity = 100%, specificity = 88%), but the other perfusion parameters overlapped with those of different histology.Kinetic parameters derived from DCE-MRI with short acquisition time provide useful information for the differential diagnosis of brain tumors.
Highlights
The differential diagnosis of brain tumor is critical to determining optimal therapy and estimating prognosis (DeAngelis 2001)
Dynamic contrast-enhanced (DCE) imaging, which allows for noninvasive evaluation of tumor vascularity, has been widely used to assess the physiology of brain tumor vascularity (Tofts 1996; Tofts et al 1999)
The results of this study indicate that kinetic parameters acquired from DCE perfusion study with short acquisition time supplement conventional imaging in predicting tumor histology
Summary
The differential diagnosis of brain tumor is critical to determining optimal therapy and estimating prognosis (DeAngelis 2001). Dynamic contrast-enhanced (DCE) imaging, which allows for noninvasive evaluation of tumor vascularity, has been widely used to assess the physiology of brain tumor vascularity (Tofts 1996; Tofts et al 1999). Dynamic acquisition of images during contrast enhancement allows for the specific descriptive parameters related to local microvasculature characteristics to be calculated. Both relaxivity (T1)- and susceptibility (T2*)-based approaches have demonstrated good potential for measuring the characteristics of tumor vasculature (Quarles et al 2012). Methods to assess changes in tissue T1 following contrast agent injection are commonly termed DCE-MRI and have been widely performed to assess microvascular permeability (Tofts 1996; Tofts et al 1999). In DCE-MRI, the signal intensity change can be measured with sufficient temporal resolution and is related to tissue contrast agent concentration
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