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European Radiology
Erschienen in: European Radiology 10/2019

15.03.2019 | Neuro

Permeability measurement using dynamic susceptibility contrast magnetic resonance imaging enhances differential diagnosis of primary central nervous system lymphoma from glioblastoma

verfasst von: Ji Ye Lee, Atle Bjørnerud, Ji Eun Park, Bo Eun Lee, Joo Hyun Kim, Ho Sung Kim

Erschienen in: European Radiology | Ausgabe 10/2019

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Abstract

Objectives

To test if adding permeability measurement to perfusion obtained from dynamic susceptibility contrast MRI (DSC-MRI) improves diagnostic performance in the differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma.

Materials and methods

DSC-MRI was acquired in 145 patients with pathologically proven glioblastoma (n = 89) or PCNSL (n = 56). The permeability metrics of contrast agent extraction fraction (Ex), apparent permeability (Ka), and leakage-corrected perfusion of normalized cerebral blood volume (nCBVres) and cerebral blood flow (nCBFres) were derived from a tissue residue function. For comparison purposes, the leakage-corrected normalized CBV (nCBV) and relative permeability constant (K2) were also obtained using the established Weisskoff-Boxerman leakage correction method. The area under the receiver operating characteristics curve (AUC) and cross-validation were used to compare the diagnostic performance of the single DSC-MRI parameters with the performance obtained with the addition of permeability metrics.

Results

PCNSL demonstrated significantly higher permeability (Ex, p < .001) and lower perfusion (nCBVres, nCBFres, and nCBV, all p < .001) than glioblastoma. The combination of Ex and nCBVres showed the highest performance (AUC, 0.96; 95% confidence interval, 0.92–0.99) for differentiating PCNSL from glioblastoma, which was a significant improvement over the single perfusion (nCBV: AUC, 0.84; nCBVres: AUC, 0.84; nCBFres: AUC, 0.82; all p < .001) or Ex (AUC, 0.80; p < .001) parameters.

Conclusions

Analysis of the combined permeability and perfusion metrics obtained from a single DSC-MRI acquisition improves the diagnostic value for differentiating PCNSL from glioblastoma in comparison with single-parameter nCBV analysis.

Key Points

• Permeability measurement can be calculated from DSC-MRI with a tissue residue function-based leakage correction.
• Adding Exto CBV aids in the differentiation of PCNSL from glioblastoma.
• CBV and Exmeasurements from DSC-MRI were highly reproducible.
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Metadaten
Titel
Permeability measurement using dynamic susceptibility contrast magnetic resonance imaging enhances differential diagnosis of primary central nervous system lymphoma from glioblastoma
verfasst von
Ji Ye Lee
Atle Bjørnerud
Ji Eun Park
Bo Eun Lee
Joo Hyun Kim
Ho Sung Kim
Publikationsdatum
15.03.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06097-9

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