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ORIGINAL RESEARCH ADULT BRAIN Clinical Value of Vascular Permeability Estimates Using Dynamic Susceptibility Contrast MRI: Improved Diagnostic Performance in Distinguishing Hypervascular Primary CNS Lymphoma from Glioblastoma X B. Lee, X J.E. Park, X A. Bjørnerud, X J.H. Kim, X J.Y. Lee, and X H.S. Kim ABSTRACT BACKGROUNDANDPURPOSE: Asmallsubsetofprimarycentralnervoussystemlymphomasexhibitshighcerebralbloodvolume,which is indistinguishable from that in glioblastoma on dynamic susceptibility contrast MR imaging. Our study aimed to test whether estimates of combined perfusion and vascular permeability metrics derived from DSC-MR imaging can improve the diagnostic performance in differentiating hypervascular primary central nervous system lymphoma from glioblastoma. MATERIALS AND METHODS: Atotalof119patients(with30primarycentralnervoussystemlymphomasand89glioblastomas)exhibited hypervascular foci using the reference method of leakage-corrected CBV (reference-normalized CBV). An alternative postprocessing method used the tissue residue function to calculate vascular permeability (extraction fraction), leakage-corrected CBV, cerebral blood flow, and mean transit time. Parameters were compared using Mann-Whitney U tests, and the diagnostic performance to distinguish primary central nervous system lymphoma from glioblastoma was calculated using the area under the curve from the receiver operating characteristic curve and was cross-validated with bootstrapping. RESULTS: Hypervascular primary central nervous system lymphoma showed similar leakage-corrected normalized CBV and leakage- correctedCBVcomparedwithglioblastoma(P .05);however,primarycentralnervoussystemlymphomaexhibitedasignificantlyhigher extraction fraction (P .001) and CBF (P .01) and shorter
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Aug 1, 2018
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