| Diagnostic examination performance by using microvascular leakage, cerebral blood volume, and blood flow derived from 3-T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in the differentiation of glioblastoma multiforme and brain metastasis. | |
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MedLine Citation:
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PMID: 20625709 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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INTRODUCTION: Conventional magnetic resonance (MR) imaging has limited capacity to differentiate between glioblastoma multiforme (GBM) and metastasis. The purposes of this study were: (1) to compare microvascular leakage (MVL), cerebral blood volume (CBV), and blood flow (CBF) in the distinction of metastasis from GBM using dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MRI), and (2) to estimate the diagnostic accuracy of perfusion and permeability MR imaging. METHODS: A prospective study of 61 patients (40 GBMs and 21 metastases) was performed at 3 T using DSC-MRI. Normalized rCBV and rCBF from tumoral (rCBVt, rCBFt), peri-enhancing region (rCBVe, rCBFe), and by dividing the value in the tumor by the value in the peri-enhancing region (rCBVt/e, rCBFt/e), as well as MVL were calculated. Hemodynamic and histopathologic variables were analyzed statistically and Spearman/Pearson correlations. Receiver operating characteristic curve analysis was performed for each of the variables. RESULTS: The rCBVe, rCBFe, and MVL were significantly greater in GBMs compared with those of metastases. The optimal cutoff value for differentiating GBM from metastasis was 0.80 which implies a sensitivity of 95%, a specificity of 92%, a positive predictive value of 86%, and a negative predictive value of 97% for rCBVe ratio. We found a modest correlation between rCBVt and rCBFt ratios. CONCLUSION: MVL measurements in GBMs are significantly higher than those in metastases. Statistically, both rCBVe, rCBVt/e and rCBFe, rCBFt/e were useful in differentiating between GBMs and metastases, supporting the hypothesis that perfusion MR imaging can detect infiltration of tumor cells in the peri-enhancing region. |
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Authors:
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Andrés Server; Tone E Døli Orheim; Bjørn A Graff; Roger Josefsen; Theresa Kumar; Per H Nakstad |
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Publication Detail:
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Type: Journal Article Date: 2010-07-13 |
Journal Detail:
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Title: Neuroradiology Volume: 53 ISSN: 1432-1920 ISO Abbreviation: Neuroradiology Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1302751 Medline TA: Neuroradiology Country: Germany |
Other Details:
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Languages: eng Pagination: 319-30 Citation Subset: IM |
Affiliation:
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Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital-Ullevaal, Oslo, Norway, a.s.alonso@medisin.uio.no. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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