title: Diffusional kurtosis imaging for differentiating between high-grade glioma and primary central nervous system lymphoma.
abstract: The aim of this study was to assess the diagnostic accuracy of diffusion kurtosis magnetic resonance imaging parameters for differentiating high-grade gliomas (HGGs) from primary central nervous system lymphomas (PCNSLs).
  
  
  
  Diffusion parameters, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ// ), radial diffusivity (λ⊥ ); and kurtosis parameters, including mean kurtosis (MK), axial kurtosis (K// ), and radial kurtosis (K⊥ ), were normalized to contralateral normal-appearing white matter (NAWMc) to decrease inter-individual and inter-regional changes across the entire brain, and then compared with the solid parts of 20 HGGs and 11 PCNSLs [median 95% confidence interval (CI), P < 0.004; 0.05/14], significance level, Kolmogorov-Smirnov test, Bonferroni correction].
  
  
  
  FA, MD, λ// , and λ⊥ values were higher in HGGs than in PCNSLs, but not significantly [HGGs: 0.209 (95% CI, 0.134-0.338), 1.385 (95% CI, 1.05-1.710), 1.655 (95% CI, 1.30-2.060), 1.228 (95% CI, 0.932-1.480), respectively; PCNSLs: 0.143 (95% CI, 0.110-0.317), 1.070 (95% CI, 0.842-1.470), 1.260 (95% CI, 0.960-1.930), 1.010 (95% CI, 0.782-1.240)], respectively; P = 0.120, 0.010, 0.004, and 0.004, respectively). However, MK and K// were significantly higher in PCNSLs compared with HGGs [PCNSLs: 0.765 (95% CI, 0.697-0.890), 0.787 (95% CI, 0.615-1.030), respectively; HGGs: 0.531 (95% CI, 0.402-0.766), 0.532 (95% CI, 0.432-0.680], respectively; P = 0.001, 0.000, respectively); but not K⊥ [0.774 (95% CI, 0.681-0.899) for PCNSLs; 0.554 (95% CI, 0.389-0.954) for HGGs; P = 0.024].
  
  
  
  There were significant differences in kurtosis parameters (MK and K// ) between HGGs and PCNSLs, while differences in diffusion parameters between them did not reach significance; hence, better separation was achieved with these parameters than with conventional diffusion imaging parameters. J. Magn. Reson. Imaging 2016;44:30-40.
authors.affiliation: Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Haopeng
authors.initials: H
authors.lastname: Pang
authors.affiliation: Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Breast Cancer, The 307th Hospital of Chinese People's liberation Army, Beijing, PR China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Dang
authors.affiliation: Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Xiaoyuan
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Zhenwei
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Department of Neurosurgery, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Jingsong
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Glioma Surgery Division, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Chengjun
authors.initials: C
authors.lastname: Yao
authors.affiliation: Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, PR China.
authors.forename: Ning
authors.initials: N
authors.lastname: Di
authors.affiliation: Department of Neurosurgery, Affiliated Ottawa Hospital of Ottawa University, Ottawa, Canada.
authors.forename: Diana Cristina
authors.initials: DC
authors.lastname: Ghinda
authors.affiliation: Department of MR Research, GE Healthcare, Shanghai, PR China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: diffusion kurtosis imaging; high-grade glioma; primary central nervous system lymphoma