Diagnostic utility of intravoxel incoherent motion mr imaging in differentiating primary central nervous system lymphoma from glioblastoma multiforme

J Magn Reson Imaging. 2016 Nov;44(5):1256-1261. doi: 10.1002/jmri.25261. Epub 2016 Apr 19.

Abstract

Purpose: To evaluate the diagnostic performance of intravoxel incoherent motion (IVIM) MR imaging and 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in differentiating primary central nervous system lymphoma (PCNSL) from glioblastoma multiforme (GBM).

Materials and methods: Fifty patients, 17 with PCNSL and 33 with GBM, were retrospectively studied. From the 3 Tesla IVIM data, the perfusion fraction (f) and diffusion coefficient (D) were obtained. In addition, the maximum standard uptake value (SUVmax ) was obtained from the FDG-PET data. Each of the three parameters was compared between PCNSL and GBM using Mann-Whitney U-test. The performance in discriminating between PCNSL and GBM was evaluated using receiver-operating characteristics analysis and area-under-the-curve (AUC) values for the three parameters.

Results: The fmax and Dmin values were significantly higher in GBM than in PCNSL (P < 0.01 and P < 0.0001, respectively). In addition, the SUVmax value was significantly lower in GBM than in PCNSL (P < 0.0005). The AUC values for fmax , Dmin , and SUVmax were 0.756, 0.905, and 0.857, respectively. The combination of the fmax and Dmin increased the diagnostic performance (AUC = 0.936) of fmax (P < 0.05), but this value was not significantly different from the values for Dmin (P = 0.30).

Conclusion: IVIM-MR imaging noninvasively provides useful quantitative information in distinguishing between PCNSL and GBM. J. Magn. Reson. Imaging 2016;44:1256-1261.

Keywords: FDG-PET; glioblastoma; intravoxel incoherent motion (IVIM); primary central nervous system lymphoma.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / pathology
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Lymphoma / diagnostic imaging*
  • Lymphoma / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Motion
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18