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18.05.2021 | Neuro

Differentiation between glioblastoma and primary CNS lymphoma: application of DCE-MRI parameters based on arterial input function obtained from DSC-MRI

verfasst von: Koung Mi Kang, Seung Hong Choi, Park Chul-Kee, Tae Min Kim, Sung-Hye Park, Joo Ho Lee, Soon-Tae Lee, Inpyeong Hwang, Roh-Eul Yoo, Tae Jin Yun, Ji-Hoon Kim, Chul-Ho Sohn

Erschienen in: European Radiology | Ausgabe 12/2021

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Abstract

Objective

This study aimed to evaluate whether arterial input functions (AIFs) obtained from dynamic susceptibility contrast (DSC)–MRI (AIFDSC) improve the reliability and diagnostic accuracy of dynamic contrast–enhanced (DCE)–derived pharmacokinetic (PK) parameters for differentiating glioblastoma from primary CNS lymphoma (PCNSL) compared with AIFs derived from DCE-MRI (AIFDCE).

Methods

This retrospective study included 172 patients with glioblastoma (n = 147) and PCNSL (n = 25). All patients had undergone preoperative DSC- and DCE-MRI. The volume transfer constant (Ktrans), volume of the vascular plasma space (vp), and volume of the extravascular extracellular space (ve) were acquired using AIFDSC and AIFDCE. The relative cerebral blood volume (rCBV) was obtained from DSC-MRI. Intraclass correlation coefficients (ICC) and ROC curves were used to assess the reliability and diagnostic accuracy of individual parameters.

Results

The mean Ktrans, vp, and ve values revealed better ICCs with AIFDSC than with AIFDCE (Ktrans, 0.911 vs 0.355; vp, 0.766 vs 0.503; ve, 0.758 vs 0.657, respectively). For differentiating all glioblastomas from PCNSL, the mean rCBV (AUC = 0.856) was more accurate than the AIFDSC-driven mean Ktrans, which had the largest AUC (0.711) among the DCE-derived parameters (p = 0.02). However, for glioblastomas with low rCBV (≤ 75th percentile of PCNSL; n = 30), the AIFDSC-driven mean Ktrans and vp were more accurate than rCBV (AUC: Ktrans, 0.807 vs rCBV, 0.515, p = 0.004; vp, 0.715 vs rCBV, p = 0.045).

Conclusion

DCE-derived PK parameters using the AIFDSC showed improved reliability and diagnostic accuracy for differentiating glioblastoma with low rCBV from PCNSL.

Key Points

An accurate differential diagnosis of glioblastoma and PCNSL is crucial because of different therapeutic strategies.
In contrast to the rCBV from DSC-MRI, another perfusion imaging technique, the DCE parameters for the differential diagnosis have been limited because of the low reliability of AIFs from DCE-MRI.
When we analyzed DCE-MRI data using AIFs from DSC-MRI (AIFDSC), AIFDSC-driven DCE parameters showed improved reliability and better diagnostic accuracy than rCBV for differentiating glioblastoma with low rCBV from PCNSL.
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Metadaten
Titel
Differentiation between glioblastoma and primary CNS lymphoma: application of DCE-MRI parameters based on arterial input function obtained from DSC-MRI
verfasst von
Koung Mi Kang
Seung Hong Choi
Park Chul-Kee
Tae Min Kim
Sung-Hye Park
Joo Ho Lee
Soon-Tae Lee
Inpyeong Hwang
Roh-Eul Yoo
Tae Jin Yun
Ji-Hoon Kim
Chul-Ho Sohn
Publikationsdatum
18.05.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 12/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08044-z

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