Aims and objectives
Glioblastoma and brain metastasis are the most common brain tumors in adulthood accounting for about half of all cases.
It is important to differentiate glioblastomas from brain metastasis,
because these two entities differ from each other in clinical course and management.
Glioblastomas and solitary brain metastases often have similar imaging appearances at conventional MR imaging.
Arterial spin labeling (ASL),
a perfusion imaging technique that utilizes electromagnetically labeled arterial blood water as an intrinsic tracer,
could be used to assess cerebral blood flow in tumor.
Diffusion...
Methods and materials
Patients
This prospective study was approved by the local ethics committee and full written consents were obtained from all patients prior to the examination.
The study included 36 patients provisionally diagnosed to have intra-axial glioblastoma or brain metastasis based on conventional MR imaging.
MRI imaging
The MR imaging was performed using a 1.5 Tesla scanner.
First non contrast study was done,
including (T1,
T2 & FLAIR sequences),
then post IV contrast T1-weighted MR images study is done using gadoterate meglumine.
The ASL perfusion imaging was...
Results
Based on histopathological results patients were divided into glioblastomas (n=21) [Fig.1] and metastatic brain tumors (n=15) [Fig.2].
Significant difference in TBF measured in the tumor and peritumor regions of glioblastomas and metastasis (P<0.001) for both.
Selection of (29.75,
17.8 mL/100 g/min) as TBF cutoff of tumor and peritumor regions to differentiate between the two groups revealed accuracy (91.7%,
88.9%),
specificity(95.2%,
90.5%)[Fig.3].
FA measured in the peritumor region revealed significant difference(p< 0.001)while tumor region revealed no significant difference(p<0.06).
Selection of (0.145,
0.245 ) as FA cutoff...
Conclusion
Both ASL and DTI metrics are valuable non invasive tools in differentiation between glioblastomas and metastasis.
Moreover combined metrics of ASL and DTI increases the diagnostic accuracy of the differentiation between both groups specially in the peri-tumor rather than the tumor region.
Personal information
Mona Talaat
[email protected]
Radiology Dpartment/ Faculty of Medicine/ Kafr Elsheikh University / Egypt
References
Mabray MC,
Barajas RF Jr,
Cha S.
Modern brain tumor imaging.
Brain Tumor Res Treat 2015;3:8-23.
Mohammadzadeh A,
Mohammadzadeh V,
Kooraki S,
Sotoudeh H,
Kadivar S,
Shakiba M,
et al.
Pretreatment Evaluation of Glioma.
Neuroimaging Clin N Am 2016;26:567-580.
Sunwoo L,
Yun TJ,
You SH,
Yoo RE,
Kang KM,
Choi SH,
et al.
Differentiation of Glioblastoma from Brain Metastasis: Qualitative and Quantitative Analysis Using Arterial Spin Labeling MR Imaging.PLoS One 2016;11:e0166662.
Lin L,
Xue Y,
Duan Q,
Sun B,
Lin H,
Huang X,
Chen X....