Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 30;14(1):31909.
doi: 10.1038/s41598-024-83452-x.

Bi-exponential diffusion-weighted imaging for differentiating high-grade gliomas from solitary brain metastases: a VOI-based histogram analysis

Yifei Su  1 , Junhao Wang  1 , Jinxia Guo  2 , Xuanchen Liu  1 , Xiaoxiong Yang  1 , Rui Cheng  1 , Chunhong Wang  1 , Cheng Xu  3 , Yexin He  3 , Hongming Ji  4
Affiliations

Bi-exponential diffusion-weighted imaging for differentiating high-grade gliomas from solitary brain metastases: a VOI-based histogram analysis

Yifei Su et al. Sci Rep. .

Abstract

This study investigated the use of bi-exponential diffusion-weighted imaging (DWI) combined with structural features to differentiate high-grade glioma (HGG) from solitary brain metastasis (SBM). A total of 57 patients (31 HGG, 26 SBM) who underwent pre-surgical multi-b DWI and structural MRI (T1W, T2W, T1W + C) were included. Volumes of interest (VOI) in the peritumoral edema area (PTEA) and enhanced tumor area (ETA) were selected for analysis. Histogram features of slow diffusion coefficient (Dslow), fast diffusion coefficient (Dfast), and perfusion fraction (frac) were extracted. Results showed that HGG patients had higher skewness of Dfast (P = 0.022) and frac (P = 0.077), higher kurtosis of Dslow (P = 0.019) and frac (P = 0.025), and lower entropy of Dslow (P = 0.005) and frac (P = 0.001) within the ETA. Additionally, HGG exhibited lower mean frac in both ETA (P = 0.007) and PTEA (P = 0.017). Combining skewness of frac in ETA with clear tumor margin enhanced diagnostic performance, achieving an optimal AUC of 0.79. These findings suggest that histogram analysis of diffusion and perfusion characteristics in ETA and structural features can effectively differentiate HGG from SBM.

Keywords: Diffusion; Diffusion-weighted imaging; High-grade glioma; Perfusion; Solitary brain metastasis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: J. Guo is an employee of GE Healthcare. The other authors have no conflicts of interest to declare. Ethics approval: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The protocol was reviewed and approved by the Ethics Committee of Shanxi Provincial People’s Hospital/Fifth Hospital of Shanxi Medical University (2022 Research Review No. 153). Consent to participate: The informed consent was waived by the Ethics Committee of Shanxi Provincial People’s Hospital /Fifth Hospital of Shanxi Medical University (2022 Research Review No. 153). Consent to publish: Not applicable.

Figures

Fig. 1
Fig. 1
Study flow chart.
Fig. 2
Fig. 2
A 63-year-old male diagnosed with glioblastoma. (A) T2W imaging. (B) T1W imaging. (C) Contrast-enhanced T1W imaging. (D) Dfast (×10-4mm2/s). (E) Dslow (×10-4mm2/s). (F) frac (%). (G-I) Histogram plot of Dfast, Dslow, and frac of the enhanced tumor area. The MRI examination revealed an irregular lesion in the sub-cortex of the right frontal lobe, characterized by a blurred margin. The lesion exhibited diffuse enhancement, marked in red, along with hyper-intensity on T2-weighted imaging and hypo-intensity on T1-weighted imaging. Peritumoral edema was also observed. Parametric values obtained from histogram analysis of the enhanced tumor area are as follows: Dfast: mean: 37.98, entropy: 3.19, skewness: 1.15, kurtosis: 6.60. Dslow: mean: 8.52, entropy: 3.68. skewness: 0.33, kurtosis: 3.60, frac: mean: 18.46, entropy: 3.07, skewness: 0.68, kurtosis: 5.06.
Fig. 3
Fig. 3
A 34-year-old female diagnosed with brain metastasis originating from breast cancer. (A) T2W imaging. (B) T1W imaging. (C) Contrast-enhanced T1W imaging. (D) Dfast (×10-4mm2/s). (E) Dslow (×10-4mm2/s). (F) frac (%). (G-I) Histogram plot of Dfast, Dslow, and frac of the enhanced tumor area. The MRI examination revealed an irregular lesion with a well-defined margin in the sub-cortex of the right occipital lobe. The lesion exhibited diffuse enhancement, marked in red, and appeared hyper-intense on T2-weighted imaging, hypo-intense on T1-weighted imaging, and was accompanied by peritumoral edema. Additionally, central necrosis was observed within the lesion. Parametric values obtained from histogram analysis of the enhanced tumor area are as follows: Dfast: mean: 45.38, entropy: 3.80, skewness: 0.70, kurtosis: 4.42; Dslow: mean: 8.55, entropy: 4.09, skewness: 0.47, kurtosis: 2.85; frac: mean: 25.15, entropy: 3.76, skewness: 0.49, kurtosis: 3.31.
Fig. 4
Fig. 4
The ROC curves for univariate (A) and binary (B) logistic regression analysis.
See this image and copyright information in PMC

References

    1. Miller, K. D. et al. Brain and other central nervous system tumor statistics, 2021. CA Cancer J. Clin.71, 381–406. 10.3322/caac.21693 (2021). - PubMed
    1. Sacks, P. & Rahman, M. Epidemiology of brain metastases. Neurosurg. Clin. N. Am.31, 481–488. 10.1016/j.nec.2020.06.001 (2020). - PubMed
    1. Louis, D. N. et al. The 2021 WHO classification of tumors of the central nervous system: A summary. Neuro Oncol.23, 1231–1251. 10.1093/neuonc/noab106 (2021). - PMC - PubMed
    1. Horbinski, C. et al. NCCN Guidelines® insights: Central nervous system cancers, Version 2.2022. J. Natl. Compr. Canc. Netw.21, 12–20. 10.6004/jnccn.2023.0002 (2023). - PubMed
    1. Cha, S. et al. Differentiation of glioblastoma multiforme and single brain metastasis by peak height and percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging. AJNR Am. J. Neuroradiol.28, 1078–1084. 10.3174/ajnr.A0484 (2007). - PMC - PubMed

LinkOut - more resources