Benefit of 3T Diffusion-weighted Imaging in Comparison to Contrast-enhanced MR Imaging for the Evaluation of Disseminated Lesions in Primary Malignant Brain Tumors

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Author(s)

    • Yamashita Yasuyuki
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
    • Hirai Toshinori
    • Department of Radiology, Faculty of Medicine, University of Miyazaki
    • Nakamura Hideo
    • Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
    • Makino Keishi
    • Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
    • Yano Shigetoshi
    • Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
    • Nishimura Shinichiro
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
    • Tateishi Machiko
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
    • Azuma Minako
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
    • Kitajima Mika
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University

Abstract

<p>Purpose: We aimed to determine whether 3T diffusion-weighted imaging (DWI) has an additive value relative to contrast-enhanced MR imaging for the detection of disseminated lesions in patients with primary malignant brain tumors.</p><p>Methods: We included consecutive 12 patients with nodular disseminated lesions of primary malignant brain tumors that were confirmed by surgery or follow-up MR imaging. All underwent conventional MR imaging, DWI at b = 1000 and 3000 s/mm<sup>2</sup>, post-contrast T<sub>1</sub>-weighted and 3D gradient-echo imaging at 3T. For the largest lesion per person, two radiologists independently evaluated the presence of additional information on DWI compared with postcontrast MR images using a 4-point scoring system. On DW images, one radiologist measured the lesion-to-brain contrast ratio (LBCR).</p><p>Results: Compared with postcontrast studies, radiologists 1 and 2, respectively, assigned more apparent lesion conspicuity in 2 (17%) and 1 (8%) DWI at b = 1000 s/mm<sup>2</sup> and 4 (33%) and 5 (42%) DWI at b = 3000 s/mm<sup>2</sup> studies. For one of them, the mean score was significantly higher for b = 3000 s/mm<sup>2</sup> than b = 1000 s/mm<sup>2</sup> (<i>P</i> < 0.05). Interobserver agreement for DWI at b = 1000 s/mm<sup>2</sup> and b = 3000 s/mm<sup>2</sup> was very good (κ = 0.85; 95% CI, 0.63–1.00) and excellent (κ = 0.93; 95% CI, 0.78–1.00), respectively. The mean LBCR was significantly higher for DWI at b = 3000 s/mm<sup>2</sup> than DWI at b = 1000 s/mm<sup>2</sup> (<i>P</i> < 0.01).</p><p>Conclusion: In the detection of disseminated lesions in patients with primary malignant brain tumors, 3T DWI has an additive value relative to contrast-enhanced MR imaging. DWI at b = 3000 s/mm<sup>2</sup> may be more useful than DWI at b = 1000 s/mm<sup>2</sup>.</p>

Journal

  • Magnetic Resonance in Medical Sciences

    Magnetic Resonance in Medical Sciences 16(3), 217-222, 2017

    Japanese Society for Magnetic Resonance in Medicine

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