Differentiation of primary central nervous system lymphoma and high-grade glioma with dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging

Liao, Weihua; Liu, Yuhui; Wang, Xiaoyi; Xinya, Jiang; Tang, Beisha; Jia-sheng, Fang; Chen, Chang; Hu, Ziyi

doi:10.1080/02841850802616752

Cited by 101 publications

(100 citation statements)

References 24 publications

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“…Our results challenge previous clinical reports of high rCBV correlation with MVD in human HGG. 38,41 These discrepancies likely reflect methodologic differences both in imaging-tissue correlation and statistics. For instance, Haris et al 38 did not use spatial coregistration, so regions of rCBV did not necessarily spatially correlate with those of MVD measurement.…”

Section: Discussionmentioning

confidence: 99%

Correlations between Perfusion MR Imaging Cerebral Blood Volume, Microvessel Quantification, and Clinical Outcome Using Stereotactic Analysis in Recurrent High-Grade Glioma

Eschbacher

Dueck

et al. 2011

AJNR Am J Neuroradiol

115

125

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BACKGROUND AND PURPOSE:Quantifying MVA rather than MVD provides better correlation with survival in HGG. This is attributed to a specific "glomeruloid" vascular pattern, which is better characterized by vessel area than number. Despite its prognostic value, MVA quantification is laborious and clinically impractical. The DSC-MR imaging measure of rCBV offers the advantages of speed and convenience to overcome these limitations; however, clinical use of this technique depends on establishing accurate correlations between rCBV, MVA, and MVD, particularly in the setting of heterogeneous vascular size inherent to human HGG.

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Section: Discussionmentioning

confidence: 99%

Correlations between Perfusion MR Imaging Cerebral Blood Volume, Microvessel Quantification, and Clinical Outcome Using Stereotactic Analysis in Recurrent High-Grade Glioma

Eschbacher

Dueck

et al. 2011

AJNR Am J Neuroradiol

115

125

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“…6 Our results for lymphoma are in concordance with the findings of previous MR perfusion studies for primary central nervous lymphoma. 24,25 These studies showed that primary central nervous lymphomas tend to have low maximum CBV ratios. On the other hand, the percentage of signal-intensity recovery indicating contrast leakage showed discrepancy between the 2 previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the percentage of signal-intensity recovery indicating contrast leakage showed discrepancy between the 2 previous studies. 24,25 In our small population of lymphomas, this parameter was variable. However, it was not the main issue in this study, and more large-population studies should be performed to validate the above findings.…”

Section: Discussionmentioning

confidence: 99%

Differentiation among Glioblastoma Multiforme, Solitary Metastatic Tumor, and Lymphoma Using Whole-Tumor Histogram Analysis of the Normalized Cerebral Blood Volume in Enhancing and Perienhancing Lesions

Kim²,

Rim³

et al. 2010

AJNR Am J Neuroradiol

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“…Lymphomas were found to be associated with lower rCBV values (5,9,10). The rCBV values of lymphoma are noted to be much less compared to high-grade gliomas (11,12). Few earlier studies highlighted salient features of enhancing malignant lesions based on rCBV measurements on DSC perfusion and with diffusion (DWI-ADC), but were not always confirmatory (9,13).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of enhancement-perfusion mismatch in differentiation of CNS lymphomas from other enhancing malignant tumors of the brain

Goyal¹,

Kumar²,

Gupta³

et al. 2017

Quant. Imaging Med. Surg.

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Background: Surgical planning and treatment options for primary or secondary central nervous system lymphomas (PCNSL or SCNSL) are different from other enhancing malignant lesions such as glioblastoma multiforme (GBM), anaplastic gliomas and metastases; so, it is critical to distinguish them preoperatively.We hypothesized that enhancement-perfusion (E-P) mismatch on dynamic susceptibility weighted magnetic resonance (DSC-MR) perfusion imaging which corresponds to low mean relative cerebral blood volume (mean rCBV) in an enhancing portion of the tumor should allow differentiation of CNS lymphomas from other enhancing malignant lesions. Methods:We retrospectively reviewed pre-treatment MRI exams, including DSC-MR perfusion images of 15 lymphoma patients. As a control group, pre-treatment DSC-MR perfusion images of biopsy proven 18 GBMs (group II), 13 metastases (group III), and 10 anaplastic enhancing gliomas (group IV) patients were also reviewed.Region of interests (ROIs) were placed around the most enhancing part of tumor on contrast-enhanced T1WI axial images and images were transferred onto co-registered DSC perfusion maps to obtain CBV in all 4 groups.The mean and maximum relative CBV values were obtained. Statistical analysis was performed on SPSS software and significance of the results between the groups was done with Mann-Whitney test, whereas optimal thresholds for tumor differentiation were done by receiver operating characteristic (ROC) analysis.Results: The enhancing component of CNS lymphomas were found to have significantly lower mean rCBV compared to enhancing component of GBM (1.2 versus 4.3; P<0.001), metastasis (1.2 versus 2.7; P<0.001), and anaplastic enhancing gliomas (1.2 versus 2.4; P<0.001). Maximum rCBV of enhancing component of lymphoma were significantly lower than GBM (3.1 versus 6.5; P<0.001) and metastasis (3.1 versus 4.9; P<0.013), and not significantly lower than anaplastic enhancing gliomas (3.9 versus 4.2; P<0.08).On the basis of ROC analysis, mean rCBV provided the best threshold [area under the curve (AUC) =0.92] and had better accuracy in differentiating malignant lesions.Conclusions: E-P mismatch in DSC perfusion MR, i.e., low mean rCBV in an enhancing portion of the tumor is strongly suggestive of lymphoma and should allow differentiation of CNS lymphoma from other enhancing malignant lesions.

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Differentiation of primary central nervous system lymphoma and high-grade glioma with dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging

Cited by 101 publications

References 24 publications

Correlations between Perfusion MR Imaging Cerebral Blood Volume, Microvessel Quantification, and Clinical Outcome Using Stereotactic Analysis in Recurrent High-Grade Glioma

Correlations between Perfusion MR Imaging Cerebral Blood Volume, Microvessel Quantification, and Clinical Outcome Using Stereotactic Analysis in Recurrent High-Grade Glioma

Differentiation among Glioblastoma Multiforme, Solitary Metastatic Tumor, and Lymphoma Using Whole-Tumor Histogram Analysis of the Normalized Cerebral Blood Volume in Enhancing and Perienhancing Lesions

Usefulness of enhancement-perfusion mismatch in differentiation of CNS lymphomas from other enhancing malignant tumors of the brain

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