Differentiation
between Supratentorial
Single Brain Metastases
and High Grade Astrocytic
Tumors: an Evaluation
of Different DSC MRI Measurements
H.
Zhang, L.A. Rödiger,
G. Zhang, M. Oudkerk
SUMMARY – This
study
evaluated
the
role
of
different
perfusion
MRI
measurements
in
the
pre-operative
differentiation
between
single
brain
metastases
and
high
grade
astrocytic
tumors.
24
high-grade
astrocytic
tumors
and
29
single
metastases
were
studied.
A
gradient
echo-planar
sequence
was
used
for
DSC
MRI.
Relative
cerebral
blood
volume,
cerebral
blood
flow
and
mean
transit
time
in
both
tumor
parenchyma
(T
rCBV,
T
rCBF
and
T
rMTT)
and
peritumoral
edema
(P
rCBV,
P
rCBF
and
P
rMTT)
were
measured.
Mann-Whitney
tests
were
used
to
assess
differences
between
single
brain
metastases
and
high
grade
astrocytic
tumors.
Receiver
operating
characteristic
analyses
were
performed
to
determine
optimum
thresholds
for
tumor
differentiation.
Sensitivity,
specificity
and
accuracy
for
identifying
brain
metastases
were
calculated.
Mean
T
rCBV,
T
rCBF,
P
rCBV
and
P
CBF
of
brain
metastases
(2.75±1.72,
2.51±2.09,
1.05±0.53,
0.87±0.40)
differed
statistically
(P <0.05)
from
those
of
high
grade
astrocytic
tumors
(6.00±2.17,
5.68±2.35,
1.77±1.19
and
1.58±0.99).
No
statistical
difference
was
found
between
mean
rMTTs
of
these
two
entities
(P >0.05).
Based
on
the
area
under
the
ROC
curves
(AUC),
the
efficiency
of
T
rCBV
and
T
rCBF
for
correct
diagnosis
of
brain
metastases
is
almost
identical
(AUC:
0.899,
0.890
respectively)
and
superior
to
other
measurements.
A
threshold
value
of
3.50
for
T
rCBF
provided
the
same
specificity
(86.7)
as
that
of
T
rCBV
but
higher
sensitivity
(86.2)
and
accuracy
(86.3).
Different
perfusion
measurements
can
be
used
to
differentiate
single
metastases
from
high-grade
astrocytic
tumors.
T
rCBF
showed
the
highest
diagnostic
efficiency
among
these
measurements.
<< indietro/back |