Differences In High-Intensity Signal Volume Between Arterial Spin Labeling And Contrast-Enhanced T1-Weighted Imaging May Be Useful For Differentiating Glioblastoma From Brain Metastasis

Abstract

: Purpose : To determine whether differences in tumor volume between arterial spin labeling (ASL) and contrast-enhanced T1-weighted MR images (CE+T1WI) can help differentiate glioblastoma (GBM) from brain metastasis. Materials and methods : Patients with a diagnosis of GBM (n=25) or brain metastasis (n=13) were examined by both conventional and ASL MR imaging. Volumes of interest with high signal intensity on ASL and CE+T1WI were defined using three dimensional analysis software. Tumor volume difference (ASL-CE) and tumor volume ratio (ASL/CE) were obtained. Absolute maximal tumor blood flow (TBF) and TBF ratio (normalized to white matter) were also measured. The Mann -Whitney U test and receiver operating characteristic curve analysis were performed to compare measurements between the tumor groups. Results : Both tumor volume difference and tumor volume ratio were significantly higher in GBM than in metastasis. Both TBF and TBF ratio were higher for GBM than for metastasis, but the differences were not significant. Conclusion : The difference in tumor volume as measured by ASL high signal intensity and CE+T1WI might be useful for differentiating GBM from metastasis, whereas ASL-derived TBF is insufficient.

Arterial Spin Labeling for Glioma Grade Discrimination: Correlations with IDH1 Genotype and 1p/19q Status

“…The measurement might be more representative and was also used in a previous study [18]. This 3D ROI has also been used to assess tumor volume [22] and to measure apparent diffusion coefficient histogram [23]. In our study, rmeanCBF had a higher specificity than other parameters as an index of differential diagnosis.

Figure 4MR images and the 3D tumor mask of a 47-year-old female with IDH1–wild-type glioblastoma.

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Differentiating Glioblastomas from Solitary Brain Metastases: An Update on the Current Literature of Advanced Imaging Modalities

“…To date, there is indeed evidence concluding that noninvasive ASL techniques can effectively differentiate glioblastoma from primary CNS lymphomas and radionecrosis of the brain [75][76][77]. Direct studies using ASL methods to differentiate glioblastoma from metastases using signal intensity have shown diagnostic benefit; however, ASL-derived tumor blood flow is largely inconclusive on whether it reliably differentiates [78][79][80] in glioblastoma versus metastases specifically. ASL was found to reliably differentiate when coupled with DTI methods in one study [79].…”

The Study of Cerebral Blood Flow Variations Following Radiation Dose Gradients for Brain Metastasis Patients During Radiotherapy

“…3D ASL uses the protons of hydrogen in the patient's own blood as an endogenous contrast agent to measure CBF to reflect local blood flow in brain tissue [20]. The results are in good agreement with traditional perfusion imaging, and the combination with conventional MR images is widely used in the diagnosis and differential diagnosis of cranio-cerebral diseases [13,15,40]. In cases of glioma recurrence, the normalized ASL-CBF ratio was 74.83% higher than that of radiation-induced brain injury [41].…”