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Furtner, J; Schöpf, V; Preusser, M; Asenbaum, U; Woitek, R; Wöhrer, A; Hainfellner, JA; Wolfsberger, S; Prayer, D.
Non-invasive assessment of intratumoral vascularity using arterial spin labeling: A comparison to susceptibility-weighted imaging for the differentiation of primary cerebral lymphoma and glioblastoma.
Eur J Radiol. 2014; 83(5):806-10 Doi: 10.1016/j.ejrad.2014.01.017
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Co-authors Med Uni Graz
Wolfsberger Stefan
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Abstract:
Using conventional MRI methods, the differentiation of primary cerebral lymphomas (PCNSL) and other primary brain tumors, such as glioblastomas, is difficult due to overlapping imaging characteristics. This study was designed to discriminate tumor entities using normalized vascular intratumoral signal intensity values (nVITS) obtained from pulsed arterial spin labeling (PASL), combined with intratumoral susceptibility signals (ITSS) from susceptibility-weighted imaging (SWI). Thirty consecutive patients with glioblastoma (n=22) and PCNSL (n=8), histologically classified according to the WHO brain tumor classification, were included. MRIs were acquired on a 3T scanner, and included PASL and SWI sequences. nVITS was defined by the signal intensity ratio between the tumor and the contralateral normal brain tissue, as obtained by PASL images. ITSS was determined as intratumoral low signal intensity structures detected on SWI sequences and were divided into four different grades. Potential differences in the nVITS and ITSS between glioblastomas and PCNSLs were revealed using statistical testing. To determine sensitivity, specificity, and diagnostic accuracy, as well as an optimum cut-off value for the differentiation of PCNSL and glioblastoma, a receiver operating characteristic analysis was used. We found that nVITS (p=0.011) and ITSS (p=0.001) values were significantly higher in glioblastoma than in PCNSL. The optimal cut-off value for nVITS was 1.41 and 1.5 for ITSS, with a sensitivity, specificity, and accuracy of more than 95%. These findings indicate that nVITS values have a comparable diagnostic accuracy to ITSS values in differentiating glioblastoma and PCNSL, offering a completely non-invasive and fast assessment of tumoral vascularity in a clinical setting.
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Aged - administration & dosage
Brain Neoplasms - blood supply, complications, pathology
Diagnosis, Differential - administration & dosage
Female - administration & dosage
Glioblastoma - blood supply, complications, pathology
Humans - administration & dosage
Image Enhancement - methods
Image Interpretation, Computer-Assisted - methods
Lymphoma - complications, pathology
Magnetic Resonance Angiography - methods
Male - administration & dosage
Middle Aged - administration & dosage
Neovascularization, Pathologic - complications, pathology
Reproducibility of Results - administration & dosage
Sensitivity and Specificity - administration & dosage
Spin Labels - administration & dosage
Young Adult - administration & dosage

Find related publications in this database (Keywords)
Glioblastoma
Primary CNS lymphoma
Arterial spin labeling
Susceptibility-weighted imaging
Intratumoural susceptibility signals
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