Dong Ho Hyun MD, Presenter: Nothing to Disclose

Sang Joon Kim MD, Abstract Co-Author: Nothing to Disclose

Choong Gon Choi, Abstract Co-Author: Nothing to Disclose

Deok Hee Lee, Abstract Co-Author: Nothing to Disclose

Jeong Hoon Kim, Abstract Co-Author: Nothing to Disclose

To assess the utility of relative cerebral blood volume (rCBV) and percent recovery (PR) of signal intensity on T2* perfusion MR for differentiation of primary central nervous system lymphoma (PCNSL), metastasis and glioblastoma

The study was conducted with the approval of the institutional review board at our hospital. We retrospectively reviewed conventional and perfusion MR images in a total of 78 patients (16 of PCNSL, 13 of metastasis, and 52 of glioblastoma) who were diagnosed in our institute from July of 2005 to March of 2009. All lesions were pathologically confirmed. Region of interest (ROI) was placed in the enhancing lesion by a neuroradiologist with a caution to avoid signal loss from a large tumor vessels. The rCBV and PR of the three groups composed of PCNSL, metastasis and glioblastoma were compared using the Kruskal-Wallis with Bonferroni test. The cut-off values of rCBV and PR for differentiating the three groups were obtained using a receiver operating characteristic curve (SPSS ver 14.0K).

The rCBVs in PCNSL, metastasis and glioblastoma were 1.53 ± 0.69, 3.48 ± 2.49 and 3.43 ± 2.03 and the PRs were 102.93 ± 26.05, 65.38 ± 15.62 and 80.58 ± 18.07, respectively. There were significant differences in PR between PCNSL and metastasis and glioblastoma (p<0.009). With regard to rCBV, there were significant difference between PCNSL and metastasis or glioma (p<0.001) but no significant difference between metastasis and glioblastoma (p>0.8). The cut-off values of rCBV and PR for PCNSL and metastasis were 1.65 and 85 % and for PCNSL and glioblastoma were 1.65 and 89.5 %.

The rCBVs and the PRs of the three groups were significantly different among PCNSL, metastasis and glioblastoma and can be used to make a differential diagnosis among the three groups.

It is sometimes difficult to differentiate between PCNSL, metastasis and glioblastoma by conventional MR alone. The rCBV and the PR are a useful adjunctive tools to make a correct diagnosis.

Hyun, D, Kim, S, Choi, C, Lee, D, Kim, J, Differentiation of Malignant Brain Tumors Using T2* Perfusion MR: Characteristics of Relative Cerebral Blood Volume and Percent Recovery of Signal Intensity in Primary CNS Lymphoma, Metastasis, and Glioblastoma.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003525.html