Differentiation Between Calcification and Hemorrhage in Brain Tumors Using Susceptibility-Weighted Imaging: A Pilot Study

Berberat, Jatta; Grobholz, Rainer; Boxheimer, Larissa; Rogers, Susanne; Remonda, Luca; Roelcke, Ulrich

doi:10.2214/ajr.13.10745

Cited by 44 publications

(49 citation statements)

References 7 publications

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“…In this study, there were 25 patients with astrocytoma, 11 with oligodendroglioma, 8 with ependymoma and 1 with GBM in observation group. Its characteristics of general CT signs are in accordance with the previous reports (Berberat et al, 2014). By comparison to the CT signs in both groups, it could be found that the CT signs of patients with glioma stroke usually manifested coexistence of hemorrhage and tumor signs.…”

Section: Discussionsupporting

confidence: 89%

Application of Computed Tomography for Differential Diagnosis of Glioma Stoke and Simple Cerebral Hemorrhage

Zhou²,

Shangguan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To explore the value of computed tomography (CT) in the differential diagnosis of glioma stroke and simple cerebral hemorrhage. Materials and Methods: A total of 45 patients with glioma stroke and stroke as the initial symptom in our hospital from Jun., 2009 to Oct., 2013 were selected along with 50 individuals with simple cerebral hemorrhage in the same period randomly collected as a control group. The CT results in both groups were analyzed and compared. Results: In the observation group, there were 25 patients with astrocytoma (55.6%), 11 with oligodendroglioma (24.4%), 8 with ependymoma (17.2%) and 1 with glioblastoma multiforma (GBM, 2.22%). Additionally, the major CT manifestation was coexistence of hemorrhage and tumor signs. By comparison, it could be found that the proportions of patients respectively with peripheral edema and spaceoccupying effect in the observation group were significantly higher than in the control group (P<0.01). Conclusions: Application of CT examination combined with medical history in patients has very important clinical value in the differential diagnosis of glioma stroke and simple cerebral hemorrhage.

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Section: Discussionsupporting

confidence: 89%

Application of Computed Tomography for Differential Diagnosis of Glioma Stoke and Simple Cerebral Hemorrhage

Zhou²,

Shangguan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…In each of these studies, SECT was used as the gold standard for presence of calcification, and thus the usefulness of these methods can be reported only for hemorrhage and calcification above 100 HU. Preliminary work suggests that calcification and hemorrhage in glioma may be differentiable under the 100HU limit using phase data derived from susceptibility-weighted imaging 43 . However, the transition from research to clinical use of phase-dependent MR techniques has been difficult due to the sensitivity of the technique to magnetic field inhomogeneity, which is the rule, rather than the exception in clinical applications.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Low-Attenuation Intracranial Hemorrhage and Calcification Using Dual-Energy Computed Tomography in a Phantom System

Nute¹,

Roux²,

Chandler³

et al. 2015

Investigative Radiology

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Objectives Calcific and hemorrhagic intracranial lesions with attenuation levels of <100 Hounsfield Units (HU) cannot currently be reliably differentiated by single-energy computed tomography (SECT). The proper differentiation of these lesion types would have a multitude of clinical applications. A phantom model was used to test the ability of dual-energy CT (DECT) to differentiate such lesions. Materials and Methods Agar gel-bound ferric oxide and hydroxyapatite were used to model hemorrhage and calcification, respectively. Gel models were scanned using SECT and DECT and organized into SECT attenuation-matched pairs at 16 attenuation levels between 0 and 100 HU. DECT data were analyzed using 3D Gaussian mixture models (GMMs), as well as a simplified threshold plane metric derived from the 3D GMM, to assign voxels to hemorrhagic or calcific categories. Accuracy was calculated by comparing predicted voxel assignments with actual voxel identities. Results We measured 6,032 voxels from each gel model, for a total of 193,024 data points (16 matched model pairs). Both the 3D GMM and its more clinically implementable threshold plane derivative yielded similar results, with >90% accuracy at matched SECT attenuation levels ≥50 HU. Conclusions Hemorrhagic and calcific lesions with attenuation levels between 50 and 100 HU were differentiable using DECT in a clinically relevant phantom system with >90% accuracy. This method warrants further testing for potential clinical applications.

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“…The CT attenuation of MR enhanced regions was significantly lower for patients with TDLs than for those with tumour (Kim et al, 2009). The finding of blood or calcium in the centre of a lesion would favour tumour (Berberat et al, 2014) vs. TDL, and some tumours (e.g. lymphoma) can appear hyperintense on CT even without CT contrast dye (Goldstein et al, 1991).…”

Section: Ct Scanmentioning

confidence: 95%

Neuro-oncology dilemma: Tumour or tumefactive demyelinating lesion

Abdoli

Freedman

2015

Multiple Sclerosis and Related Disorders

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Tumefactive demyelinating lesions (TDLs) are not an uncommon manifestation of demyelinating disease but can pose diagnostic challenges in patients without a pre-existing diagnosis of multiple sclerosis (MS) as well as in known MS patients. Brain tumours can also arise in MS patients and can be seen in chronic MS patients as co-morbidities. Delayed diagnosis or unnecessary intervention or treatment will affect the ultimate prognosis of these patients. In this article, we will review some typical cases illustrating the dilemma and review the information that helps to differentiate the two conditions. The intention is not to present an extensive differential diagnosis of both entities, but to examine some typical examples when the decision arises to decide between the two. We take a somewhat different approach, by presenting the cases in "real time", allowing the readers to consider in their own minds which diagnosis they favour, discussing in detail some of the pertinent literature, then revealing later the actual diagnosis. We would urge readers to consider re-visiting their first thoughts about each case after reading the discussion, before reading the follow-up of each case. The overall objective is to highlight the real possibility of being forced to decide between these two entities in clinical practise, present a reasonable approach to help differentiate them and especially to focus on the possibility of TDLs in order to avoid unnecessary biopsy.

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Differentiation Between Calcification and Hemorrhage in Brain Tumors Using Susceptibility-Weighted Imaging: A Pilot Study

Cited by 44 publications

References 7 publications

Application of Computed Tomography for Differential Diagnosis of Glioma Stoke and Simple Cerebral Hemorrhage

Application of Computed Tomography for Differential Diagnosis of Glioma Stoke and Simple Cerebral Hemorrhage

Differentiation of Low-Attenuation Intracranial Hemorrhage and Calcification Using Dual-Energy Computed Tomography in a Phantom System

Neuro-oncology dilemma: Tumour or tumefactive demyelinating lesion

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