Differentiation of glioblastoma and primary central nervous system lymphomas using multiparametric diffusion and perfusion magnetic resonance imaging

Hung,Nguyen Duy; Anh,Nguyen Ngoc; Minh,Nguyen Dinh; Huyen,Dang Khanh; Duc,Nguyen Minh

doi:10.3892/br.2023.1664

Differentiation of glioblastoma and primary central nervous system lymphomas using multiparametric diffusion and perfusion magnetic resonance imaging

Authors:
- Nguyen Duy Hung
- Nguyen Ngoc Anh
- Nguyen Dinh Minh
- Dang Khanh Huyen
- Nguyen Minh Duc
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Affiliations: Department of Radiology, Hanoi Medical University, Hanoi 100000, Vietnam, Department of Radiology, Viet Duc Hospital, Hanoi 100000, Vietnam, Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh 700000, Vietnam
Published online on: September 22, 2023 https://doi.org/10.3892/br.2023.1664
Article Number: 82
Copyright: © Hung et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to determine whether combining diffusion‑weighted (DWI) and dynamic susceptibility contrast‑enhanced perfusion‑weighted (DSC‑PWI) magnetic resonance imaging (MRI) could differentiate between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM). The present retrospective study evaluated 45 patients with histologically confirmed brain tumors, of which 18 had PCNSLs and 27 had GBMs. All patients underwent conventional, DWI, and DSC‑PWI MRIs before the surgical removal of the lesion or stereotactic biopsy. The solid tumor component, peritumoral edema, and abnormal white matter were measured in three regions of interest to evaluate relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and DWI. In conventional MRI, there were significant differences in tumor numbers, tumor enhancement type, tumor necrosis, hemorrhage and open‑ring sign between GBM and PCNSL. Solid tumor ADC and rCBV values (ADCt and rCBVt, respectively) and their ratios with abnormal white matter amounts were significantly higher in GBM cases than in PCNSL cases (P<0.05). The rCBV value for peritumoral edema (rCBVe) and its ratio with abnormal white matter amount (rCBVe/n) were significantly higher in GBM cases than in PCNSL cases (P<0.05). However, ADC values did not differ significantly for peritumoral edema. DWI values did not differ significantly. Combining rCBVt and rCBVe/n provided a perfect area under the receiver operating characteristic curve of 1.00, with 100% sensitivity and 100% specificity for distinguishing GBM from PCNSL. In the results of the present study, the major criterion in the decision‑making process distinguishing PCNSL from GBM was the combined rCBVt and rCBVe/n parameter. A minor criterion was the ADCt value of the lesion.

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