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01-12-2020 | Glioma | Educational Review

Multiparametric MRI: practical approach and pictorial review of a useful tool in the evaluation of brain tumours and tumour-like lesions

Authors: Vijay Sawlani, Markand Dipankumar Patel, Nigel Davies, Robert Flintham, Roman Wesolowski, Ismail Ughratdar, Ute Pohl, Santhosh Nagaraju, Vladimir Petrik, Andrew Kay, Saiju Jacob, Paul Sanghera, Victoria Wykes, Colin Watts, Harish Poptani

Published in: Insights into Imaging | Issue 1/2020

Abstract

MRI has a vital role in the assessment of intracranial lesions. Conventional MRI has limited specificity and multiparametric MRI using diffusion-weighted imaging, perfusion-weighted imaging and magnetic resonance spectroscopy allows more accurate assessment of the tissue microenvironment. The purpose of this educational pictorial review is to demonstrate the role of multiparametric MRI for diagnosis, treatment planning and for assessing treatment response, as well as providing a practical approach for performing and interpreting multiparametric MRI in the clinical setting. A variety of cases are presented to demonstrate how multiparametric MRI can help differentiate neoplastic from non-neoplastic lesions compared to conventional MRI alone.

Hall WA (1998) The safety and efficacy of stereotactic biopsy for intracranial lesions. Cancer 82:1749–1755PubMed

Malhotra HS, Jain KK, Agarwal A et al (2009) Characterization of tumefactive demyelinating lesions using MR imaging and in-vivo proton MR spectroscopy. Mult Scler 15:193–203PubMed

Hourani R, Brant LJ, Rizk T, Weingart JD, Barker PB, Horská A (2008) Can proton MR spectroscopic and perfusion imaging differentiate between neoplastic and nonneoplastic brain lesions in adults? AJNR Am J Neuroradiol 29:366–372PubMed

Yang D, Korogi Y, Sugahara T et al (2002) Cerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar perfusion and diffusion-weighted MRI. Neuroradiology 44:656–666PubMed

Di Costanzo A, Scarabino T, Trojsi F et al (2014) Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach. Radiol Med 119:616–624PubMed

Sawlani V, Davies N, Patel M et al (2019) Evaluation of response to stereotactic radiosurgery in brain metastases using multiparametric magnetic resonance imaging and a review of the literature. Clin Oncol (R Coll Radiol) 31:41–49

Grech-Sollars M, Hales PW, Miyazaki K et al (2015) Multi-centre reproducibility of diffusion MRI parameters for clinical sequences in the brain. NMR Biomed 28:468–485PubMedPubMedCentral

Kitis O, Altay H, Calli C, Yunten N, Akalin T, Yurtseven T (2005) Minimum apparent diffusion coefficients in the evaluation of brain tumors. Eur J Radiol 55:393–400PubMed

Abrigo JM, Fountain DM, Provenzale JM et al (2018) Magnetic resonance perfusion for differentiating low-grade from high-grade gliomas at first presentation. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011551.pub2

10.

Safriel Y, Pol-Rodriguez M, Novotny EJ, Rothman DL, Fulbright RK (2005) Reference values for long echo time MR spectroscopy in healthy adults. AJNR Am J Neuroradiol 26:1439–1445PubMed

11.

Krukowski P, Podgórski P, Guziński M, Szewczyk P, Sąsiadek M (2010) Analysis of the brain proton magnetic resonance spectroscopy - differences between normal grey and white matter. Pol J Radiol 75:22–26PubMedPubMedCentral

12.

Usinskiene J, Ulyte A, Bjørnerud A et al (2016) Optimal differentiation of high- and low-grade glioma and metastasis: a meta-analysis of perfusion, diffusion, and spectroscopy metrics. Neuroradiology 58:339–350PubMed

13.

Lee EJ, Lee SK, Agid R, Bae JM, Keller A, Terbrugge K (2008) Preoperative Grading of presumptive low-grade astrocytomas on MR imaging: diagnostic Value of minimum apparent diffusion coefficient. AJNR Am J Neuroradiol 29:1872–1877PubMed

14.

Hakyemez B, Erdogan C, Ercan I, Ergin N, Uysal S, Atahan S (2005) High-grade and low-grade gliomas: differentiation by using perfusion MR imaging. Clin Radiol 60:493–502PubMed

15.

Murakami R, Hirai T, Sugahara T et al (2009) Grading astrocytic tumors by using apparent diffusion coefficient parameters: superiority of a one-versus two-parameter pilot method 1. Radiology 251:838PubMed

16.

Batchelor T, Loeffler JS (2006) Primary CNS Lymphoma. J Clin Oncol 24:1281–1288PubMed

17.

Yamasaki F, Takayasu T, Nosaka R et al (2015) Magnetic resonance spectroscopy detection of high lipid levels in intraaxial tumors without central necrosis: a characteristic of malignant lymphoma. J Neurosurg. 122(6):1370–1379PubMed

18.

Saini J, Kumar Gupta P, Awasthi A et al (2018) Multiparametric imaging-based differentiation of lymphoma and glioblastoma: using T1-perfusion, diffusion, and susceptibility-weighted MRI. Clin Radiol 73:986.e7–986.e15

19.

Pignatti F, van den Bent M, Curran D et al (2002) Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma. J Clin Oncol 20:2076–2084PubMed

20.

Murphy ES, Leyrer CM, Parsons M et al (2018) Risk factors for malignant transformation of low-grade glioma. Int J Radiat Oncol Biol Phys 100:965–971PubMed

21.

Rees J, Watt H, Jäger HR et al (2009) Volumes and growth rates of untreated adult low-grade gliomas indicate risk of early malignant transformation. Eur J Radiol 72:54–64PubMed

22.

Bulik M, Jancalek R, Vanicek J, Skoch A, Mechl M (2013) Potential of MR spectroscopy for assessment of glioma grading. Clin Neurol Neurosurg 115:146–153PubMed

23.

Scott JN, Brasher PM, Sevick RJ, Rewcastle NB, Forsyth PA (2002) How often are nonenhancing supratentorial gliomas malignant? A population study. Neurology. 59(6):947–949PubMed

24.

Danchaivijitr N, Waldman AD, Tozer DJ et al (2008) Low-grade gliomas: do changes in rCBV measurements at longitudinal perfusion-weighted MR Imaging predict malignant transformation? Radiology 247:170–178PubMed

25.

Soares DP, Law M (2009) Magnetic resonance spectroscopy of the brain: review of metabolites and clinical applications. Clin Radiol 64:12–21PubMed

26.

Muragaki Y, Chernov M, Maruyama T et al (2008) Low-grade glioma on stereotactic biopsy: how often is the diagnosis accurate? Minim Invasive Neurosurg 51:275–279PubMed

27.

Jin T, Ren Y, Zhang H, Xie Q, Yao Z, Feng X (2019) Application of MRS- and ASL-guided navigation for biopsy of intracranial tumors. Acta Radiol 60:374–381PubMed

28.

Georgakis MK, Spinos D, Pourtsidis A et al (2018) Incidence and survival of gliomatosis cerebri: a population-based cancer registration study. J Neurooncol 138:341–349PubMed

29.

Förster A, Brehmer S, Seiz-Rosenhagen M et al (2019) Heterogeneity of glioblastoma with gliomatosis cerebri growth pattern on diffusion and perfusion MRI. J Neurooncol 142:103–109PubMed

30.

Abbasi AW, Westerlaan HE, Holtman GA, Aden KM, van Laar PJ, van der Hoorn A (2018) Incidence of tumour progression and pseudoprogression in high-grade gliomas: a systematic review and meta-analysis. Clin Neuroradiol 28:401–411PubMed

31.

Matsusue E, Fink JR, Rockhill JK, Ogawa T, Maravilla KR (2010) Distinction between glioma progression and post-radiation change by combined physiologic MR imaging. Neuroradiology 52:297–306PubMed

32.

Hu LS, Baxter LC, Smith KA et al (2009) Relative cerebral blood volume values to differentiate high-grade glioma recurrence from posttreatment radiation effect: direct correlation between image-guided tissue histopathology and localized dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging measurements. Am J Neuroradiol 30:552–558PubMed

33.

Xu J-L, Shi D-P, Dou S, Li Y-L, Yan F (2011) Distinction between postoperative recurrent glioma and delayed radiation injury using MR perfusion weighted imaging. J Med Imaging Radiat Oncol 55:587–594PubMed

34.

Sawlani V, Taylor R, Rowley K, Redfern R, Martin J, Poptani H (2012) Magnetic resonance spectroscopy for differentiating pseudo-progression from true progression in GBM on concurrent chemoradiotherapy. Neuroradiol J 25:575–586PubMed

35.

Zeng Q-S, Li C-F, Liu H, Zhen J-H, Feng D-C (2007) Distinction between Recurrent glioma and radiation injury using magnetic resonance spectroscopy in combination with diffusion-weighted imaging. Int J Radiat Oncol Biol Phys 68:151–158PubMed

36.

Hein PA, Eskey CJ, Dunn JF, Hug EB (2004) Diffusion-weighted imaging in the follow-up of treated high-grade gliomas: tumor recurrence versus radiation injury. AJNR Am J Neuroradiol 25:201–209PubMed

37.

Song YS, Choi SH, Park C-K et al (2013) True progression versus pseudoprogression in the treatment of glioblastomas: a comparison study of Normalized cerebral blood volume and apparent diffusion coefficient by histogram analysis. Korean J Radiol 14:662PubMedPubMedCentral

38.

O’Beirn M, Benghiat H, Meade S et al (2018) The expanding role of Radiosurgery for brain metastases. Medicines (Basel) 5:90

39.

Patel TR, McHugh BJ, Bi WL, Minja FJ, Knisely JPS, Chiang VL (2011) A comprehensive review of MR imaging changes following radiosurgery to 500 brain metastases. Am J Neuroradiol 32:1885–1892PubMed

40.

Osenbach RK, Loftus CM (1992) Diagnosis and management of brain abscess. Neurosurg Clin N Am 3:403–420PubMed

41.

Hsu S-H, Chou M-C, Ko C-W et al (2013) Proton MR spectroscopy in patients with pyogenic brain abscess: MR spectroscopic imaging versus single-voxel spectroscopy. Eur J Radiol 82:1299–1307PubMed

42.

Xu X-X, Li B, Yang H-F et al (2014) Can diffusion-weighted imaging be used to differentiate brain abscess from other ring-enhancing brain lesions? A meta-analysis. Clin Radiol 69:909–915PubMed

43.

Horvath-Rizea D, Surov A, Hoffmann K-T et al (2018) The value of whole lesion ADC histogram profiling to differentiate between morphologically indistinguishable ring enhancing lesions-comparison of glioblastomas and brain abscesses. Oncotarget 9:18148–18159PubMedPubMedCentral

44.

Peng J, Ouyang Y, Fang W-D et al (2012) Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur J Radiol 81:4057–4063PubMed

45.

Gupta RK, Roy R, Dev R et al (1996) Finger printing of mycobacterium tuberculosis in patients with intracranial tuberculomas by usingin vivo,ex vivo, andin vitro magnetic resonance spectroscopy. Magn Reson Med 36:829–833PubMed

46.

Morales H, Alfaro D, Martinot C, Fayed N, Gaskill-Shipley M (2015) MR spectroscopy of intracranial tuberculomas: a singlet peak at 3.8 ppm as potential marker to differentiate them from malignant tumors. Neuroradiol J 28(3):294–302

47.

Odaka M, Yuki N, Yamada M et al (2003) Bickerstaff’s brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain–Barré syndrome. Brain 126:2279–2290PubMed

48.

Ogawara K, Kuwabara S, Yuki N (2002) Fisher syndrome or Bickerstaff brainstem encephalitis? Anti-GQ1b IgG antibody syndrome involving both the peripheral and central nervous systems. Muscle Nerve 26:845–849PubMed

49.

Lucchinetti CF, Gavrilova RH, Metz I et al (2008) Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis. Brain 131:1759–1775PubMedPubMedCentral

50.

Saindane AM, Cha S, Law M, Xue X, Knopp EA, Zagzag D (2002) Proton MR spectroscopy of tumefactive demyelinating lesions. Am J Neuroradiol 23:1378–1386PubMed

51.

Öz G, Alger JR, Barker PB et al (2014) Clinical Proton MR Spectroscopy in Central Nervous System Disorders. Radiology 270:658–679PubMedPubMedCentral

52.

Welker K, Boxerman J, Kalnin A et al (2015) ASFNR recommendations for clinical performance of MR dynamic susceptibility contrast perfusion imaging of the brain. AJNR Am J Neuroradiol. 36(6):E41–E51PubMedPubMedCentral

Title: Multiparametric MRI: practical approach and pictorial review of a useful tool in the evaluation of brain tumours and tumour-like lesions
Authors: Vijay Sawlani
Markand Dipankumar Patel
Nigel Davies
Robert Flintham
Roman Wesolowski
Ismail Ughratdar
Ute Pohl
Santhosh Nagaraju
Vladimir Petrik
Andrew Kay
Saiju Jacob
Paul Sanghera
Victoria Wykes
Colin Watts
Harish Poptani
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Glioma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Glioma
Glioma
Published in: Insights into Imaging / Issue 1/2020
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-020-00888-1

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Multiparametric MRI: practical approach and pictorial review of a useful tool in the evaluation of brain tumours and tumour-like lesions

Abstract

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Abstract

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