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AJNR - American Journal of Neuroradiology

Published ahead of print on December 7, 2007
doi: 10.3174/ajnr.A0872

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American Journal of Neuroradiology 29:471-475, March 2008
© 2008 American Society of Neuroradiology

BRAIN

Primary Cerebral Lymphoma and Glioblastoma Multiforme: Differences in Diffusion Characteristics Evaluated with Diffusion Tensor Imaging

C.-H. Toh^a, M. Castillo^c, A.M.-C. Wong^a, K.-C. Wei^b, H.-F. Wong^a, S.-H. Ng^a and Y.-L. Wan^a

^a Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
^b Department of Neurosurgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
^c Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC

Please address correspondence to Cheng-Hong Toh, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu Hsing St, Kwei Shan Hsiang, Tao-Yuan 333, Taiwan; e-mail: eldomtoh{at}hotmail.com

BACKGROUND AND PURPOSE: Differentiating between primary cerebral lymphoma and glioblastoma multiforme (GBM) based on conventional MR imaging sequences may be impossible. Our hypothesis was that there are significant differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between lymphoma and GBM, which will allow for differentiation between them.

MATERIALS AND METHODS: Preoperative diffusion tensor imaging (DTI) was performed in 10 patients with lymphoma and 10 patients with GBM. Regions of interest were placed in only solid-enhancing tumor areas and the contralateral normal-appearing white matter (NAWM) to measure the FA and ADC values. The differences in FA and ADC between lymphoma and GBM, as well as between solid-enhancing areas of each tumor type and contralateral NAWM, were analyzed statistically. Cutoff values of FA, FA ratio, ADC, and ADC ratio for distinguishing lymphomas from GBMs were determined by receiver operating characteristic curve analysis.

RESULTS: FA and ADC values of lymphoma were significantly decreased compared with NAWM. Mean FA, FA ratio, ADC (x10^–3 mm²/s), and ADC ratios were 0.140 ± 0.024, 0.25 ± 0.04, 0.630 ± 0.155, and 0.83 ± 0.14 for lymphoma, respectively, and 0.229 ± 0.069, 0.40 ± 0.12, 0.963 ± 0.119, and 1.26 ± 0.13 for GBM, respectively. All of the values were significantly different between lymphomas and GBM. Cutoff values to differentiate lymphomas from GBM were 0.192 for FA, 0.33 for FA ratio, 0.818 for ADC, and 1.06 for ADC ratio.

CONCLUSIONS: The FA and ADC of primary cerebral lymphoma were significantly lower than those of GBM. DTI is able to differentiate lymphomas from GBM.

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