Differentiation of primary central nervous system lymphoma from high-grade glioma and brain metastasis using arterial spin labeling and dynamic contrast-enhanced magnetic resonance imaging

Publication date: Available online 8 January 2019

Source: European Journal of Radiology

Author(s): Yi-bin Xi, Xiao-wei Kang, Ning Wang, Ting-ting Liu, Yuan-qiang Zhu, Guang Cheng, Kai Wang, Chen Li, Fan Guo, Hong Yin

Abstract

Background and Purpose

Conventional magnetic resonance imaging (MRI) is sometimes difficult to distinguish primary central nervous system lymphoma (PCNSL) from other malignant brain tumors effectively. The study aimed to evaluate the diagnostic performance of arterial spin labeling (ASL) and dynamic contrast-enhanced (DCE)-derived permeability parameters to differentiate PCNSL from high-grade glioma (HGG) and brain metastasis.

Materials and Methods

Eight patients with PCNSL, twenty one patients with HGG and six brain metastasis underwent preoperative 3.0-T MR imaging including conventional, ASL and DCE. Quantitative parameters including relative cerebral blood flow (rCBF), extravascular extracellular volume fraction (V_e) and the volume transfer constant (K^trans) among PCNSL, HGG and metastasis were compared with a one-way analysis of variance. In addition, the area under the receiver-operating characteristic (ROC) curve (AUC) was constructed to evaluate the differentiation diagnostic performance of each parameter and the combination.

Results

The PCNSL demonstrated significantly lower rCBF, higher K^trans and V_e compared with HGG and metastasis. For the ROC analyses, both K^trans and rCBF had good diagnostic performance for discriminating PCNSL from HGG and metastasis, with the AUC of 0.880 and 0.889. With the combination of rCBF and K^trans, the diagnostic ability for PCNSL was improved with AUC of 0.986.

Conclusion

rCBF and K^trans are useful parameters for differentiating PCNSL from HGG and brain metastasis. The combination of rCBF and K^trans further helps to improve the diagnostic performance of PCNSL.

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