The Role of Diffusion-Weighted Mri in Differential Diagnosis and Prediction of Survival in Patients With Brain Metastases

Abstract

Background: Brain metastases are observed in up to 40% of all intracranial tumors. Some types of metastatic tumors cause difficulties in differential diagnosis, since they have similar signal characteristics with other pathological entities in neuroimaging. Obviously, the additional diagnostic methods to determine the prognosis and tactics of further management of this group of patients should be implemented.Aim: To study the role of diffusion-weighted magnetic resonance imaging (MRI) in differential diagnostics and predicting the survival rate in patients with brain metastases. Materials and methods: The study included data from MRI and morphological studies of 23 patients with brain metastases. The obtained values of the apparent diffusion coefficient (ADC) of tumors were compared with their histological type, cell density, and the index of proliferative activity Ki-67. In addition, the influence of ADC values on the overall survival rate was assessed.Results: A reliable inverse correlation of ADC values and the index of proliferative activity for various types of brain metastases (r=-0.74, p=0.014) was established. The dependence of ADC values and overall survival rate of patients with metastases in the brain is presented. The overall survival rate in patients with an ADC value greater than 947.2 mm2/sec was 9.8 months (95% CI: 8.6−11.3), and with ADC value less than 947.2 mm2/sec ― 6.4 months (95% CI: 3.7−9.1).Conclusion: The technique of diffusion-weighted MRI plays an important role in the differential diagnosis of brain metastases; it can be used as a tool of comprehensive preoperative assessment when planning the surgery and as a prognostic factor of overall survival rate for this group of patients.

The Role of Diffusion-Weighted Mri of Patients With Spine Metastases

“…24 There have been several studies focusing on the correlation between ADC values of metastatic tumors and overall patient survival. [25][26][27] It was clearly demonstrated in a study by R. Zakaria et al 26 that if the ADC value of metastatic brain tumors is greater than 919.4 mm 2 /sec, a significant increase in overall survival is noted (9.7 months (95% CI: 8.5-11.0) versus 6.2 months (95% CI: 3.7-8.8), p=0.049). C.-C. Lee et al 27 in his clinical series of 42 patients with brain metastases, did not observe any significant differences in overall survival of patients with different ACD values following a course of radiosurgery.…”