Utility of dynamic contrast-enhanced magnetic resonance imaging for differentiating glioblastoma, primary central nervous system lymphoma and brain metastatic tumor

Abstract

Purpose: The study aimed to investigate the use of dynamic contrast-enhanced magnetic resonance imaging (MRI)-derived permeability parameters for the differentiation of glioblastoma multiformes (GBMs), primary central nervous system lymphomas (PCNSLs), and brain metastatic tumors (MTs).

Materials and methods: Seventy-five patients with histopathologically confirmed GBMs (n=38), PCNSLs (n=16) and MTs (n=21) underwent dynamic contrast-enhanced MRIs before surgery. The volume transfer constant K(trans), the flux rate constant between extravascular extracellular space and plasma Kep, the extravascular extracellular volume Ve and the fractional plasma volume Vp were measured within the entire contrast-enhancing tumor by extended Tofts model. A one-way analysis of variance was used to compare all of the parameters among these three tumors, followed by the post-hoc test. Receiver operating characteristic curves were constructed to evaluate the diagnostic performance of the permeability parameters.

Results: Mean K(trans) value and Ve value were significantly higher in PCNSLs than in GBMs (P<0.001 and P=0.011) and MTs (P<0.001 and P<0.001). No significant difference was observed in all of the permeability parameters between GBMs and MTs. According to the receiver operating characteristic analyses, both K(trans) and Ve had good diagnostic performance for discriminating between PCNSLs and GBMs (the area under the curve: 0.847 and 0.785, respectively), as well as between PCNSLs and MTs (the area under the curve: 0.851 and 0.884, respectively).

Conclusions: The K(trans) and Ve derived from dynamic contrast-enhanced MRI facilitate the differentiation of PCNSLs from GBMs and MTs.

Keywords: Dynamic contrast-enhanced perfusion; Glioblastoma; Metastasis; Primary central nervous system lymphoma.