Differentiating between Central Nervous System Lymphoma and High-grade Glioma Using Dynamic Susceptibility Contrast and Dynamic Contrast-enhanced MR Imaging with Histogram Analysis
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- Murayama Kazuhiro
- Department of Radiology, Fujita Health University
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- Nishiyama Yuya
- Department of Neurosurgery, Fujita Health University
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- Hirose Yuichi
- Department of Neurosurgery, Fujita Health University
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- Abe Masato
- Department of Pathology, School of Health Sciences, Fujita Health University
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- Ohyu Shigeharu
- Toshiba Medical Systems Corporation
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- Ninomiya Ayako
- Toshiba Medical Systems Corporation
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- Fukuba Takashi
- Department of Radiology, Fujita Health University Hospital
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- Katada Kazuhiro
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University
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- Toyama Hiroshi
- Department of Radiology, Fujita Health University
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<p>Purpose: We evaluated the diagnostic performance of histogram analysis of data from a combination of dynamic susceptibility contrast (DSC)-MRI and dynamic contrast-enhanced (DCE)-MRI for quantitative differentiation between central nervous system lymphoma (CNSL) and high-grade glioma (HGG), with the aim of identifying useful perfusion parameters as objective radiological markers for differentiating between them.</p><p>Methods: Eight lesions with CNSLs and 15 with HGGs who underwent MRI examination, including DCE and DSC-MRI, were enrolled in our retrospective study. DSC-MRI provides a corrected cerebral blood volume (cCBV), and DCE-MRI provides a volume transfer coefficient (Ktrans) for transfer from plasma to the extravascular extracellular space. Ktrans and cCBV were measured from a round region-of-interest in the slice of maximum size on the contrast-enhanced lesion. The differences in t values between CNSL and HGG for determining the most appropriate percentile of Ktrans and cCBV were investigated. The differences in Ktrans, cCBV, and Ktrans/cCBV between CNSL and HGG were investigated using histogram analysis. Receiver operating characteristic (ROC) analysis of Ktrans, cCBV, and Ktrans/cCBV ratio was performed.</p><p>Results: The 30th percentile (C30) in Ktrans and 80th percentile (C80) in cCBV were the most appropriate percentiles for distinguishing between CNSL and HGG from the differences in t values. CNSL showed significantly lower C80 cCBV, significantly higher C30 Ktrans, and significantly higher C30 Ktrans/C80 cCBV than those of HGG. In ROC analysis, C30 Ktrans/C80 cCBV had the best discriminative value for differentiating between CNSL and HGG as compared to C30 Ktrans or C80 cCBV.</p><p>Conclusion: The combination of Ktrans by DCE-MRI and cCBV by DSC-MRI was found to reveal the characteristics of vascularity and permeability of a lesion more precisely than either Ktrans or cCBV alone. Histogram analysis of these vascular microenvironments enabled quantitative differentiation between CNSL and HGG.</p>
収録刊行物
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- Magnetic Resonance in Medical Sciences
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Magnetic Resonance in Medical Sciences 17 (1), 42-49, 2018
日本磁気共鳴医学会