Dynamic imaging of intracranial lesions using fast spin-echo imaging: differentiation of brain tumors and treatment effects.
The purpose of this study was to develop a technique for differentiating between recurrent brain tumors and treatment-related changes, such as radiation necrosis, using dynamic MRI. Ninety-five patients with intracranial mass lesions were evaluated using T1-weighted fast spin-echo (FSE) MRI at 1.5 T. Pathologies included treatment-related changes (n = 32), primary tumors (n = 41), metastatic tumors (n = 5), meningiomas (n = 4), and mixed primary/treatment related changes (n = 13). Signal enhancement-time curves were analyzed by fitting to a sigmoidal-exponential function. Maximal enhancement rates were calculated as the first derivative of the fitted curve. Based on the maximal enhancement rates, treatment-related changes could be differentiated from primary tumors, metastatic tumors, and meningiomas at the P < .05 confidence level. Lesions of mixed tumor and treatment-related change had intermediate values. Dynamic MRI can be used to differentiate treatment-related changes from primary tumors in previously treated patient populations based on maximal enhancement rates. Individual case studies demonstrate the clinical significance of these findings.
Hazle
J D
JD
Department of Diagnostic Radiology, The University of Texas, M. D. Anderson Cancer Center, Houston 77030, USA.
Jackson
E F
EF
Schomer
D F
DF
Leeds
N E
NE
D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000175:diagnosis / Q000628:therapy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy*; D002648:Child; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000628:therapy; D005910:Glioma / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008579:Meningioma / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies