open access

Vol 53, No 3 (2019)
Research Paper
Submitted: 2019-03-22
Accepted: 2019-06-03
Published online: 2019-06-10
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Multiparametric MRI in differentiating solitary brain metastasis from high-grade glioma: diagnostic value of the combined use of diffusion-weighted imaging, dynamic susceptibility contrast imaging, and magnetic resonance spectroscopy parameters

Kerim Aslan1, Hediye Pinar Gunbey2, Leman Tomak3, Lutfi Incesu1
·
Pubmed: 31180131
·
Neurol Neurochir Pol 2019;53(3):227-237.
Affiliations
  1. Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, 55139 Samsun, Türkiye
  2. Department of Radiology, Health Sciences University Kartal Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey, 34865 Istanbul, Türkiye
  3. Department of Biostatistics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, 55139 Samsun, Türkiye

open access

Vol 53, No 3 (2019)
Research papers
Submitted: 2019-03-22
Accepted: 2019-06-03
Published online: 2019-06-10

Abstract

Objective. The purpose of this study was to determine whether the combined use of diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and dynamic susceptibility contrast imaging (DSCI) parameters could provide a more accurate diagnosis in the differentiation of high-grade glioma (HGG) from solitary brain metastasis (SBM) in the enhancing tumour and in the peritumoural region.

Materials and methods. Fifty-six patients who received DWI, DSCI, and MRS before surgery were assessed. In differentiating SBM from HGG, the cutoff values of the DWI-apparent diffusion coefficient (ADCmin, ADCmax, and ADCmean), DSCI-relative cerebral blood volume (rCBV), and MRS-Cho/Cr, Cho/NAA, and NAA/Cr parameters for the peritumoural region were determined with ROC. The combined ROC curve was used for the different combinations of the peritumoural region DWI, DSCI, and MRS parameters in differentiating between the two tumours, and the best model combination was formed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. This study was approved by the Institutional Review Board at our institutes.

Results. In the enhancing tumour, all the parameters except NAA/Cr (P = 0.024) exhibited no statistical difference in differentiating between these two groups (P > 0.05). AUC values for ADCmin, ADCmax, ADCmean, rADCmin, rADCmax, rADCmean, rCBV, Cho/Cr, Cho/NAA, and NAA/Cr parameters in the peritumoural region in differentiating SBM from HGG were 0.860, 0.822, 0.848, 0.822, 0.801, 0.822, 0.906, 0.851, 0.903, and 0.784, respectively. In differentiating HGG from SBM, the best model consisted of the
combination of peritumoural ADCmin, rCBV, and Cho/NAA parameters. AUC values were 0.970.

Conclusions. The combination of peritumoural region ADCmin, rCBV, and Cho/NAA parameters can help in differentiating SBM from HGG, with a diagnostic accuracy of 97%.

Abstract

Objective. The purpose of this study was to determine whether the combined use of diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and dynamic susceptibility contrast imaging (DSCI) parameters could provide a more accurate diagnosis in the differentiation of high-grade glioma (HGG) from solitary brain metastasis (SBM) in the enhancing tumour and in the peritumoural region.

Materials and methods. Fifty-six patients who received DWI, DSCI, and MRS before surgery were assessed. In differentiating SBM from HGG, the cutoff values of the DWI-apparent diffusion coefficient (ADCmin, ADCmax, and ADCmean), DSCI-relative cerebral blood volume (rCBV), and MRS-Cho/Cr, Cho/NAA, and NAA/Cr parameters for the peritumoural region were determined with ROC. The combined ROC curve was used for the different combinations of the peritumoural region DWI, DSCI, and MRS parameters in differentiating between the two tumours, and the best model combination was formed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. This study was approved by the Institutional Review Board at our institutes.

Results. In the enhancing tumour, all the parameters except NAA/Cr (P = 0.024) exhibited no statistical difference in differentiating between these two groups (P > 0.05). AUC values for ADCmin, ADCmax, ADCmean, rADCmin, rADCmax, rADCmean, rCBV, Cho/Cr, Cho/NAA, and NAA/Cr parameters in the peritumoural region in differentiating SBM from HGG were 0.860, 0.822, 0.848, 0.822, 0.801, 0.822, 0.906, 0.851, 0.903, and 0.784, respectively. In differentiating HGG from SBM, the best model consisted of the
combination of peritumoural ADCmin, rCBV, and Cho/NAA parameters. AUC values were 0.970.

Conclusions. The combination of peritumoural region ADCmin, rCBV, and Cho/NAA parameters can help in differentiating SBM from HGG, with a diagnostic accuracy of 97%.

Get Citation

Keywords

Solitary brain metastasis, high-grade glioma, diffusion-weighted imaging, dynamic susceptibility contrast

About this article
Title

Multiparametric MRI in differentiating solitary brain metastasis from high-grade glioma: diagnostic value of the combined use of diffusion-weighted imaging, dynamic susceptibility contrast imaging, and magnetic resonance spectroscopy parameters

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 3 (2019)

Article type

Research Paper

Pages

227-237

Published online

2019-06-10

Page views

2141

Article views/downloads

521

DOI

10.5603/PJNNS.a2019.0024

Pubmed

31180131

Bibliographic record

Neurol Neurochir Pol 2019;53(3):227-237.

Keywords

Solitary brain metastasis
high-grade glioma
diffusion-weighted imaging
dynamic susceptibility contrast

Authors

Kerim Aslan
Hediye Pinar Gunbey
Leman Tomak
Lutfi Incesu

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