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Primary central nervous system lymphoma and atypical glioblastoma: differentiation using the initial area under the curve derived from dynamic contrast-enhanced MR and the apparent diffusion coefficient

Authors
 Yoon Seong Choi  ;  Ho-Joon Lee  ;  Sung Soo Ahn  ;  Jong Hee Chang  ;  Seok-Gu Kang  ;  Eui Hyun Kim  ;  Se Hoon Kim  ;  Seung-Koo Lee 
Citation
 European Radiology, Vol.27(4) : 1344-1351, 2017 
Journal Title
 European Radiology 
ISSN
 0938-7994 
Issue Date
2017
MeSH
Aged ; Area Under Curve ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/pathology ; Central Nervous System Neoplasms/diagnostic imaging* ; Central Nervous System Neoplasms/pathology ; Contrast Media* ; Diagnosis, Differential ; Female ; Glioblastoma/diagnostic imaging* ; Glioblastoma/pathology ; Humans ; Image Enhancement/methods* ; Lymphoma/diagnostic imaging* ; Lymphoma/pathology ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity
Keywords
ADC ; DCE-MRI ; DTI ; Glioblastoma ; Primary central nervous system lymphoma
Abstract
OBJECTIVES: To evaluate the ability of the initial area under the curve (IAUC) derived from dynamic contrast-enhanced MR imaging (DCE-MRI) and apparent diffusion coefficient (ADC) in differentiating between primary central nervous system lymphoma (PCNSL) and atypical glioblastoma (GBM). METHODS: We retrospectively identified 19 patients with atypical GBM (less than 13 % necrosis of the enhancing tumour), and 23 patients with PCNSL. The histogram parameters of IAUC at 30, 60, 90 s (IAUC30, IAUC60, and IAUC90), and ADC were compared between PCNSL and GBM. The diagnostic performances and added values of the IAUC and ADC for differentiating between PCNSL and GBM were evaluated. Interobserver agreement was assessed via intraclass correlation coefficient (ICC). RESULTS: The IAUC and ADC parameters were higher in GBM than in PCNSL. The 90th percentile (p90) of IAUC30 and 10th percentile (p10) of ADC showed the best diagnostic performance. Adding p90 of IAUC30 to p10 of ADC improved the differentiation between PCNSL and GBM (area under the ROC curve [AUC] = 0.886), compared to IAUC30 or ADC alone (AUC = 0.789 and 0.744; P < 0.05 for all). The ICC was 0.96 for p90 of IAUC30. CONCLUSIONS: The IAUC may be a useful parameter together with ADC for differentiating between PCNSL and atypical GBM. KEY POINTS: • High reproducibility is essential for practical implementation of advanced MRI parameters. • IAUC and ADC are highly reproducible parameters. • IAUC values were higher in atypical GBM than in PCNSL. • Adding IAUC to ADC improved the differentiation between PCNSL and GBM. • IAUC with ADC are useful for differentiating PCNSL from GBM.
Full Text
https://link.springer.com/article/10.1007%2Fs00330-016-4484-2
DOI
10.1007/s00330-016-4484-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
강석구(Kang, Seok Gu) ORCID logo https://orcid.org/0000-0001-5676-2037
김세훈(Kim, Se Hoon) ORCID logo https://orcid.org/0000-0001-7516-7372
김의현(Kim, Eui Hyun) ORCID logo https://orcid.org/0000-0002-2523-7122
안성수(Ahn, Sung Soo) ORCID logo https://orcid.org/0000-0002-0503-5558
이승구(Lee, Seung Koo) ORCID logo https://orcid.org/0000-0001-5646-4072
이호준(Lee, Ho Joon)
장종희(Chang, Jong Hee)
최윤성(Choi, Yoon Seong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154017
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