Primary central nervous system lymphoma and atypical glioblastoma: differentiation using the initial area under the curve derived from dynamic contrast-enhanced MR and the apparent diffusion coefficient

Choi, Yoon Seong; Lee, Ho‐Joon; Ahn, Sung Soo; Chang, Jong Hee; Kang, Seok‐Gu; Kim, Eui Hyun; Kim, Se Hoon; Lee, Seung Koo

doi:10.1007/s00330-016-4484-2

Cited by 46 publications

(60 citation statements)

References 34 publications

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“…Detailed information of excluded studies is described in the Supplementary Materials. One further relevant study was also identified, resulting in a final total of 22 studies investigating the diagnostic performance of MRI for differentiating PCNSL from glioblastoma, with these studies covering 1182 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies enrolled patients in a consecutive manner, while the enrollment was not explicit in the others. Nineteen studies used only histopathology as the reference standard, while two studies used histopathology and clinicoradiologic diagnosis for patients with PCNSL …”

Section: Resultsmentioning

confidence: 99%

“…A variety of MRI sequences were used in various combinations (Table ), with the most commonly used sequences being DWI in 14 studies, DSC in nine studies, and DCE in four studies . The other less‐commonly used sequences were ASL in four studies, SWI in four studies, MRS in three studies, and IVIM in two studies .…”

Section: Resultsmentioning

confidence: 99%

“…In terms of the ROI placement, the entire enhancing tumor was selected in 14 studies, and both the entire enhancing tumor and peritumoral area were selected in seven studies . A variety of different cutoff values were used, with multiparametric MRI sequences being used to determine optimal cutoff values in 11 studies . MRI was interpreted by 1–3 neuroradiologists, with the readers being blinded to the reference standard in six studies …”

Section: Resultsmentioning

confidence: 99%

“…During the last decade, multiple MRI sequences have been introduced for differentiating PCNSL from glioblastoma . These sequences, which include diffusion‐weighted imaging (DWI), dynamic susceptibility‐weighted contrast‐enhanced imaging (DSC), dynamic contrast‐enhanced imaging (DCE), arterial spin labeling (ASL), susceptibility‐weighted imaging (SWI), intravoxel incoherent motion (IVIM), and magnetic resonance spectroscopy (MRS), have demonstrated variable diagnostic performance.…”

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confidence: 99%

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MRI as a diagnostic biomarker for differentiating primary central nervous system lymphoma from glioblastoma: A systematic review and meta‐analysis

Suh

Kim

Jung

et al. 2019

Magnetic Resonance Imaging

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Background Accurate preoperative differentiation of primary central nervous system lymphoma (PCNSL) and glioblastoma is clinically crucial because the treatment strategies differ substantially. Purpose To evaluate the diagnostic performance of MRI for differentiating PCNSL from glioblastoma. Study Type Systematic review and meta‐analysis. Subjects Ovid‐MEDLINE and EMBASE databases were searched to find relevant original articles up to November 25, 2018. The search term combined synonyms for "lymphoma," "glioblastoma," and "MRI." Field Strength/Sequence Patients underwent at least one MRI sequence including diffusion‐weighted imaging (DWI), dynamic susceptibility‐weighted contrast‐enhanced imaging (DSC), dynamic contrast‐enhanced imaging (DCE), arterial spin labeling (ASL), susceptibility‐weighted imaging (SWI), intravoxel incoherent motion (IVIM), and magnetic resonance spectroscopy (MRS) using 1.5 or 3 T. Assessment Quality assessment was performed according to the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. Statistical Tests Hierarchical logistic regression modeling was used to obtain pooled sensitivity and specificity. Meta‐regression was performed. Results Twenty‐two studies with 1182 patients were included. MRI sequences demonstrated high overall diagnostic performance with pooled sensitivity of 91% (95% confidence interval [CI], 87–93%) and specificity of 89% (95% CI, 85–93%). The area under the hierarchical summary receiver operating characteristic curve was 0.92 (95% CI, 0.90–0.94). Studies using DSC or ASL showed high diagnostic performance (sensitivity of 93% [95% CI, 89–97%] and specificity of 91% [95% CI, 86–96%]). Heterogeneity was only detected in specificity (I2 = 66.84%) and magnetic field strength was revealed to be a significant factor affecting study heterogeneity. Data Conclusion MRI showed overall high diagnostic performance for differentiating PCNSL from glioblastoma, with studies using DSC or ASL showing high diagnostic performance. Therefore, MRI sequences including DSC or ASL is a potential diagnostic tool for differentiating PCNSL from glioblastoma. Level of Evidence: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:560–572.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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MRI as a diagnostic biomarker for differentiating primary central nervous system lymphoma from glioblastoma: A systematic review and meta‐analysis

