Differentiation of True Recurrence from Delayed Radiation Therapy-related Changes in Primary Brain Tumors Using Diffusion-weighted Imaging, Dynamic Susceptibility Contrast Perfusion Imaging, and Susceptibility-weighted Imaging.
10.13104/jksmrm.2014.18.2.120
- Author:
Dong Hyeon KIM
1
;
Seung Hong CHOI
;
Inseon RYOO
;
Tae Jin YOON
;
Tae Min KIM
;
Se Hoon LEE
;
Chul Kee PARK
;
Ji Hoon KIM
;
Chul Ho SOHN
;
Sung Hye PARK
;
Il Han KIM
Author Information
1. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. verocay@snuh.org
- Publication Type:Original Article
- Keywords:
Tumor recurrence;
Radiation therapy-related change;
Diffusion-weighted imaging;
Perfusion imaging Susceptibility-weighted imaging
- MeSH:
Blood Volume;
Brain Neoplasms*;
Diagnosis;
Diagnosis, Differential;
Diffusion;
Follow-Up Studies;
Humans;
Logistic Models;
Magnetic Resonance Imaging;
Perfusion Imaging*;
Recurrence*;
Sensitivity and Specificity
- From:Journal of the Korean Society of Magnetic Resonance in Medicine
2014;18(2):120-132
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weighted imaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patients treated with RT for primary brain tumors. MATERIALS AND METHODS: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newly appearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions were confirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume (nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for the enhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regression model was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtained from receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy for the diagnosis. RESULTS: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004), and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference was observed in the mean ADC values between the two groups. A multivariable logistic regression analysis showed that proSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11 of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively. CONCLUSION: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesions more than one year after RT completion in brain tumor patients.
