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Comparison of Apparent Diffusion Coefficient and Intravoxel Incoherent Motion for Differentiating among Glioblastoma, Metastasis, and Lymphoma Focusing on Diffusion-Related Parameter.

Shim WH, Kim HS, Choi CG, Kim SJ - PLoS ONE (2015)

Bottom Line: Using a mono-exponential fitting of diffusion signal decay, the mean ADCmin was significantly lower in PCNSL than in glioblastoma and metastasis.However, using a bi-exponential fitting, the mean Dmin did not significantly differ in the three groups.The mean fmax significantly increased in the glioblastomas (reader 1, 0.103; reader 2, 0.109) and the metastasis (reader 1, 0.105; reader 2, 0.107), compared to the primary CNS lymphomas (reader 1, 0.025; reader 2, 0.023) (P < .001 for each).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background and purpose: Brain tumor cellularity has been assessed by using apparent diffusion coefficient (ADC). However, the ADC value might be influenced by both perfusion and true molecular diffusion, and the perfusion effect on ADC can limit the reliability of ADC in the characterization of tumor cellularity, especially, in hypervascular brain tumors. In contrast, the IVIM technique estimates parameter values for diffusion and perfusion effects separately. The purpose of our study was to compare ADC and IVIM for differentiating among glioblastoma, metastatic tumor, and primary CNS lymphoma (PCNSL) focusing on diffusion-related parameter.

Materials and methods: We retrospectively reviewed the data of 128 patients with pathologically confirmed glioblastoma (n = 55), metastasis (n = 31), and PCNSL (n = 42) prior to any treatment. Two neuroradiologists independently calculated the maximum IVIM-f (fmax) and minimum IVIM-D (Dmin) by using 16 different b-values with a bi-exponential fitting of diffusion signal decay, minimum ADC (ADCmin) by using 0 and 1000 b-values with a mono-exponential fitting and maximum normalized cerebral blood volume (nCBVmax). The differences in fmax, Dmin, nCBVmax, and ADCmin among the three tumor pathologies were determined by one-way ANOVA with multiple comparisons. The fmax and Dmin were correlated to the corresponding nCBV and ADC using partial correlation analysis, respectively.

Results: Using a mono-exponential fitting of diffusion signal decay, the mean ADCmin was significantly lower in PCNSL than in glioblastoma and metastasis. However, using a bi-exponential fitting, the mean Dmin did not significantly differ in the three groups. The mean fmax significantly increased in the glioblastomas (reader 1, 0.103; reader 2, 0.109) and the metastasis (reader 1, 0.105; reader 2, 0.107), compared to the primary CNS lymphomas (reader 1, 0.025; reader 2, 0.023) (P < .001 for each). The correlation between fmax and the corresponding nCBV was highest in glioblastoma group, and the correlation between Dmin and the corresponding ADC was highest in primary CNS lymphomas group.

Conclusion: Unlike ADC value derived from a mono-exponential fitting of diffusion signal, diffusion-related parametric value derived from a bi-exponential fitting with separation of perfusion effect doesn't differ among glioblastoma, metastasis, and PCNSL.

No MeSH data available.


Related in: MedlinePlus

Intravoxel incoherent motion imaging of Primary CNS lymphoma.Primary CNS lymphoma of the left medial fronto-parietal lobe, as seen on axial, contrast-enhanced, T1-weighted imaging (A). IVIM-derived f shows no increase of perfusion in the corresponding, solid, enhancing lesion of the tumor (B). IVIM-derived D shows a similar D value to that of the surrounding, normal white matter (C). A diffusion signal decay as a function of multiple b values within the ROI of the tumor solid area is monoexponential (D).
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pone.0134761.g005: Intravoxel incoherent motion imaging of Primary CNS lymphoma.Primary CNS lymphoma of the left medial fronto-parietal lobe, as seen on axial, contrast-enhanced, T1-weighted imaging (A). IVIM-derived f shows no increase of perfusion in the corresponding, solid, enhancing lesion of the tumor (B). IVIM-derived D shows a similar D value to that of the surrounding, normal white matter (C). A diffusion signal decay as a function of multiple b values within the ROI of the tumor solid area is monoexponential (D).

Mentions: The data regarding fmax, D*max, and nCBVmax in the three types of tumor are summarized in Fig 2, and representative cases for glioblastoma, metastatic tumor, and PCNSL are shown in Figs 3–5, respectively. The mean fmax was significantly higher in the glioblastoma group (reader 1, 0.103 ± 0.017; reader 2, 0.109 ± 0.024) and in the metastasis group (reader 1, 0.105 ± 0.022; reader 2, 0.107 ± 0.026) than in the PCNSL group (reader 1, 0.025 ± 0.014; reader 2, 0.023 ± 0.012) (P < .001 for each), respectively. The mean D*max was also significantly higher in the glioblastoma group (reader 1, 51.4 ± 22.9; reader 2, 57.5 ± 25.6) and in the metastasis group (reader 1, 61.1 ± 29.7; reader 2, 62.5 ± 31.2) than in the PCNSL group (reader 1, 8.2 ± 4.1; reader 2, 7.8 ± 3.9) (P < .001 for each).


