Differentiation between high-grade glioma and metastatic brain tumor using single-voxel proton MR spectroscopy

Ishimaru, Hideki; Morikawa, Minoru; Iwanaga, Soji; Kaminogo, Makio; Ochi, Makoto; Hayashi, Kuniaki

doi:10.1007/s003300000814

Cited by 145 publications

(118 citation statements)

References 21 publications

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“…Burtscher et al (157) showed that HGGs could be differentiated from metastases by the presence of abnormal spectra in the normal-appearing brain tissue adjacent to the lesion. Ishimaru et al (74) showed that the absence of intratumoral Cr peak was suggestive of metastases, since 21 of 25 metastases in this study had no definitive Cr peak. In addition, the authors noticed that the absence of Lip signal at a TE of 30 ms could exclude the diagnosis of metastasis.…”

Section: Mrsi: Metastatic Neoplasm Versus High-grade Glioma (Paper Ii)mentioning

confidence: 99%

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Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

et al. 2009

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Background: Conventional magnetic resonance (MR) imaging has a number of limitations in the diagnosis of the most common intracranial brain tumors, including tumor specification and the detection of tumoral infiltration in regions of peritumoral edema. Purpose: To prospectively assess if diffusion-weighted MR imaging (DWI) could be used to differentiate between different types of brain tumors and to distinguish between peritumoral infiltration in high-grade gliomas, lymphomas, and pure vasogenic edema in metastases and meningiomas. Material and Methods: MR imaging and DWI was performed on 93 patients with newly diagnosed brain tumors: 59 patients had histologically verified high-grade gliomas (37 glioblastomas multiforme, 22 anaplastic astrocytomas), 23 patients had metastatic brain tumors, five patients had primary cerebral lymphomas, and six patients had meningiomas. Apparent diffusion coefficient (ADC) values of tumor (enhancing regions or the solid portion of tumor) and peritumoral edema, and ADC ratios (ADC of tumor or peritumoral edema to ADC of contralateral white matter, ADC of tumor to ADC of peritumoral edema) were compared with the histologic diagnosis. ADC values and ratios of high-grade gliomas, primary cerebral lymphomas, metastases, and meningiomas were compared by using ANOVA and multiple comparisons. Optimal thresholds of ADC values and ADC ratios for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results: Statistically significant differences were found for minimum and mean of ADC tumor and ADC tumor ratio values between metastases and high-grade gliomas when including only one factor at a time. Including a combination of in total four parameters (mean ADC tumor, and minimum, maximum and mean ADC tumor ratio) resulted in sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 72.9, 82.6, 91.5, and 54.3% respectively. In the ROC curve analysis, the area under the curve of the combined four parameters was the largest (0.84), indicating a good test. Conclusion: Our results suggest that ADC values and ADC ratios (minimum and mean of ADC tumor and ADC tumor ratio) may be helpful in the differentiation of metastases from high-grade gliomas. It cannot distinguish high-grade gliomas from lymphomas, and lymphomas from metastases. ADC values and ADC ratios in peritumoral edema cannot be used to differentiate edema with infiltration of tumor cells from vasogenic edema when measurements for high-grade gliomas, lymphomas, metastases, and meningiomas were compared.

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Section: Mrsi: Metastatic Neoplasm Versus High-grade Glioma (Paper Ii)mentioning

confidence: 99%

“…The intratumoral MRS is also not able to reliably differentiate between the metastases and glioma (23). Ishmaru et al (74) showed that the absence of intratumoral Cr peak was suggestive of metastasis. In addition, the authors noticed that the absence of Lip signal of a TE of 30 ms could exclude the diagnosis of metastases.…”

Section: Metastatic Neoplasmsmentioning

confidence: 99%

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

et al. 2009

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“…The institutional review board of the performing hospital approved this study, and written informed consent was obtained from the legal guardians of pediatric on the basis of MR spectroscopy findings has been difficult because of excessive magnetic susceptibility perturbations and low spatial resolution (24)(25)(26). Because of the technical challenges and inadequate sensitivity or specificity of the use of MR imaging for distinguishing low-from high-grade pediatric brain tumors, invasive tissue biopsy remains the reference standard for tumor grading.…”

Section: Patientsmentioning

confidence: 99%

Differentiation of Low- and High-Grade Pediatric Brain Tumors with Highb-Value Diffusion-weighted MR Imaging and a Fractional Order Calculus Model

