Glioblastoma versus solitary brain metastasis: MRI differentiation using the edema perfusion gradient
| Autor: | Andjoli Davidhi, Fernando Aparici-Robles, Javier Juan-Albarracín, Miguel Mazon Momparler, Alexandre Perez-Girbes, Juan M. García-Gómez, J. Carreres-Polo, Elies Fuster-Garcia, José Miguel Carot-Sierra |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_treatment
MRI differentiation glioblastoma metastasis perfusion gradient Contrast Media Metastasis Diagnosis Differential Interstitial space Edema medicine Humans Radiology Nuclear Medicine and imaging Neuroradiology business.industry Brain Neoplasms medicine.disease Magnetic Resonance Imaging Radiation therapy Perfusion Cerebral blood flow Neurology (clinical) medicine.symptom Nuclear medicine business Glioblastoma Brain metastasis |
| Zdroj: | JOURNAL OF NEUROIMAGING r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 1552-6569 1051-2284 |
| Popis: | Background and purpose Differentiation between glioblastoma multiforme (GBM) and solitary brain metastasis (SBM) remains a challenge in neuroradiology with up to 40% of the cases to be incorrectly classified using only conventional MRI. The inclusion of perfusion MRI parameters provides characteristic features that could support the distinction of these pathological entities. On these grounds, we aim to use a perfusion gradient in the peritumoral edema. Methods Twenty-four patients with GBM or an SBM underwent conventional and perfusion MR imaging sequences before tumors' surgical resection. After postprocessing of the images, quantification of dynamic susceptibility contrast (DSC) perfusion parameters was made. Three concentric areas around the tumor were defined in each case. The monocompartimental and pharmacokinetics parameters of perfusion MRI were analyzed in both series. Results DSC perfusion MRI models can provide useful information for the differentiation between GBM and SBM. It can be observed that most of the perfusion MR parameters (relative cerebral blood volume, relative cerebral blood flow, relative Ktrans, and relative volume fraction of the interstitial space) clearly show higher gradient for GBM than SBM. GBM also demonstrates higher heterogeneity in the peritumoral edema and most of the perfusion parameters demonstrate higher gradients in the area closest to the enhancing tumor. Conclusion Our results show that there is a difference in the perfusion parameters of the edema between GBM and SBM demonstrating a vascularization gradient. This could help not only for the diagnosis, but also for planning surgical or radiotherapy treatments delineating the real extension of the tumor. |
| Databáze: | OpenAIRE |
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