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Clinical Trial
. 2013 Jun-Jul;34(6):1145-9.
doi: 10.3174/ajnr.A3383. Epub 2013 Jan 24.

Differentiation of primary central nervous system lymphomas and glioblastomas: comparisons of diagnostic performance of dynamic susceptibility contrast-enhanced perfusion MR imaging without and with contrast-leakage correction

C H Toh  1 , K-C Wei, C-N Chang, S-H Ng, H-F Wong
Affiliations
Clinical Trial

Differentiation of primary central nervous system lymphomas and glioblastomas: comparisons of diagnostic performance of dynamic susceptibility contrast-enhanced perfusion MR imaging without and with contrast-leakage correction

C H Toh et al. AJNR Am J Neuroradiol. 2013 Jun-Jul.

Abstract

Background and purpose: Contrast leakage results in underestimation of the CBV of brain tumors. Our aim was to compare the diagnostic performance of DSC perfusion MR imaging without and with mathematic contrast-leakage correction in differentiating PCNSLs and glioblastomas.

Materials and methods: Perfusion parameters-CBV, corrected CBV, and leakage coefficient-were measured in enhancing tumor portions and contralateral NAWM of 15 PCNSLs and 20 glioblastomas, respectively. The ratios of CBV and corrected CBV were calculated by dividing the tumor values by those obtained from contralateral NAWM. A paired t test was used to compare tumor K2 and NAWM K2, as well as tumor CBV ratios without and with leakage correction. Comparisons of CBV, corrected CBV, and K2 between PCNSLs and glioblastomas were done by using a 2-sample t test. The diagnostic performance of DSC perfusion MR imaging without and with contrast-leakage correction was assessed with receiver operating characteristic curve analysis.

Results: PCNSLs and glioblastomas demonstrated higher K2 than those in their contralateral NAWM. Corrected CBV ratios were significantly higher than the uncorrected ones for both tumors. PCNSLs had lower CBV ratios (P < .001), lower corrected CBV ratios (P < .001), and higher K2 (P = .001) compared with glioblastomas. In differentiating between PCNSLs and glioblastomas, the area under the curve of the CBV ratio, corrected CBV ratio, and K2 were 0.984, 0.940, and 0.788, respectively.

Conclusions: PCNSL can be differentiated from glioblastoma with CBV ratios, corrected CBV ratios, and K2. CBV without contrast-leakage correction seems to have the best diagnostic performance in differentiating the 2 tumors.

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Figures

Fig 1.
Fig 1.
Measurements of perfusion parameters in a 22-year-old man with PCNSL. Axial contrast-enhanced MPRAGE (A) shows an enhancing mass in the right temporo-occipital region. B, On contrast-enhanced MPRAGE, 2 ROIs are placed, one over the entire enhancing tumor and another at the contralateral NAWM for the measurement of CBV (C), corrected CBV (D), and K2 (E), respectively.
Fig 2.
Fig 2.
Measurements of perfusion parameters in a 40-year-old woman with glioblastoma. Axial contrast-enhanced MPRAGE (A) shows an enhancing mass in the right lateral frontal region. B, On contrast-enhanced MPRAGE, 2 ROIs are placed, one over the entire enhancing tumor and another at the contralateral NAWM for the measurement of CBV (C), corrected CBV (D), and K2 (E), respectively.
Fig 3.
Fig 3.
Receiver operating characteristic curve analysis for comparisons of the diagnostic performance of CBV, corrected CBV, and K2.
See this image and copyright information in PMC

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