title: 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.
abstract: OBJECTIVE
  The histogram method has been shown to demonstrate heterogeneous morphologic features of tumor vascularity. This study aimed to determine whether whole-tumor histogram analysis of the normalized CBV for contrast-enhancing lesions and perienhancing lesions can differentiate among GBMs, SMTs, and lymphomas.
  
  
  METHODS
  Fifty-nine patients with histopathologically confirmed GBMs (n = 28), SMTs (n = 22), or lymphomas (n = 12) underwent conventional MR imaging and dynamic susceptibility contrast-enhanced imaging before surgery. Histogram distribution of the normalized CBV was obtained from whole-tumor voxels in contrast-enhancing lesions and perienhancing lesions. The HW, PHP, and MV were determined from histograms. One-way ANOVA was used initially to test the overall equality of mean values for each type of tumor. Subsequently, posttest multiple comparisons were performed.
  
  
  RESULTS
  For whole-tumor histogram analyses for contrast-enhancing lesions, only PHP could differentiate among GBMs (4.79 ± 1.31), SMTs (3.32 ± 1.10), and lymphomas (2.08 ± 0.54). The parameters HW and MV were not significantly different between GBMs and SMTs, whereas the 2 histogram parameters were significantly higher in GBMs and SMTs compared with lymphomas. For the analyses of perienhancing lesions, only MV could differentiate among GBMs (1.90 ± 0.26), SMTs (0.80 ± 0.21), and lymphomas (1.27 ± 0.34). HW and PHP were not significantly different between SMTs and lymphomas.
  
  
  CONCLUSIONS
  Using a whole-tumor histogram analysis of normalized CBV for contrast-enhancing lesions and perienhancing lesions facilitates differentiation of GBMs, SMTs and lymphomas.
authors.affiliation: Department of Diagnostic Radiology, Ajou University School of Medicine, Mt. 5 Woncheon-dong, Yeongtong-gu, Suwon, Gyeonggi-do, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Ma
authors.forename: H S
authors.initials: HS
authors.lastname: Kim
authors.forename: N-J
authors.initials: NJ
authors.lastname: Rim
authors.forename: S-H
authors.initials: SH
authors.lastname: Kim
authors.forename: K-G
authors.initials: KG
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001811:Blood Volume Determination / Q000379:methods*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000556:secondary*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult