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01-02-2013 | Diagnostic Neuroradiology

Differentiating primary CNS lymphoma from glioblastoma multiforme: assessment using arterial spin labeling, diffusion-weighted imaging, and ¹⁸F-fluorodeoxyglucose positron emission tomography

Authors: Koji Yamashita, Takashi Yoshiura, Akio Hiwatashi, Osamu Togao, Koji Yoshimoto, Satoshi O. Suzuki, Koichiro Abe, Kazufumi Kikuchi, Yasuhiro Maruoka, Masahiro Mizoguchi, Toru Iwaki, Hiroshi Honda

Published in: Neuroradiology | Issue 2/2013

Abstract

Introduction

Our purpose was to evaluate the diagnostic performance of arterial spin labeling (ASL) perfusion imaging, diffusion-weighted imaging (DWI), and ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) in differentiating primary central nervous system lymphomas (PCNSLs) from glioblastoma multiformes (GBMs).

Methods

Fifty-six patients including 19 with PCNSL and 37 with GBM were retrospectively studied. From the ASL data, an absolute tumor blood flow (aTBF) and a relative tumor blood flow (rTBF) were obtained within the enhancing portion of each tumor. In addition, the minimum apparent diffusion coefficient (ADCmin) and the maximum standard uptake value (SUVmax) were obtained from DWI and FDG-PET data, respectively. Each of the four parameters was compared between PCNSLs and GBMs using Kruskal–Wallis test. The performance in discriminating between PCNSLs and GBMs was evaluated using the receiver-operating characteristics analysis. Area-under-the-curve (AUC) values were compared among the four parameters using a nonparametric method.

Results

The aTBF, rTBF, and ADCmin were significantly higher in GBMs (mean aTBF ± SD = 91.6 ± 56.0 mL/100 g/min, mean rTBF ± SD = 2.61 ± 1.61, mean ADCmin ± SD = 0.78 ± 0.19 × 10⁻³ mm²/s) than in PCNSLs (mean aTBF ± SD = 37.3 ± 10.5 mL/100 g/min, mean rTBF ± SD = 1.24 ± 0.37, mean ADCmin ± SD = 0.61 ± 0.13 × 10⁻³ mm²/s) (p < 0.005, respectively). In addition, SUVmax was significantly lower in GBMs (mean ± SD = 13.1 ± 6.34) than in PCNSLs (mean ± SD = 22.5 ± 7.83) (p < 0.005). The AUC for aTBF (0.888) was higher than those for rTBF (0.810), ADCmin (0.768), and SUVmax (0.848), although their difference was not statistically significant.

Conclusion

ASL perfusion imaging is useful for differentiating PCNSLs from GBMs as well as DWI and FDG-PET.

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Title: Differentiating primary CNS lymphoma from glioblastoma multiforme: assessment using arterial spin labeling, diffusion-weighted imaging, and 18F-fluorodeoxyglucose positron emission tomography
Authors: Koji Yamashita
Takashi Yoshiura
Akio Hiwatashi
Osamu Togao
Koji Yoshimoto
Satoshi O. Suzuki
Koichiro Abe
Kazufumi Kikuchi
Yasuhiro Maruoka
Masahiro Mizoguchi
Toru Iwaki
Hiroshi Honda
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 2/2013
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-012-1089-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Differentiating primary CNS lymphoma from glioblastoma multiforme: assessment using arterial spin labeling, diffusion-weighted imaging, and ¹⁸F-fluorodeoxyglucose positron emission tomography

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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