Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation

Rizzo, Laura; Crasto, S.; Moruno, P. Garcia; Cassoni, Paola; Rudà, Roberta; Boccaletti, Riccardo; Brosio, M.; Lucchi, R. De; Fava, Carmen

doi:10.1007/s11547-009-0401-y

Cited by 39 publications

(42 citation statements)

References 23 publications

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“…4). Differentiation between benign and malignant tumours, as well as tumour grading, can be improved using information related to regional blood flow parameters, as areas of increased microcirculation have been shown to correspond well with areas of active tumour growth [32,37]. For diagnosis and follow-up of brain neoplasms, the rCBV and the form of the SI time curves are of greatest interest [34,36,38,39].…”

Section: Applications Of Contrast-enhanced Mri In Neuroimagingmentioning

confidence: 99%

High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review

2010

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Evaluation of brain lesions using magnetic resonance imaging (MRI) provides information that is critical for accurate diagnosis, prognosis, therapeutic intervention and monitoring response. Conventional contrast-enhanced MR neuroimaging using gadolinium (Gd) contrast agents primarily depicts disruption of the blood-brain barrier, demonstrating location and extent of disease, and also the morphological details at the lesion site. However, conventional imaging results do not always accurately predict tumour aggressiveness. Advanced functional MRI techniques such as dynamic contrast-enhanced perfusion-weighted imaging utilise contrast agents to convey physiological information regarding the haemodynamics and neoangiogenic status of the lesion that is often complementary to anatomical information obtained through conventional imaging. Most of the Gd contrast agents available have similar T1 and T2 relaxivities, and thus their contrast-enhancing capabilities are comparable. Exceptions are gadobenate-dimeglumine, Gd-EOB-DTPA, Gadobutrol and gadofosveset, which, owing to their transient-protein-binding capability, possess almost twice (and more) the T1 and T2 relaxivities as other agents at all magnetic field strengths. Numerous comparative studies have demonstrated the advantages of the increased relaxivity in terms of enhanced image contrast, image quality and diagnostic confidence. Here we summarise the benefits of higher relaxivity for the most common neuroimaging applications including MRI, perfusion-weighted imaging and MRA for evaluation of brain tumours, cerebrovascular disease and other CNS lesions.

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Section: Applications Of Contrast-enhanced Mri In Neuroimagingmentioning

confidence: 99%

High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review

2010

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“…2.29). Selective analysis of solid tumor areas may help improve accuracy of ADC in predicting tumor cellularity and grade, but even when only the solid portion or darkest area on ADC is used for analysis, there is marked variation in the ADC values [269][270][271][272]. For example, when the reported ADC values from three studies that found a difference between high-grade and low-grade malignant tumors are combined, the mean ADC values for high-grade tumors are between 520 to 1,130 × 10 −6 mm 2 /s compared to 1,010 to 1,350 × 10 −6 mm 2 /s for low-grade tumors, with much greater variation between the ADC of individual cases [269][270][271].…”

Section: Primary Glial Neoplasms and Intracranial Metastasesmentioning

confidence: 99%

“…Increased cellularity and higher grade of malignant intracranial metastases tend to correlate inversely with the tumor ADC values, but similar to primary brain tumors there is substantial variability and overlap between low-grade and highgrade tumors and between metastases and primary brain tumors [272,274]. Some studies have found that analysis of ADC of peritumoral "edema" can be helpful for distinguishing different tumor types.…”

Section: Primary Glial Neoplasms and Intracranial Metastasesmentioning

confidence: 99%

Clinical Applications of Diffusion

Forghani

Schaefer

2011

Functional Neuroradiology

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“…Diffusion weighted imaging (DWI) represents a new perspective of MR applied to the study of abdominal pathologies, is based on the diffusion motion of water molecules [2] and displays information about extracellular compartment, tissue cellularity and the integrity of the cellular membranes [3]. This technique has been applied in oncological setting, in the detection and characterization of cerebral, thoracic, abdominal neoplastic lesions and in the evaluation of tumoral response to chemioterapic treatments [4][5][6][7]. Other applications are represented by the study of inflammatory diseases of the brain, kidney, liver [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performances of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Fibrosis and Post-Operative Endoscopic Recurrence in Crohn’s Disease

Samperi¹

2016

GHOA

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Background: Diffusion-weighted represents a new application of magnetic resonance imaging (DW-MRI) to assess inflammatory activity in Crohn's disease. ADC is a quantitative parameter of this phenomenon. We aimed to verify the correlation between DWI findings both with pathological evaluation of fibrosis in surgical specimen both with endoscopic recurrence.Methods: 31 pts undergoing ileocolonic resection for CD were submitted to DW-MRI. Conventional MRI findings of terminal or neo-terminal ileum were recorded together with a semiquantitative evaluation of DWI signal intensity and with ADC calculation. For the first aim, Acute Inflammatory (AIS) and Fibrostenosis score was correlated to ADC values of matched ileo-cecal segment. ROC curves analysis was used to find out an ADC cut-off value able to distinguish "low and high grade" severity of post-operative recurrence. Results:Comparison of DWI findings with surgical specimens pathologic evaluation showed a very good correlation, inverse and statistically significant, between ADC and AIS total (r=-0.90, p=0.013). The mean ADC value of the 5 pts with fibrosis was not statistically different from the 5 pts without. The comparison between ADC and Rutgeerts'score showed a good correlation, inverse and statistically significant (rho= -0.73, P=0.002). ROC curves analysis highlighted that a value of ADC ≤ 1.82 x10 -3 mm 2 /s could predict a severe recurrence (Rs >i2) with a sensitivity of 88.9% and a specificity of 83.3%. Conclusion:This study showed the ability of DWI sequences to provide quantitative measures of inflammation, allowing a more objective assessment of CD. Further studies should clarify whether ADC evaluation could predict the presence of fibrosis in surgical specimens.

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Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation

Abstract: DWI has an important role in the differential diagnosis of cystic cerebral masses but not in tumour characterisation. PWI is helpful in differentiating high-from low-grade gliomas and lymphomas from high-grade gliomas.

Cited by 39 publications

References 23 publications

High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review

High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review

Clinical Applications of Diffusion

Diagnostic Performances of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Fibrosis and Post-Operative Endoscopic Recurrence in Crohn’s Disease

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