From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China.
School of Biomedical Engineering (D.W.), Shanghai Jiao Tong University, Shanghai, P.R. China.
AJNR Am J Neuroradiol. 2020 Apr;41(4):583-590. doi: 10.3174/ajnr.A6466. Epub 2020 Mar 5.
Accurate differentiation between glioblastoma and solitary brain metastasis is of vital importance clinically. This study aimed to investigate the potential value of the inflow-based vascular-space-occupancy MR imaging technique, which has no need for an exogenous contrast agent, in differentiating glioblastoma and solitary brain metastasis and to compare it with DSC MR imaging.
Twenty patients with glioblastoma and 22 patients with solitary brain metastasis underwent inflow-based vascular-space-occupancy and DSC MR imaging with a 3T clinical scanner. Two neuroradiologists independently measured the maximum inflow-based vascular-space-occupancy-derived arteriolar CBV and DSC-derived CBV values in intratumoral regions and peritumoral T2-hyperintense regions, which were normalized to the contralateral white matter (relative arteriolar CBV and relative CBV, inflow-based vascular-space-occupancy relative arteriolar CBV, and DSC-relative CBV). The intraclass correlation coefficient, Student test, or Mann-Whitney test and receiver operating characteristic analysis were performed.
All parameters of both regions had good or excellent interobserver reliability (0.74∼0.89). In peritumoral T2-hyperintese regions, DSC-relative CBV ( < .001), inflow-based vascular-space-occupancy arteriolar CBV ( = .001), and relative arteriolar CBV ( = .005) were significantly higher in glioblastoma than in solitary brain metastasis, with areas under the curve of 0.94, 0.83, and 0.72 for discrimination, respectively. In the intratumoral region, both inflow-based vascular-space-occupancy arteriolar CBV and relative arteriolar CBV were significantly higher in glioblastoma than in solitary brain metastasis (both < .001), with areas under the curve of 0.91 and 0.90, respectively. Intratumoral DSC-relative CBV showed no significant difference ( = .616) between the 2 groups.
Inflow-based vascular-space-occupancy has the potential to discriminate glioblastoma from solitary brain metastasis, especially in the intratumoral region.
准确区分胶质母细胞瘤和单发脑转移瘤在临床上至关重要。本研究旨在探讨无需外源性对比剂的流入相关血管空间占用 MRI 技术在区分胶质母细胞瘤和单发脑转移瘤中的潜在价值，并与 DSC MRI 进行比较。
20 例胶质母细胞瘤患者和 22 例单发脑转移瘤患者在 3T 临床扫描仪上进行了流入相关血管空间占用和 DSC MRI 检查。两名神经放射科医生独立测量了肿瘤内区域和瘤周 T2 高信号区域的最大流入相关血管空间占用衍生的动脉 CBV 和 DSC 衍生的 CBV 值，并将其归一化为对侧白质（相对动脉 CBV 和相对 CBV，流入相关血管空间占用相对动脉 CBV 和 DSC-相对 CBV）。采用组内相关系数、Student t 检验或 Mann-Whitney U 检验和受试者工作特征曲线分析。
所有区域的参数均具有良好或优秀的观察者间可靠性（0.74∼0.89）。在瘤周 T2 高信号区域，DSC-相对 CBV（ <.001）、流入相关血管空间占用动脉 CBV（ =.001）和相对动脉 CBV（ =.005）在胶质母细胞瘤中显著高于单发脑转移瘤，鉴别诊断的曲线下面积分别为 0.94、0.83 和 0.72。在肿瘤内区域，胶质母细胞瘤中的流入相关血管空间占用动脉 CBV 和相对动脉 CBV 均显著高于单发脑转移瘤（均<.001），曲线下面积分别为 0.91 和 0.90。肿瘤内 DSC-相对 CBV 在两组之间无显著差异（ =.616）。
流入相关血管空间占用技术有可能区分胶质母细胞瘤和单发脑转移瘤，尤其是在肿瘤内区域。
