Quantitative Evaluation of Diffusion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Differentiation Between Primary Central Nervous System Lymphoma and Glioblastoma

This study aimed to evaluate the utility of diffusion and permeability parameters derived from diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for differentiating primary central nervous system lymphoma (PCNSL) and glioblastoma multiforme (GBM) and to assess the correlation among these parameters. Materials and Methods: Forty-two patients with GBM and 18 patients with PCNSL underwent conventional 3.0-T MRI, diffusion-weighted imaging, and DCE-MRI before surgery. Normalized apparent diffusion coefficient ratio (rADC) and DCE-MRI–derived parameters (the volume transfer constant [Ktrans], the flux rate constant, the volume fraction of extravascular extracellular space [Ve], and the fractional plasma volume) were measured within the entire enhancing tumor and compared between the 2 groups. The diagnostic ability of each parameter and their optimal combination for differentiating between PCNSL and GBM, and the correlation among these parameters, were statistically analyzed. Results: The PCNSLs demonstrated significantly lower rADC (P = 0.000), higher Ktrans (P = 0.000), and higher Ve (P = 0.001) than GBMs. With the combination of rADC and Ktrans, the diagnostic ability for discriminating between PCNSL and GBM was significantly improved (area under the receiver operating characteristic curve [AUC] = 0.930) as compared with rADC (AUC = 0.858) and Ktrans (AUC = 0.852) alone (P
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Neuroradiology Source Type: research