Which is the best advanced MR imaging protocol for predicting recurrent metastatic brain tumor following gamma-knife radiosurgery: focused on perfusion method

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• 作者：Myeong Ju Koh ; Ho Sung Kim ; Choong Gon Choi ; Sang Joon Kim
• 关键词：Recurrent metastatic brain tumor ; Gamma ; knife radiosurgery ; Dynamic contrast ; enhanced MR imaging ; Dynamic susceptibility contrast ; enhanced ; Diffusion ; weighted imaging
• 刊名：Neuroradiology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：57
• 期：4
• 页码：367-376
• 全文大小：2,569 KB
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• 作者单位：Myeong Ju Koh (1)
  Ho Sung Kim (1)
  Choong Gon Choi (1)
  Sang Joon Kim (1)
  
  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, South Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neuroradiology
  Imaging and Radiology
  Neurology
  Neurosurgery
  Neurosciences
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1920

文摘

Introduction High spatial resolution of dynamic contrast-enhanced (DCE) MR imaging allows characterization of heterogenous tumor microenvironment. Our purpose was to determine which is the best advanced MR imaging protocol, focused on additional MR perfusion method, for predicting recurrent metastatic brain tumor following gamma-knife radiosurgery (GKRS). Methods Seventy-two consecutive patients with post-GKRS metastatic brain tumor were enrolled. Two readers independently calculated the percentile histogram cutoffs for normalized cerebral blood volume (nCBV) from dynamic susceptibility contrast (DSC) imaging and initial area under the time signal-intensity curve (IAUC) from DCE imaging, respectively. Area under the receiver operating characteristic curve (AUC) and interreader agreement were assessed. Results For differentiating tumor recurrence from therapy effect, adding DCE imaging to diffusion-weighted imaging (DWI) significantly improved AUC from 0.79 to 0.95 for reader 1 and from 0.80 to 0.96 for reader 2, respectively. There was no significant difference of AUC between the combination of DWI with DSC imaging and the combination of DWI with DCE imaging for both readers. With the combination of DWI and DCE imaging, the sensitivity and specificity were 86.7 and 88.1?% for reader 1 and 90.0 and 85.7?% for reader 2, respectively. The intraclass correlation coefficient (ICC) between readers was highest for calculation of the 90th percentile histogram cutoffs for IAUC (ICC, 0.87). Conclusion Adding perfusion MR imaging to DWI significantly improves the prediction of recurrent metastatic tumor; however, the diagnostic performance is not affected by selection of either DSC or DCE MR perfusion method.