Document Detail


Diagnostic performance of spectroscopic and perfusion MRI for distinction of brain tumors.
MedLine Citation:
PMID:  16801657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the value of spectroscopic and perfusion MRI for glioma grading and for distinguishing glioblastomas from metastases and from CNS lymphomas. METHODS: The authors examined 79 consecutive patients with first detection of a brain neoplasm on nonenhanced CT scans and no therapy prior to evaluation. Spectroscopic MRI; arterial spin-labeling MRI for measuring cerebral blood flow (CBF); first-pass dynamic, susceptibility-weighted, contrast-enhanced MRI for measuring cerebral blood volume; and T1-weighted dynamic contrast-enhanced MRI were performed. Receiver operating characteristic analysis was performed, and optimum thresholds for tumor classification and glioma grading were determined. RESULTS: Perfusion MRI had a higher diagnostic performance than spectroscopic MRI. Because of a significantly higher tumor blood flow in glioblastomas compared with CNS lymphomas, a threshold value of 1.2 for CBF provided sensitivity of 97%, specificity of 80%, positive predictive value (PPV) of 94%, and negative predictive value (NPV) of 89%. Because CBF was significantly higher in peritumoral nonenhancing T2-hyperintense regions of glioblastomas compared with metastases, a threshold value of 0.5 for CBF provided sensitivity, specificity, PPV, and NPV of 100%, 71%, 94%, and 100%. Glioblastomas had the highest tumor blood flow values among all other glioma grades. For discrimination of glioblastomas from grade 3 gliomas, sensitivity was 97%, specificity was 50%, PPV was 84%, and NPV was 86% (CBF threshold value of 1.4), and for discrimination of glioblastomas from grade 2 gliomas, sensitivity was 94%, specificity was 78%, PPV was 94%, and NPV was 78% (CBF threshold value of 1.6). CONCLUSION: Perfusion MRI is predictive in distinguishing glioblastomas from metastases, CNS lymphomas and other gliomas vs MRI and magnetic resonance spectroscopy.
Authors:
M A Weber; S Zoubaa; M Schlieter; E Jüttler; H B Huttner; K Geletneky; C Ittrich; M P Lichy; A Kroll; J Debus; F L Giesel; M Hartmann; M Essig
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  66     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-27     Completed Date:  2006-07-19     Revised Date:  2006-09-28    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1899-906     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany. m.a.weber@dkfz.de
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MeSH Terms
Descriptor/Qualifier:
Brain Neoplasms / classification*,  diagnosis*
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging / methods*
Magnetic Resonance Spectroscopy / methods*
Male
Middle Aged
Perfusion
Reproducibility of Results
Sensitivity and Specificity
Comments/Corrections
Erratum In:
Neurology. 2006 Sep 12;67(5):920

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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