Primary Central Nervous System Lymphoma and Atypical Glioblastoma: Multiparametric Differentiation by Using Diffusion-, Perfusion-, and Susceptibility-weighted MR Imaging

Abstract

Combined evaluation of mean ADC, mean rCBV, and presence of ITSS allowed reliable differentiation of PCNSL and atypical glioblastoma in most patients, and these results support an integration of advanced MR imaging techniques for the routine diagnostic workup of patients with these tumors.

Assessment of tumor oxygenation and its impact on treatment response in bevacizumab-treated recurrent glioblastoma

“…DSC-MRI was performed as described previously. 17 Briefly, before dynamic imaging, a 0.1 mmol/kg prebolus dose of gadoterate meglumine (Gd-DOTA, DOTAREM, Guerbet, France) was administered to diminish any T1 effects from contrast agent extravasation. DSC-MRI was performed with a T2*-weighted gradient-echo EPI sequence during the bolus injection of a standard dose (0.1 mmol/kg) of intravenous gadoterate meglumine.…”

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).…”

“…As an adjunct to the conventional MR imaging in which GBM and PCNSL show characteristic but occasionally an overlapping pattern of enhancement, advanced MR imaging techniques offer useful physiologic information facilitating the precise evaluation of brain masses (5)(6)(7)(8)(9)(10)(11)(12). 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).…”

“…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).…”

Advanced MR Imaging in Neuro-oncology

“…For glioblastomas, it was shown that ITSS correspond with micro-haemorrhages inside of the tumour [13]. It has been proven that ITSS can be used for differential diagnosis of glioblastoma and primary central nervous system (CNS) lymphomas, which mostly do not show any ITSS [14]. Furthermore, it was shown that SWI is helpful for differential diagnosis of cerebral metastases with unknown primary [15] or glioma grading ( Fig.…”