title: Dynamic contrast-enhanced MRI perfusion for differentiating between melanoma and lung cancer brain metastases.
abstract: Brain metastases originating from different primary sites overlap in appearance and are difficult to differentiate with conventional MRI. Dynamic contrast-enhanced (DCE)-MRI can assess tumor microvasculature and has demonstrated utility in characterizing primary brain tumors. Our aim was to evaluate the performance of plasma volume (Vp) and volume transfer coefficient (Ktrans) derived from DCE-MRI in distinguishing between melanoma and nonsmall cell lung cancer (NSCLC) brain metastases. Forty-seven NSCLC and 23 melanoma brain metastases were retrospectively assessed with DCE-MRI. Regions of interest were manually drawn around the metastases to calculate Vpmeanand Kmeantrans. The Mann-Whitney U test and receiver operating characteristic analysis (ROC) were performed to compare perfusion parameters between the two groups. The Vpmeanof melanoma brain metastases (4.35, standard deviation [SD] = 1.31) was significantly higher (P = 0.03) than Vpmeanof NSCLC brain metastases (2.27, SD = 0.96). The Kmeantrans values were higher in melanoma brain metastases, but the difference between the two groups was not significant (P = 0.12). Based on ROC analysis, a cut-off value of 3.02 for Vpmean(area under curve = 0.659 with SD = 0.074) distinguished between melanoma brain metastases and NSCLC brain metastases (P < 0.01) with 72% specificity. Our data show the DCE-MRI parameter Vpmeancan differentiate between melanoma and NSCLC brain metastases. The ability to noninvasively predict tumor histology of brain metastases in patients with multiple malignancies can have important clinical implications.
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.|Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Vaios
authors.identifier: http://orcid.org/0000-0003-0252-0694
authors.initials: V
authors.lastname: Hatzoglou
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Jamie
authors.initials: J
authors.lastname: Tisnado
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Alpesh
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.|Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Kyung K
authors.initials: KK
authors.lastname: Peck
authors.affiliation: Department of Neurology, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Mariza
authors.initials: M
authors.lastname: Daras
authors.affiliation: Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York City, New York.|Department of Neurology, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Omuro
authors.affiliation: Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York City, New York.|Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Beal
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.|Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York City, New York.
authors.forename: Andrei I
authors.initials: AI
authors.lastname: Holodny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000378:metabolism; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000378:metabolism; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D003287:Contrast Media
keywords: Brain tumors; melanoma; neuroimaging; non-small cell lung cancer; perfusion weighted MRI