Diffusion Tensor Imaging Can Discriminate the Primary Cell Type of Intracranial Metastases for Patients with Lung Cancer

Overview

Journal Magn Reson Med Sci

Specialty Radiology

Date 2021 Mar 4

PMID 33658441

Citations 1

Authors

Sabriye Sennur Bilgin

Mehmet Ali Gultekin

Ismail Yurtsever

Temel Fatih Yilmaz

Dilek Hacer Cesme

Melike Bilgin

Atakan Topcu

Mehmet Besiroglu

Haci Mehmet Turk

Alpay Alkan

Mehmet Bilgin

Affiliations

Soon will be listed here.

Abstract

Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer.

Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated.

Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10 mm/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC.

Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.

Citing Articles

Imaging in translational cancer research.

Kurz F, Schlemmer H Cancer Biol Med. 2022; 19(11).

PMID: 36476372 PMC: 9724222. DOI: 10.20892/j.issn.2095-3941.2022.0677.

References

White M, Zhang Y, Yu F, Kazmi S . Diffusion tensor MR imaging of cerebral gliomas: evaluating fractional anisotropy characteristics. AJNR Am J Neuroradiol. 2010; 32(2):374-81. PMC: 7965729. DOI: 10.3174/ajnr.A2267. View

Lu S, Ahn D, Johnson G, Law M, Zagzag D, Grossman R . Diffusion-tensor MR imaging of intracranial neoplasia and associated peritumoral edema: introduction of the tumor infiltration index. Radiology. 2004; 232(1):221-8. DOI: 10.1148/radiol.2321030653. View

Wang L, Goldstein F, Veledar E, Levey A, Lah J, Meltzer C . Alterations in cortical thickness and white matter integrity in mild cognitive impairment measured by whole-brain cortical thickness mapping and diffusion tensor imaging. AJNR Am J Neuroradiol. 2009; 30(5):893-9. PMC: 2901819. DOI: 10.3174/ajnr.A1484. View

Stadlbauer A, Ganslandt O, Buslei R, Hammen T, Gruber S, Moser E . Gliomas: histopathologic evaluation of changes in directionality and magnitude of water diffusion at diffusion-tensor MR imaging. Radiology. 2006; 240(3):803-10. DOI: 10.1148/radiol.2403050937. View

Alexandru D, Bota D, Linskey M . Epidemiology of central nervous system metastases. Prog Neurol Surg. 2012; 25:13-29. DOI: 10.1159/000331167. View

Inoue T, Ogasawara K, Beppu T, Ogawa A, Kabasawa H . Diffusion tensor imaging for preoperative evaluation of tumor grade in gliomas. Clin Neurol Neurosurg. 2005; 107(3):174-80. DOI: 10.1016/j.clineuro.2004.06.011. View

Schaefer P, Grant P, Gonzalez R . Diffusion-weighted MR imaging of the brain. Radiology. 2000; 217(2):331-45. DOI: 10.1148/radiology.217.2.r00nv24331. View

Kinoshita M, Hashimoto N, Goto T, Kagawa N, Kishima H, Izumoto S . Fractional anisotropy and tumor cell density of the tumor core show positive correlation in diffusion tensor magnetic resonance imaging of malignant brain tumors. Neuroimage. 2008; 43(1):29-35. DOI: 10.1016/j.neuroimage.2008.06.041. View

Ohno Y, Koyama H, Nogami M, Takenaka D, Yoshikawa T, Yoshimura M . Whole-body MR imaging vs. FDG-PET: comparison of accuracy of M-stage diagnosis for lung cancer patients. J Magn Reson Imaging. 2007; 26(3):498-509. DOI: 10.1002/jmri.21031. View

10.

Kruger S, Mottaghy F, Buck A, Maschke S, Kley H, Frechen D . Brain metastasis in lung cancer. Comparison of cerebral MRI and 18F-FDG-PET/CT for diagnosis in the initial staging. Nuklearmedizin. 2010; 50(3):101-6. DOI: 10.3413/Nukmed-0338-10-07. View

11.

Byrnes T, Barrick T, Bell B, Clark C . Diffusion tensor imaging discriminates between glioblastoma and cerebral metastases in vivo. NMR Biomed. 2010; 24(1):54-60. DOI: 10.1002/nbm.1555. View

12.

Hygino Cruz Jr L, Sorensen A . Diffusion tensor magnetic resonance imaging of brain tumors. Magn Reson Imaging Clin N Am. 2006; 14(2):183-202. DOI: 10.1016/j.mric.2006.06.003. View

13.

Zakaria R, Das K, Radon M, Bhojak M, Rudland P, Sluming V . Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes. BMC Med Imaging. 2014; 14:26. PMC: 4126355. DOI: 10.1186/1471-2342-14-26. View

14.

Liu K, Ma Z, Feng L . Apparent diffusion coefficient as an effective index for the therapeutic efficiency of brain chemoradiotherapy for brain metastases from lung cancer. BMC Med Imaging. 2018; 18(1):30. PMC: 6142399. DOI: 10.1186/s12880-018-0275-3. View

15.

Lu S, Ahn D, Johnson G, Cha S . Peritumoral diffusion tensor imaging of high-grade gliomas and metastatic brain tumors. AJNR Am J Neuroradiol. 2003; 24(5):937-41. PMC: 7975803. View

16.

Gultekin M, Turk H, Yurtsever I, Atasoy B, Aliyev A, Yilmaz T . The Utility and Efficiency of Diffusion Tensor Imaging Values to Determine Epidermal Growth Factor Receptor Gene Mutation Status in Brain Metastasis from Lung Adenocarcinoma; A Preliminary Study. Curr Med Imaging. 2021; 16(10):1271-1277. DOI: 10.2174/1573405615666191122122207. View

17.

Herneth A, Guccione S, Bednarski M . Apparent diffusion coefficient: a quantitative parameter for in vivo tumor characterization. Eur J Radiol. 2003; 45(3):208-13. DOI: 10.1016/s0720-048x(02)00310-8. View

18.

Sinha S, Bastin M, Whittle I, Wardlaw J . Diffusion tensor MR imaging of high-grade cerebral gliomas. AJNR Am J Neuroradiol. 2002; 23(4):520-7. PMC: 7975109. View

19.

Wang S, Kim S, Poptani H, Woo J, Mohan S, Jin R . Diagnostic utility of diffusion tensor imaging in differentiating glioblastomas from brain metastases. AJNR Am J Neuroradiol. 2014; 35(5):928-34. PMC: 7964538. DOI: 10.3174/ajnr.A3871. View

20.

Hayashida Y, Hirai T, Morishita S, Kitajima M, Murakami R, Korogi Y . Diffusion-weighted imaging of metastatic brain tumors: comparison with histologic type and tumor cellularity. AJNR Am J Neuroradiol. 2006; 27(7):1419-25. PMC: 7977525. View