Differentiation of Primary Central Nervous System Lymphomas from High-Grade Gliomas by rCBV and Percentage of Signal Intensity Recovery Derived from Dynamic Susceptibility-Weighted Contrast-Enhanced Perfusion MR Imaging

Abstract

The combination of rCBV measurement with percentage of signal intensity recovery can help in more accurate differentiation of PCNSL from HGG.

Differentiation between primary central nervous system lymphoma and glioblastoma: a comparative study of parameters derived from dynamic susceptibility contrast-enhanced perfusion-weighted MRI

“…PCNSL has been shown to have lower vascularity and higher permeability than glioblastoma. 7,14,19,20,25 These differences are considered to reflect their histological changes. PCNSL lacks abundant neovascularisation, but grows angiocentrically and tends to cluster around preexisting brain vessels.…”

“…The PSR can be measured by using either signal intensity at the end of the first-pass 19 or mean signal intensity after the first-pass. 16,20 In some cases, signal intensity continues to recover or increase after the first-pass, and measurement points can be varied. 9,21 Meanwhile, the present authors' analysis of signal intensityetime curves, the slopes during the first-pass (i.e., drop and rise) of PCNSL seem to be different from those of glioblastoma; therefore, this slope ratio can be useful as a simple index for tumour differentiation.…”

ASFNR Recommendations for Clinical Performance of MR Dynamic Susceptibility Contrast Perfusion Imaging of the Brain

“…Peak height of the ΔR2/ΔR2* curve correlates well with rCBV, though the area under the relaxivity–time curve is the most commonly used measure for rCBV. PSR has been shown to differ in high-grade glioma, lymphoma, and metastases, 5,98 probably due to physiologic differences in vascular permeability and tumor cell size and cell volume fraction for these tumors and the complex interaction of these factors on the T1- and T2*-weighting of DSC-MRI signal. The signal–time curve tends to return closer to baseline with high-grade glioma than with metastases, presumably due to the absence of the blood-brain barrier and dominant T2/T2* effects of “pooled” gadolinium in the latter.…”

Differentiation between Glioblastoma and Primary Central Nervous System Lymphoma Using Dynamic Susceptibility Contrast-Enhanced Perfusion MR Imaging: Comparison Study of the Manual versus Semiautomatic Segmentation Method

“…The potential of an nCBV or rCBV as a reliable index of GBM or PCNSL diagnosis has been reported several times (5,(7)(8)(9)(10)(11)(13)(14)(15)(16)(17)(18)(19)(20)(21). According to a previous report using the maximum, the mean or the median value of nCBV, GBM has a significantly higher nCBV value compared to PCNSL (5, 7-10, 13-21).…”

“…Previous studies have shown that dynamic susceptibility contrast-enhanced (DSC) perfusion MR imaging (PWI) analysis is a reliable way to differentiate GBM from PCNSL, and especially, the relative cerebral blood volume (rCBV) from DSC PWI, which reflects microvascular density and angiogenesis, is the most important hemodynamic parameter for a differential diagnosis of GBM and PCNSL (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”