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Added value and diagnostic performance of intratumoral susceptibility signals in the differential diagnosis of solitary enhancing brain lesions: preliminary study.

Kim, HS; Jahng, GH; Ryu, CW; Kim, SY
AJNR. American journal of neuroradiology, 30(8):1574-1579, 2009
Journal Title
AJNR. American journal of neuroradiology
BACKGROUND AND PURPOSE: It has been reported that high-resolution susceptibility-weighted imaging (HR-SWI) is a promising tool for assessing brain tumor characterization noninvasively. The purpose of this study was to determine the added value and diagnostic performance of HR-SWI for differentiating solitary enhancing brain lesions (SELs) by assessing intratumoral susceptibility signals (ITSSs).

MATERIALS AND METHODS: Sixty-four consecutive patients with SELs, without previous surgery, were retrospectively reviewed. We performed 2 consensus reviews, by using conventional MR images alone and with adjunctive HR-SWI. We applied an ITSS grading system based on the degree of the ITSS. Then, we compared the presence and grade of the ITSSs among specific pathologic types of SELs.

RESULTS: Two observers diagnosed tumor pathology accurately in 43 (67%) of 64 SELs after reviewing the conventional images alone and 50 (78%) of 64 SELs after reviewing the adjunctive HR-SWI (P = .016, McNemar test). ITSSs were seen in 25 (100%) of 25 glioblastoma multiformes (GBMs), in 2 (40%) of 5 anaplastic astrocytomas, and in 11 (73%) of 15 metastatic tumors. Although the ITSSs were unable to distinguish between GBMs and solitary metastatic tumors, differentiation between GBMs and solitary metastatic tumors was achieved (P = .01) by using a high ITSS degree (grade 3). Moreover, the ITSSs could discriminate high-grade gliomas from lymphomas and nontumorous lesions with a specificity of 100% (P < .0001).

CONCLUSIONS: The use of ITSSs on HR-SWIs significantly improves the accuracy for the differential diagnosis of SELs compared with the use of conventional MR imaging alone.
MeSH terms
AdultAgedBrain/pathology*Brain Neoplasms/diagnosis*Diagnosis, DifferentialFemaleHumansImage Enhancement/methods*Magnetic Resonance Imaging/methods*MaleMiddle AgedObserver VariationPilot ProjectsReproducibility of ResultsSensitivity and SpecificityYoung Adult
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Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
김, 호성김, 선용
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