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Comparison of Diffusion Tensor Imaging and Magnetic Resonance Perfusion Imaging in Differentiating Recurrent Brain Neoplasm From Radiation Necrosis

Masch, William R; Wang, Page I; Chenevert, Thomas L; Junck, Larry; Tsien, Christina; Heth, Jason A and Sundgren, Pia LU (2016) In Academic Radiology 23(5). p.569-576
Abstract
RATIONALE AND OBJECTIVES:



To compare differences in diffusion tensor imaging (DTI) and dynamic susceptibility-weighted contrast-enhanced (DSC) magnetic resonance (MR) perfusion imaging characteristics of recurrent neoplasm and radiation necrosis in patients with brain tumors previously treated with radiotherapy with or without surgery and chemotherapy.

MATERIALS AND METHODS:



Patients with a history of brain neoplasm previously treated with radiotherapy with or without chemotherapy and surgery who developed a new enhancing lesion on posttreatment surveillance MRI were enrolled. DSC perfusion MRI and DTI were performed. Region of interest cursors were manually drawn in the contrast-enhancing... (More)
RATIONALE AND OBJECTIVES:



To compare differences in diffusion tensor imaging (DTI) and dynamic susceptibility-weighted contrast-enhanced (DSC) magnetic resonance (MR) perfusion imaging characteristics of recurrent neoplasm and radiation necrosis in patients with brain tumors previously treated with radiotherapy with or without surgery and chemotherapy.

MATERIALS AND METHODS:



Patients with a history of brain neoplasm previously treated with radiotherapy with or without chemotherapy and surgery who developed a new enhancing lesion on posttreatment surveillance MRI were enrolled. DSC perfusion MRI and DTI were performed. Region of interest cursors were manually drawn in the contrast-enhancing lesions, in the perilesional white matter edema, and in the contralateral normal-appearing frontal lobe white matter. DTI and DSC perfusion MR indices were compared in recurrent tumor versus radiation necrosis.

RESULTS:



Twenty-two patients with 24 lesions were included. Sixteen (67%) lesions were placed into the recurrent neoplasm group and eight (33%) lesions were placed into the radiation necrosis group using biopsy results as the gold standard in all but three patients. Mean apparent diffusion coefficient values, mean parallel eigenvalues, and mean perpendicular eigenvalues in the contrast-enhancing lesion were significantly lower, and relative cerebral blood volume was significantly higher for the recurrent neoplasm group compared to the radiation necrosis group (P < 0.01, P = 0.03, P < 0.01, and P < 0.01, respectively).

CONCLUSIONS:



The combined assessment of DTI and DSC MR perfusion properties of new contrast-enhancing lesions is helpful in distinguishing recurrent neoplasm from radiation necrosis in patients with a history of brain neoplasm previously treated with radiotherapy with or without surgery and chemotherapy. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Academic Radiology
volume
23
issue
5
pages
569 - 576
publisher
Elsevier
external identifiers
  • pmid:26916251
  • scopus:84962916698
  • wos:000375022100006
ISSN
1878-4046
DOI
10.1016/j.acra.2015.11.015
language
English
LU publication?
yes
id
2ff78218-fc68-412c-bbe4-fce60d710897 (old id 8821625)
date added to LUP
2016-03-02 10:13:14
date last changed
2017-08-22 08:49:52
@article{2ff78218-fc68-412c-bbe4-fce60d710897,
  abstract     = {RATIONALE AND OBJECTIVES:<br/><br>
<br/><br>
To compare differences in diffusion tensor imaging (DTI) and dynamic susceptibility-weighted contrast-enhanced (DSC) magnetic resonance (MR) perfusion imaging characteristics of recurrent neoplasm and radiation necrosis in patients with brain tumors previously treated with radiotherapy with or without surgery and chemotherapy.<br/><br>
MATERIALS AND METHODS:<br/><br>
<br/><br>
Patients with a history of brain neoplasm previously treated with radiotherapy with or without chemotherapy and surgery who developed a new enhancing lesion on posttreatment surveillance MRI were enrolled. DSC perfusion MRI and DTI were performed. Region of interest cursors were manually drawn in the contrast-enhancing lesions, in the perilesional white matter edema, and in the contralateral normal-appearing frontal lobe white matter. DTI and DSC perfusion MR indices were compared in recurrent tumor versus radiation necrosis.<br/><br>
RESULTS:<br/><br>
<br/><br>
Twenty-two patients with 24 lesions were included. Sixteen (67%) lesions were placed into the recurrent neoplasm group and eight (33%) lesions were placed into the radiation necrosis group using biopsy results as the gold standard in all but three patients. Mean apparent diffusion coefficient values, mean parallel eigenvalues, and mean perpendicular eigenvalues in the contrast-enhancing lesion were significantly lower, and relative cerebral blood volume was significantly higher for the recurrent neoplasm group compared to the radiation necrosis group (P &lt; 0.01, P = 0.03, P &lt; 0.01, and P &lt; 0.01, respectively).<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
The combined assessment of DTI and DSC MR perfusion properties of new contrast-enhancing lesions is helpful in distinguishing recurrent neoplasm from radiation necrosis in patients with a history of brain neoplasm previously treated with radiotherapy with or without surgery and chemotherapy.},
  author       = {Masch, William R and Wang, Page I and Chenevert, Thomas L and Junck, Larry and Tsien, Christina and Heth, Jason A and Sundgren, Pia},
  issn         = {1878-4046},
  language     = {eng},
  month        = {02},
  number       = {5},
  pages        = {569--576},
  publisher    = {Elsevier},
  series       = {Academic Radiology},
  title        = {Comparison of Diffusion Tensor Imaging and Magnetic Resonance Perfusion Imaging in Differentiating Recurrent Brain Neoplasm From Radiation Necrosis},
  url          = {http://dx.doi.org/10.1016/j.acra.2015.11.015},
  volume       = {23},
  year         = {2016},
}