Suh

Kim

Jung

et al. 2019

Magnetic Resonance Imaging

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LCK expression is a potential biomarker for distinguishing primary central nervous system lymphoma from glioblastoma multiforme

et al. 2020

FEBS Open Bio

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Glioblastoma multiforme (GBM) and primary central nervous system lymphoma (PCNSL) are both malignant cerebral tumors; however, their treatments are vastly different. Early and precise diagnosis is vital for subsequent adequate treatment to improve prognosis. Reliable biomarkers that can easily distinguish GBM and PCNSL are urgently needed. We evaluated the diagnostic potential of lymphocyte‐specific protein tyrosine kinase (LCK) as a biomarker in differentiating PCNSL from GBM using established computational approaches (Gene Expression Profiling Interactive Analysis, The Cancer Proteome Atlas, Tumor Immune Estimation Resource, GEO, Oncomine) and immunohistochemistry. The results showed that LCK was expressed at a high level in PCNSL patients but at a low level in GBM patients. Moreover, LCK expression positively correlated with the levels of infiltrating B cells in diffuse large B‐cell lymphoma (DLBCL) and GBM. Overall, bioinformatics analysis and immunohistochemistry revealed that LCK expression is a potential biomarker for distinguishing PCNSL from GBM.

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Diagnostic accuracy of dynamic contrast‐enhanced perfusion MRI in stratifying gliomas: A systematic review and meta‐analysis

et al. 2019

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Background T1‐weighted dynamic contrast‐enhanced (DCE) perfusion magnetic resonance imaging (MRI) has been broadly utilized in the evaluation of brain tumors. We aimed at assessing the diagnostic accuracy of DCE‐MRI in discriminating between low‐grade gliomas (LGGs) and high‐grade gliomas (HGGs), between tumor recurrence and treatment‐related changes, and between primary central nervous system lymphomas (PCNSLs) and HGGs. Methods We performed this study based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis of Diagnostic Test Accuracy Studies criteria. We systematically surveyed studies evaluating the diagnostic accuracy of DCE‐MRI for the aforementioned entities. Meta‐analysis was conducted with the use of a random effects model. Results Twenty‐seven studies were included after screening of 2945 possible entries. We categorized the eligible studies into three groups: those utilizing DCE‐MRI to differentiate between HGGs and LGGs (14 studies, 546 patients), between recurrence and treatment‐related changes (9 studies, 298 patients) and between PCNSLs and HGGs (5 studies, 224 patients). The pooled sensitivity, specificity, and area under the curve for differentiating HGGs from LGGs were 0.93, 0.90, and 0.96, for differentiating tumor relapse from treatment‐related changes were 0.88, 0.86, and 0.89, and for differentiating PCNSLs from HGGs were 0.78, 0.81, and 0.86, respectively. Conclusions Dynamic contrast‐enhanced‐Magnetic resonance imaging is a promising noninvasive imaging method that has moderate or high accuracy in stratifying gliomas. DCE‐MRI shows high diagnostic accuracy in discriminating between HGGs and their low‐grade counterparts, and moderate diagnostic accuracy in discriminating recurrent lesions and treatment‐related changes as well as PCNSLs and HGGs.

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Primary central nervous system lymphoma and atypical glioblastoma: differentiation using the initial area under the curve derived from dynamic contrast-enhanced MR and the apparent diffusion coefficient

Cited by 46 publications

References 34 publications

MRI as a diagnostic biomarker for differentiating primary central nervous system lymphoma from glioblastoma: A systematic review and meta‐analysis

MRI as a diagnostic biomarker for differentiating primary central nervous system lymphoma from glioblastoma: A systematic review and meta‐analysis

LCK expression is a potential biomarker for distinguishing primary central nervous system lymphoma from glioblastoma multiforme

Diagnostic accuracy of dynamic contrast‐enhanced perfusion MRI in stratifying gliomas: A systematic review and meta‐analysis

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