Sung-Hye You1,2, Tae Jin Yun3,4, Hye Jeong Choi1,2, Roh-Eul Yoo1,2, Koung Mi Kang1,2, Seung Hong Choi1,2, Ji-Hoon Kim1,2, Chul-Ho Sohn1,2. 1. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. 2. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. 3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. radiologyyun@gmail.com. 4. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. radiologyyun@gmail.com.
Abstract
OBJECTIVES: To evaluate the diagnostic performance of arterial spin labelling perfusion weighted images (ASL-PWIs) to differentiate primary CNS lymphoma (PCNSL) from glioblastoma (GBM). METHODS: ASL-PWIs of pathologically confirmed PCNSL (n = 21) or GBM (n = 93) were analysed. For qualitative analysis, tumours were visually scored into five categories based on ASL-CBF maps. For quantitative analysis, normalised CBF values were derived by contralateral grey matter (GM) in intra- and peritumoral areas (nCBFintratumoral and nCBFperitumoral, respectively). Visual scoring scales and quantitative parameters from PCNSL and GBM were compared. In addition, the area under the receiver-operating characteristic (ROC) curve was used to determine the diagnostic accuracy of ASL-PWI for differentiating PCNSL from GBM. Weighted kappa or intraclass correlation coefficients (ICCs) were used to assess reliability between two observers. RESULTS: In qualitative analysis, scores 5 (CBFintratumoral>CBFGM, 68.8% [64/93]) and 4 (CBFintratumoral ≈ CBFGM, 47.6% [10/21]) were the most frequently reported scores for GBM and PCNSL, respectively. In quantitative analysis, both nCBFintratumoral and nCBFperitumoral in PCNSL were significantly lower than those in the GBM (nCBFintratumoral, 0.89 ± 0.59 [mean and SD] vs. 2.68 ± 1.89, p < 0.001; nCBFperitumoral, 0.17 ± 0.08 vs. 0.45 ± 0.28, p < 0.001). nCBFperitumoral demonstrated the best diagnostic performance (area under the ROC curve: visual scoring, 0.814; nCBFintratumoral, 0.849; nCBFperitumoral, 0.908; p < 0.001 for all). Interobserver agreements for visual scoring (weighted kappa = 0.869), nCBFintratumoral_GM (ICC = 0.958) and nCBFperitumoral_GM (ICC = 0.947) were all excellent. CONCLUSIONS: ASL-PWI performs well in differentiating PCNSL from GBM in both qualitative and quantitative analyses. KEY POINTS: • ASL-PWI performs well (AUC > 0.8) in differentiating PCNSL from GBM. • The visual scoring template demonstrated good diagnostic performance, similar to quantitative analysis. • nCBFperitumoral demonstrated better diagnostic performance than nCBFintratumoral or visual scoring.
OBJECTIVES: To evaluate the diagnostic performance of arterial spin labelling perfusion weighted images (ASL-PWIs) to differentiate primary CNS lymphoma (PCNSL) from glioblastoma (GBM). METHODS:ASL-PWIs of pathologically confirmed PCNSL (n = 21) or GBM (n = 93) were analysed. For qualitative analysis, tumours were visually scored into five categories based on ASL-CBF maps. For quantitative analysis, normalised CBF values were derived by contralateral grey matter (GM) in intra- and peritumoral areas (nCBFintratumoral and nCBFperitumoral, respectively). Visual scoring scales and quantitative parameters from PCNSL and GBM were compared. In addition, the area under the receiver-operating characteristic (ROC) curve was used to determine the diagnostic accuracy of ASL-PWI for differentiating PCNSL from GBM. Weighted kappa or intraclass correlation coefficients (ICCs) were used to assess reliability between two observers. RESULTS: In qualitative analysis, scores 5 (CBFintratumoral>CBFGM, 68.8% [64/93]) and 4 (CBFintratumoral ≈ CBFGM, 47.6% [10/21]) were the most frequently reported scores for GBM and PCNSL, respectively. In quantitative analysis, both nCBFintratumoral and nCBFperitumoral in PCNSL were significantly lower than those in the GBM (nCBFintratumoral, 0.89 ± 0.59 [mean and SD] vs. 2.68 ± 1.89, p < 0.001; nCBFperitumoral, 0.17 ± 0.08 vs. 0.45 ± 0.28, p < 0.001). nCBFperitumoral demonstrated the best diagnostic performance (area under the ROC curve: visual scoring, 0.814; nCBFintratumoral, 0.849; nCBFperitumoral, 0.908; p < 0.001 for all). Interobserver agreements for visual scoring (weighted kappa = 0.869), nCBFintratumoral_GM (ICC = 0.958) and nCBFperitumoral_GM (ICC = 0.947) were all excellent. CONCLUSIONS: ASL-PWI performs well in differentiating PCNSL from GBM in both qualitative and quantitative analyses. KEY POINTS: • ASL-PWI performs well (AUC > 0.8) in differentiating PCNSL from GBM. • The visual scoring template demonstrated good diagnostic performance, similar to quantitative analysis. • nCBFperitumoral demonstrated better diagnostic performance than nCBFintratumoral or visual scoring.
Entities:
Keywords:
Brain neoplasms; Glioblastoma; Lymphoma; Magnetic resonance imaging; Perfusion imaging
Authors: Soonmee Cha; Edmond A Knopp; Glyn Johnson; Stephan G Wetzel; Andrew W Litt; David Zagzag Journal: Radiology Date: 2002-04 Impact factor: 11.105
Authors: Carissa M White; Whitney B Pope; Taryar Zaw; Joe Qiao; Kourosh M Naeini; Albert Lai; Phioanh L Nghiemphu; J J Wang; Timothy F Cloughesy; Benjamin M Ellingson Journal: J Neuroimaging Date: 2012-06-05 Impact factor: 2.486
Authors: A J Bastos-Leite; J P A Kuijer; S A R B Rombouts; E Sanz-Arigita; E C van Straaten; A A Gouw; W M van der Flier; P Scheltens; F Barkhof Journal: AJNR Am J Neuroradiol Date: 2008-05-01 Impact factor: 3.825
Authors: S Nakajima; T Okada; A Yamamoto; M Kanagaki; Y Fushimi; T Okada; Y Arakawa; Y Takagi; S Miyamoto; K Togashi Journal: Clin Radiol Date: 2015-09-14 Impact factor: 2.350
Authors: Tobias Engelhorn; Nic E Savaskan; Marc A Schwarz; Jürgen Kreutzer; Eric P Meyer; Eric Hahnen; Oliver Ganslandt; Arnd Dörfler; Christopher Nimsky; Michael Buchfelder; Ilker Y Eyüpoglu Journal: Cancer Sci Date: 2009-07-24 Impact factor: 6.716
Authors: A I Batalov; R M Afandiev; N E Zakharova; E L Pogosbekyan; A A Shulgina; G L Kobyakov; A A Potapov; I N Pronin Journal: Neuroradiology Date: 2022-02-03 Impact factor: 2.995
Authors: Anna Falk Delgado; Danielle Van Westen; Markus Nilsson; Linda Knutsson; Pia C Sundgren; Elna-Marie Larsson; Alberto Falk Delgado Journal: Insights Imaging Date: 2019-08-23
Authors: Lelio Guida; Vittorio Stumpo; Jacopo Bellomo; Christiaan Hendrik Bas van Niftrik; Martina Sebök; Moncef Berhouma; Andrea Bink; Michael Weller; Zsolt Kulcsar; Luca Regli; Jorn Fierstra Journal: Cancers (Basel) Date: 2022-03-10 Impact factor: 6.639