Hatzoglou Vaios, Tisnado Jamie, Mehta Alpesh, Peck Kyung K, Daras Mariza, Omuro Antonio M, Beal Kathryn, Holodny Andrei I
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York.
Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York City, New York.
Cancer Med. 2017 Apr;6(4):761-767. doi: 10.1002/cam4.1046. Epub 2017 Mar 17.
Brain metastases originating from different primary sites overlap in appearance and are difficult to differentiate with conventional MRI. Dynamic contrast-enhanced (DCE)-MRI can assess tumor microvasculature and has demonstrated utility in characterizing primary brain tumors. Our aim was to evaluate the performance of plasma volume (Vp) and volume transfer coefficient (K ) derived from DCE-MRI in distinguishing between melanoma and nonsmall cell lung cancer (NSCLC) brain metastases. Forty-seven NSCLC and 23 melanoma brain metastases were retrospectively assessed with DCE-MRI. Regions of interest were manually drawn around the metastases to calculate Vp and Kmeantrans. The Mann-Whitney U test and receiver operating characteristic analysis (ROC) were performed to compare perfusion parameters between the two groups. The Vp of melanoma brain metastases (4.35, standard deviation [SD] = 1.31) was significantly higher (P = 0.03) than Vp of NSCLC brain metastases (2.27, SD = 0.96). The Kmeantrans values were higher in melanoma brain metastases, but the difference between the two groups was not significant (P = 0.12). Based on ROC analysis, a cut-off value of 3.02 for Vp (area under curve = 0.659 with SD = 0.074) distinguished between melanoma brain metastases and NSCLC brain metastases (P < 0.01) with 72% specificity. Our data show the DCE-MRI parameter Vp can differentiate between melanoma and NSCLC brain metastases. The ability to noninvasively predict tumor histology of brain metastases in patients with multiple malignancies can have important clinical implications.
源自不同原发部位的脑转移瘤在外观上有重叠，难以通过传统磁共振成像（MRI）进行鉴别。动态对比增强（DCE）-MRI可评估肿瘤微血管系统，并已证明在原发性脑肿瘤的特征性描述中具有实用价值。我们的目的是评估从DCE-MRI得出的血浆容积（Vp）和容积转移系数（Ktrans）在区分黑色素瘤和非小细胞肺癌（NSCLC）脑转移瘤方面的性能。对47例NSCLC脑转移瘤和23例黑色素瘤脑转移瘤进行了DCE-MRI回顾性评估。在转移瘤周围手动绘制感兴趣区域，以计算Vp和Ktrans均值。采用曼-惠特尼U检验和受试者工作特征分析（ROC）来比较两组之间的灌注参数。黑色素瘤脑转移瘤的Vp（4.35，标准差[SD]=1.31）显著高于NSCLC脑转移瘤的Vp（2.27，SD=0.96）（P=0.03）。黑色素瘤脑转移瘤的Ktrans均值较高，但两组之间的差异不显著（P=0.12）。基于ROC分析，Vp的截断值为3.02（曲线下面积=0.659，SD=0.074）可区分黑色素瘤脑转移瘤和NSCLC脑转移瘤（P＜-0.01），特异性为72%。我们的数据表明，DCE-MRI参数Vp可区分黑色素瘤和NSCLC脑转移瘤。对患有多种恶性肿瘤的患者的脑转移瘤进行肿瘤组织学的无创预测，可能具有重要的临床意义。
