B Wang1, B Zhao2, Y Zhang2, M Ge3, P Zhao3, C Li2, Q Pang3, S Xu3, Y Liu4. 1. School of Medicine, Shandong University, Jinan, 250012, PR China. 2. Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, PR China. 3. Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, PR China. 4. Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, PR China. Electronic address: 13805311573@126.com.
Abstract
AIM: To investigate the efficiency of absolute cerebral blood volume (CBV) in the differentiation of tumour recurrence (TR) and radionecrosis (RN) in brain metastases (BM) and to evaluate the performance of absolute CBV compared to relative CBV (rCBV). MATERIALS AND METHODS: Between March 2015 and June 2017, 46 patients with BM underwent quantitative dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) because new enhancement had been demonstrated in irradiated lesions after gamma knife radiotherapy. The patients were assigned to either the TR group or RN group on the basis of MR perfusion follow-up or histopathological outcome. Absolute CBV of lesions (CBVlesion) and contralateral normal appearing white matter (CBVNAWM) in both groups were obtained. Mean rCBV were calculated as CBVlesion/CBVNAWM, which was equal to rCBV using traditional DSC-PWI. RESULTS: CBVlesion of TR alone was significantly higher than the other parameters in both groups (p<0.001, separately). CBVlesion had smaller interobserver difference than CBVNAWM and rCBV (p<0.001, separately). Although CBVlesion significantly correlated with rCBV (r=0.914, p<0.001) and both had a similar specificity (96%) in differential diagnosis, CBVlesion had a higher sensitivity (96.9% versus 90.9%) to predict the treatment outcome. The best cut-off value of CBVlesion was 21.8 ml/100 g. CONCLUSION: Quantitative DSC-PWI is a powerful method for the assessment of radiosurgically treated brain metastases. Absolute CBV has higher diagnostic efficiency than rCBV, which enables an absolute quantification of the regional CBV and prediction of tumour response. These advantages promote the intra- and inter-patient quantitative image comparison across different institutions.
AIM: To investigate the efficiency of absolute cerebral blood volume (CBV) in the differentiation of tumour recurrence (TR) and radionecrosis (RN) in brain metastases (BM) and to evaluate the performance of absolute CBV compared to relative CBV (rCBV). MATERIALS AND METHODS: Between March 2015 and June 2017, 46 patients with BM underwent quantitative dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) because new enhancement had been demonstrated in irradiated lesions after gamma knife radiotherapy. The patients were assigned to either the TR group or RN group on the basis of MR perfusion follow-up or histopathological outcome. Absolute CBV of lesions (CBVlesion) and contralateral normal appearing white matter (CBVNAWM) in both groups were obtained. Mean rCBV were calculated as CBVlesion/CBVNAWM, which was equal to rCBV using traditional DSC-PWI. RESULTS: CBVlesion of TR alone was significantly higher than the other parameters in both groups (p<0.001, separately). CBVlesion had smaller interobserver difference than CBVNAWM and rCBV (p<0.001, separately). Although CBVlesion significantly correlated with rCBV (r=0.914, p<0.001) and both had a similar specificity (96%) in differential diagnosis, CBVlesion had a higher sensitivity (96.9% versus 90.9%) to predict the treatment outcome. The best cut-off value of CBVlesion was 21.8 ml/100 g. CONCLUSION: Quantitative DSC-PWI is a powerful method for the assessment of radiosurgically treated brain metastases. Absolute CBV has higher diagnostic efficiency than rCBV, which enables an absolute quantification of the regional CBV and prediction of tumour response. These advantages promote the intra- and inter-patient quantitative image comparison across different institutions.
Authors: Yang Yunqi; Niu Aihua; Zheng Zhiming; Liu Yingchao; Wang Qiang; Ming Yang; Zhang Yi Journal: Front Neurol Date: 2022-03-18 Impact factor: 4.003