RT Journal Article
SR Electronic
T1 Added Value and Diagnostic Performance of Intratumoral Susceptibility Signals in the Differential Diagnosis of Solitary Enhancing Brain Lesions: Preliminary Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1574
OP 1579
DO 10.3174/ajnr.A1635
VO 30
IS 8
A1 H.S. Kim
A1 G.-H. Jahng
A1 C.W. Ryu
A1 S.Y. Kim
YR 2009
UL http://www.ajnr.org/content/30/8/1574.abstract
AB 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.