title: Evaluation of glioblastomas and lymphomas with whole-brain CT perfusion: Comparison between a delay-invariant singular-value decomposition algorithm and a Patlak plot.
abstract: OBJECTIVE
  Correction of contrast leakage is recommended when enhancing lesions during perfusion analysis. The purpose of this study was to assess the diagnostic performance of computed tomography perfusion (CTP) with a delay-invariant singular-value decomposition algorithm (SVD+) and a Patlak plot in differentiating glioblastomas from lymphomas.
  
  
  METHODS
  This prospective study included 17 adult patients (12 men and 5 women) with pathologically proven glioblastomas (n=10) and lymphomas (n=7). CTP data were analyzed using SVD+ and a Patlak plot. The relative tumor blood volume and flow compared to contralateral normal-appearing gray matter (rCBV and rCBF derived from SVD+, and rBV and rFlow derived from the Patlak plot) were used to differentiate between glioblastomas and lymphomas. The Mann-Whitney U test and receiver operating characteristic (ROC) analyses were used for statistical analysis.
  
  
  RESULTS
  Glioblastomas showed significantly higher rFlow (3.05±0.49, mean±standard deviation) than lymphomas (1.56±0.53; P<0.05). There were no statistically significant differences between glioblastomas and lymphomas in rBV (2.52±1.57 vs. 1.03±0.51; P>0.05), rCBF (1.38±0.41 vs. 1.29±0.47; P>0.05), or rCBV (1.78±0.47 vs. 1.87±0.66; P>0.05). ROC analysis showed the best diagnostic performance with rFlow (Az=0.871), followed by rBV (Az=0.771), rCBF (Az=0.614), and rCBV (Az=0.529).
  
  
  CONCLUSIONS
  CTP analysis with a Patlak plot was helpful in differentiating between glioblastomas and lymphomas, but CTP analysis with SVD+ was not.
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan. Electronic address: hiwatasi@radiol.med.kyushu-u.ac.jp.
authors.forename: Akio
authors.initials: A
authors.lastname: Hiwatashi
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Togao
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of neurosurgery, Graduate School of medical sciences, Kyushu university, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimoto
authors.affiliation: Department of neurosurgery, Graduate School of medical sciences, Kyushu university, Fukuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizoguchi
authors.affiliation: Department of neuropathology, Graduate School of medical sciences, Kyushu university, Fukuoka, Japan.
authors.forename: Satoshi O
authors.initials: SO
authors.lastname: Suzuki
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
authors.affiliation: Department of clinical radiology, Graduate School of medical sciences, Kyushu university, 3-1-1, Maidashi, Higashi-ku, 812-8582 Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: CT perfusion; Glioblastoma; Lymphoma; Patlak plot