Sui¹,

Wang

Liu

et al. 2015

Radiology

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).q RSNA, 2015 Purpose:To demonstrate that a new set of parameters (D, b, and m) from a fractional order calculus (FROC) diffusion model can be used to improve the accuracy of MR imaging for differentiating among low-and high-grade pediatric brain tumors. Materials and Methods:The institutional review board of the performing hospital approved this study, and written informed consent was obtained from the legal guardians of pediatric patients. Multi-b-value diffusion-weighted magnetic resonance (MR) imaging was performed in 67 pediatric patients with brain tumors. Diffusion coefficient D, fractional order parameter b (which correlates with tissue heterogeneity), and a microstructural quantity m were calculated by fitting the multi-b-value diffusion-weighted images to an FROC model. D, b, and m values were measured in solid tumor regions, as well as in normal-appearing gray matter as a control. These values were compared between the lowand high-grade tumor groups by using the Mann-Whitney U test. The performance of FROC parameters for differentiating among patient groups was evaluated with receiver operating characteristic (ROC) analysis. Results:None of the FROC parameters exhibited significant differences in normal-appearing gray matter (P  .24), but all showed a significant difference (P , . Conclusion:The FROC parameters can be used to differentiate between low-and high-grade pediatric brain tumor groups. The combination of FROC parameters or individual parameters may serve as in vivo, noninvasive, and quantitative imaging markers for classifying pediatric brain tumors.q RSNA, 2015

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“…However, the distinction between metastasis and glioblastomas is marginally higher for long TE than it is for short TE spectra. Ishimaru et al (2001) found that glioblastomas are better resolved from metastases in long TE MRS than in short TE due to overlapping peaks and the dynamic range of the detector being dominated by lipids, diminishing the sensitivity to choline and creatine. This subtle difference suggests that long TE MRS might prove a better option to explore this task in the future with bigger samples.…”

Section: Discussionmentioning

confidence: 99%

“…Few in vitro studies were performed (Faria et al, 2011;Gray et al, 1998). The application of long or short echo-time (TE) spectroscopy has also been reported, as the choice of echo time affects the apparent concentration of every metabolite taking into account its transversal relaxation time (Majós et al, 2004) and also considerations about the dynamic range of the detectors (Ishimaru et al, 2001). In Figure 1, the median and interquartile range of example spectra are shown, highlighting the differences between spectral profiles between two echo times and also between two tissue types, brain abscesses and anaplastic astrocytomas, in both echo times.…”

Section: Introductionmentioning

confidence: 99%

Pattern recognition of abscesses and brain tumors through MR spectroscopy: Comparison of experimental conditions and radiological findings

2017

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Introduction: The interpretation of brain tumors and abscesses MR spectra is complex and subjective. In clinical practice, different experimental conditions such as field strength or echo time (TE) reveal different metabolite information. Our study aims to show in which scenarios magnetic resonance spectroscopy can differentiate among brain tumors, normal tissue and abscesses using classification algorithms. Methods: Pairwise classification between abscesses, brain tumor classes, and healthy subjects tissue spectra was performed, also the multiclass classification between meningiomas, grade I-II-III gliomas, and glioblastomas and metastases, in 1.5T short TE (n = 195), 1.5T long TE (n = 231) and 3.0T long TE (n = 59) point resolved spectroscopy setups, using LCModel metabolite concentration as input to classifiers. Results: Areas under the curve of the Receiver Operating Characteristic above 0.9 were obtained for the classification between abscesses and all classes except glioblastomas, reaching 0.947 when classifying against metastases, grade I-II gliomas and glioblastomas (0.980), meningiomas and glioblastomas (0.956), grade I-II gliomas and metastases (0.989), meningiomas and metastases (0.990), and between healthy tissue and all other classes in both conditions except for anaplastic astrocytomas in short TE 1.5T setup. When the multiclass classification agrees with radiological diagnosis the accuracy reaches 96.8% for short TE and 98.9% for long TE. Conclusions: The results in the three conditions were similar, highlighting comparable quality, robust quantification and good regularization and flexibility in either algorithm. Multiclass classification provides useful information to the radiologist. These findings show the potential of the development of decision support systems as well as tools for the accompaniment of treatments.

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Differentiation between high-grade glioma and metastatic brain tumor using single-voxel proton MR spectroscopy

Cited by 145 publications

References 21 publications

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

Differentiation of Low- and High-Grade Pediatric Brain Tumors with Highb-Value Diffusion-weighted MR Imaging and a Fractional Order Calculus Model

Pattern recognition of abscesses and brain tumors through MR spectroscopy: Comparison of experimental conditions and radiological findings

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