Comparison of Apparent Diffusion Coefficient and Intravoxel Incoherent Motion for Differentiating among Glioblastoma, Metastasis, and Lymphoma Focusing on Diffusion-Related Parameter.

Shim WH, Kim HS, Choi CG, Kim SJ - PLoS ONE (2015)

Intravoxel incoherent motion imaging of Primary CNS lymphoma.Primary CNS lymphoma of the left medial fronto-parietal lobe, as seen on axial, contrast-enhanced, T1-weighted imaging (A). IVIM-derived f shows no increase of perfusion in the corresponding, solid, enhancing lesion of the tumor (B). IVIM-derived D shows a similar D value to that of the surrounding, normal white matter (C). A diffusion signal decay as a function of multiple b values within the ROI of the tumor solid area is monoexponential (D).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4520473&req=5

pone.0134761.g005: Intravoxel incoherent motion imaging of Primary CNS lymphoma.Primary CNS lymphoma of the left medial fronto-parietal lobe, as seen on axial, contrast-enhanced, T1-weighted imaging (A). IVIM-derived f shows no increase of perfusion in the corresponding, solid, enhancing lesion of the tumor (B). IVIM-derived D shows a similar D value to that of the surrounding, normal white matter (C). A diffusion signal decay as a function of multiple b values within the ROI of the tumor solid area is monoexponential (D).
Mentions: The data regarding fmax, D*max, and nCBVmax in the three types of tumor are summarized in Fig 2, and representative cases for glioblastoma, metastatic tumor, and PCNSL are shown in Figs 3–5, respectively. The mean fmax was significantly higher in the glioblastoma group (reader 1, 0.103 ± 0.017; reader 2, 0.109 ± 0.024) and in the metastasis group (reader 1, 0.105 ± 0.022; reader 2, 0.107 ± 0.026) than in the PCNSL group (reader 1, 0.025 ± 0.014; reader 2, 0.023 ± 0.012) (P < .001 for each), respectively. The mean D*max was also significantly higher in the glioblastoma group (reader 1, 51.4 ± 22.9; reader 2, 57.5 ± 25.6) and in the metastasis group (reader 1, 61.1 ± 29.7; reader 2, 62.5 ± 31.2) than in the PCNSL group (reader 1, 8.2 ± 4.1; reader 2, 7.8 ± 3.9) (P < .001 for each).

Bottom Line: Using a mono-exponential fitting of diffusion signal decay, the mean ADCmin was significantly lower in PCNSL than in glioblastoma and metastasis.However, using a bi-exponential fitting, the mean Dmin did not significantly differ in the three groups.The mean fmax significantly increased in the glioblastomas (reader 1, 0.103; reader 2, 0.109) and the metastasis (reader 1, 0.105; reader 2, 0.107), compared to the primary CNS lymphomas (reader 1, 0.025; reader 2, 0.023) (P < .001 for each).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background and purpose: Brain tumor cellularity has been assessed by using apparent diffusion coefficient (ADC). However, the ADC value might be influenced by both perfusion and true molecular diffusion, and the perfusion effect on ADC can limit the reliability of ADC in the characterization of tumor cellularity, especially, in hypervascular brain tumors. In contrast, the IVIM technique estimates parameter values for diffusion and perfusion effects separately. The purpose of our study was to compare ADC and IVIM for differentiating among glioblastoma, metastatic tumor, and primary CNS lymphoma (PCNSL) focusing on diffusion-related parameter.

Materials and methods: We retrospectively reviewed the data of 128 patients with pathologically confirmed glioblastoma (n = 55), metastasis (n = 31), and PCNSL (n = 42) prior to any treatment. Two neuroradiologists independently calculated the maximum IVIM-f (fmax) and minimum IVIM-D (Dmin) by using 16 different b-values with a bi-exponential fitting of diffusion signal decay, minimum ADC (ADCmin) by using 0 and 1000 b-values with a mono-exponential fitting and maximum normalized cerebral blood volume (nCBVmax). The differences in fmax, Dmin, nCBVmax, and ADCmin among the three tumor pathologies were determined by one-way ANOVA with multiple comparisons. The fmax and Dmin were correlated to the corresponding nCBV and ADC using partial correlation analysis, respectively.

Results: Using a mono-exponential fitting of diffusion signal decay, the mean ADCmin was significantly lower in PCNSL than in glioblastoma and metastasis. However, using a bi-exponential fitting, the mean Dmin did not significantly differ in the three groups. The mean fmax significantly increased in the glioblastomas (reader 1, 0.103; reader 2, 0.109) and the metastasis (reader 1, 0.105; reader 2, 0.107), compared to the primary CNS lymphomas (reader 1, 0.025; reader 2, 0.023) (P < .001 for each). The correlation between fmax and the corresponding nCBV was highest in glioblastoma group, and the correlation between Dmin and the corresponding ADC was highest in primary CNS lymphomas group.

Conclusion: Unlike ADC value derived from a mono-exponential fitting of diffusion signal, diffusion-related parametric value derived from a bi-exponential fitting with separation of perfusion effect doesn't differ among glioblastoma, metastasis, and PCNSL.

No MeSH data available.


Related in: MedlinePlus