Utility of dynamic contrast-enhanced magnetic resonance imaging for differentiating glioblastoma, primary central nervous system lymphoma and brain metastatic tumor.
OBJECTIVE
The study aimed to investigate the use of dynamic contrast-enhanced magnetic resonance imaging (MRI)-derived permeability parameters for the differentiation of glioblastoma multiformes (GBMs), primary central nervous system lymphomas (PCNSLs), and brain metastatic tumors (MTs).


METHODS
Seventy-five patients with histopathologically confirmed GBMs (n=38), PCNSLs (n=16) and MTs (n=21) underwent dynamic contrast-enhanced MRIs before surgery. The volume transfer constant K(trans), the flux rate constant between extravascular extracellular space and plasma Kep, the extravascular extracellular volume Ve and the fractional plasma volume Vp were measured within the entire contrast-enhancing tumor by extended Tofts model. A one-way analysis of variance was used to compare all of the parameters among these three tumors, followed by the post-hoc test. Receiver operating characteristic curves were constructed to evaluate the diagnostic performance of the permeability parameters.


RESULTS
Mean K(trans) value and Ve value were significantly higher in PCNSLs than in GBMs (P<0.001 and P=0.011) and MTs (P<0.001 and P<0.001). No significant difference was observed in all of the permeability parameters between GBMs and MTs. According to the receiver operating characteristic analyses, both K(trans) and Ve had good diagnostic performance for discriminating between PCNSLs and GBMs (the area under the curve: 0.847 and 0.785, respectively), as well as between PCNSLs and MTs (the area under the curve: 0.851 and 0.884, respectively).


CONCLUSIONS
The K(trans) and Ve derived from dynamic contrast-enhanced MRI facilitate the differentiation of PCNSLs from GBMs and MTs.
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: lushan1118@163.com.
Shanshan
S
Lu
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: gaoqian123011@163.com.
Qianqian
Q
Gao
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: yujing0303@163.com.
Jing
J
Yu
Department of Pathology,The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: yuhao040511@163.com.
Yang
Y
Li
GE healthcare, Shanghai, China. Electronic address: peng.cao@ge.com.
Peng
P
Cao
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: hbshi346@163.com.
Haibin
H
Shi
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. Electronic address: hongxunning@sina.com.
Xunning
X
Hong
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media
Dynamic contrast-enhanced perfusion; Glioblastoma; Metastasis; Primary central nervous system lymphoma