RT Journal Article SR Electronic T1 Differentiation between Glioblastomas, Solitary Brain Metastases, and Primary Cerebral Lymphomas Using Diffusion Tensor and Dynamic Susceptibility Contrast-Enhanced MR Imaging JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 507 OP 514 DO 10.3174/ajnr.A2333 VO 32 IS 3 A1 S. Wang A1 S. Kim A1 S. Chawla A1 R.L. Wolf A1 D.E. Knipp A1 A. Vossough A1 D.M. O'Rourke A1 K.D. Judy A1 H. Poptani A1 E.R. Melhem YR 2011 UL http://www.ajnr.org/content/32/3/507.abstract AB BACKGROUND AND PURPOSE: Glioblastomas, brain metastases, and PCLs may have similar enhancement patterns on MR imaging, making the differential diagnosis difficult or even impossible. The purpose of this study was to determine whether a combination of DTI and DSC can assist in the differentiation of glioblastomas, solitary brain metastases, and PCLs. MATERIALS AND METHODS: Twenty-six glioblastomas, 25 brain metastases, and 16 PCLs were retrospectively identified. DTI metrics, including FA, ADC, CL, CP, CS, and rCBV were measured from the enhancing, immediate peritumoral and distant peritumoral regions. A 2-level decision tree was designed, and a multivariate logistic regression analysis was used at each level to determine the best model for classification. RESULTS: From the enhancing region, significantly elevated FA, CL, and CP and decreased CS values were observed in glioblastomas compared with brain metastases and PCLs (P < .001), whereas ADC, rCBV, and rCBVmax values of glioblastomas were significantly higher than those of PCLs (P < .01). The best model to distinguish glioblastomas from nonglioblastomas consisted of ADC, CS (or FA) from the enhancing region, and rCBV from the immediate peritumoral region, resulting in AUC = 0.938. The best predictor to differentiate PCLs from brain metastases comprised ADC from the enhancing region and CP from the immediate peritumoral region with AUC = 0.909. CONCLUSIONS: The combination of DTI metrics and rCBV measurement can help in the differentiation of glioblastomas from brain metastases and PCLs. ADCapparent diffusion coefficientAUCarea under the curveCBVcerebral blood volumeCLlinear anisotropy coefficientCPplanar anisotropy coefficientCSspheric anisotropy coefficientDPRdistant peritumoral regionDSCdynamic susceptibility contrast-enhancedDTIdiffusion tensor imagingERenhancing regionFAfractional anisotropyFLAIRfluid-attenuated inversion recoveryGRAPPAgeneralized autocalibrating partially parallel acquisitionIPRimmediate peritumoral regionLRMlogistic regression modelMPRAGEmagnetization-prepared rapid acquisition of gradient echoPCLprimary cerebral lymphomaPWIperfusion-weighted imagingrCBVrelative cerebral blood volumerCBVmaxmaximum relative cerebral blood volumeROCreceiver operating characteristic analysisROIregion of interestWMwhite matter