Joint Approach of Diffusion- and Perfusion-weighted MRI in Intra-axial Mass Like Lesions in Clinical Practice Simulation

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Sep 8

PMID 30192785

Citations 1

Authors

Ra Gyoung Yoon

Ho Sung Kim

Gil Sun Hong

Ji Eun Park

Seung Chai Jung

Sang Joon Kim

Jeong Hoon Kim

Affiliations

Soon will be listed here.

Abstract

Although advanced magnetic resonance imaging (MRI) techniques provide useful information for the differential diagnosis of intra-axial mass-like lesions, the specific diagnostic role of multimodal MRI over conventional magnetic resonance imaging (CMRI) alone in the differential diagnosis of mass-like lesions from a large heterogeneous cohort has not been studied. In this study, we aimed to determine the added value of a joint approach of diffusion-weighted imaging (DWI) and dynamic-susceptibility-contrast perfusion imaging (DSC-PWI) for diagnosis of intra-axial mass-like lesions, comparing them with CMRI alone. Furthermore, we performed these evaluations in a manner simulating clinical practice. Our institutional review board approved this retrospective study and waived the requirement for informed consent. A total of 1038 patients with intra-axial mass-like lesions were retrospectively recruited according to their histological and clinico-radiological diagnoses made between January 2005 and December 2014. All patients underwent CMRI, DWI and DSC-PWI. The diagnostic accuracy and confidence in diagnosing each type of intra-axial mass-like lesions, and for differentiating the intra-axial brain tumors from non-neoplastic lesions, were compared according to the MRI protocols. The disease-specific sensitivity of joint approach differed according to specific disease entities in diagnosing each disease category. Joint approach provided the best diagnostic accuracy for discriminating intra-axial brain tumors from non-neoplastic lesions, with high diagnostic accuracy (95.3-96.7%), specificity (82-84.0%), positive-predictive-value (97.0-97.3%), and negative-predictive-value (84.8-92.7%), with the reader's confidence values being significantly improved over those on CMRI alone (all p-values < 0.001). In conclusion, joint approach of DWI, DSC-PWI to CMRI helps to differentiate non-neoplastic lesions from intra-axial brain tumors, and improves diagnostic confidence compared with CMRI alone. The benefit from the combined imaging differs for each disease category; thus joint approach needs to be customized according to clinical suspicion.

Citing Articles

Heterogeneity Diffusion Imaging of gliomas: Initial experience and validation.

Wang Q, Guzman Perez-Carrillo G, Ponisio M, LaMontagne P, Dahiya S, Marcus D PLoS One. 2019; 14(11):e0225093.

PMID: 31725772 PMC: 6855653. DOI: 10.1371/journal.pone.0225093.

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