Keywords:
Neuroradiology brain, Oncology, CNS, MR-Diffusion/Perfusion, MR, Diagnostic procedure, Imaging sequences, Observer performance, Cancer, Multidisciplinary cancer care
Authors:
S. Türk1, J. Kim2, R. Lobo3, J. Bapuraj3, T. Ma3, T. Johnson3, S. Camelo Piragua3, L. R. Junck3, A. Srinivasan3; 1Izmir/TR, 2Ann Arbor/US, 3Ann Arbor, MI/US
DOI:
10.26044/ecr2019/C-0958
Results
20 female and 30 male patients were included.
The mean age for female patients was 56 years ( SD: 13) and the mean age for male patients was 48 years (SD: 14).
For the first visit,
none of the radiologists could identify true progression.
(p=0.87) For the first and second visits,
nodular enhancement (compared to a band-like) pattern was more likely suggested pseudoprogression (for the first visit OR:0.14,
p<0.00,
for the second visit OR:0.19,
p<0.04).
CBV and CBF values which were lower around the margins of the operated cavity than in the contralateral white matter were more likely associated with pseudoprogression (OR:0.09,
p<0.00).
A 25% increase in the enhancing area was more likely associated with pseudoprogression (OR:0.1,
p<0.03).
Comparative increase in the surrounding FLAIR hyperintensity by more than 50% of the area was correlated with pseudoprogression (OR:0.2,
p<0.04).
Nonenhancing portions of the tumor,
one or multiple enhancing lesions,
ADC,
MTT,
and K2 values were not be found to be significant discriminators between groups on visual assessment by the neuroradiologists.
In the follow-up images increasing or decreasing ADC or intensity (brightness) of the FLAIR signal or intensity (brightness) of enhancement on post-contrast T1 images could not be found useful to discriminate groups by human observers.
For the second and third visits,
the OR to identify true progression was 1.4 (p<0.03).
Interobserver kappa correlation was low.
(Table 2)