Distinguishing Recurrent Primary Brain Tumor from Radiation Injury: A Preliminary Study Using a Susceptibility-Weighted MR Imaging-Guided Apparent Diffusion Coefficient Analysis Strategy
Distinguishing Recurrent Primary Brain Tumor from Radiation Injury: A Preliminary Study Using a Susceptibility-Weighted MR Imaging-Guided Apparent Diffusion Coefficient Analysis Strategy
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DOI：
10.3174/ajnr.a2011
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发表时间：
2010-06-01
影响因子：
3.5
通讯作者：
Rose, S.
中科院分区：
文献类型：
--
作者：
Al Sayyari, A.;Buckley, R.;Rose, S.
背景和目的：准确描述肿瘤复发是神经肿瘤学中的一个重要问题。我们的目的是通过使用CE-SWI，一种技术，提供了改进的可视化的异质性模式的脑肿瘤病理学，以指导分析的ADC测量范围内的peritumoral territory.MATERIALS和METHODS：17例正在接受治疗的高级别神经胶质肿瘤的脑肿瘤复发的识别参加了这项研究。所有患者在随访CE-T1时均出现新的增强病变。组织学分析或广泛的临床随访证实了复发或放化疗损伤。以半自动方式提取配准的CE-SWI和CE-T1图像上的增强区域，并将其转移到配准的ADC图上。序列MR图像上的增强体积内定义的ADC测量的显着差异进行了分析，通过使用非参数Kolmogorov-Smirnov的方法和相关的临床随访diagnosis.RESULTS：分析的串行数据显示，诊断为肿瘤复发的患者有显着减少的增强体积内划定的CE-SWI的ADC测量。相比之下，SD患者有显着升高的ADC内CE-SWI增强volume.CONCLUSIONS：一系列CE-SWI地图上描绘的增强体积增加的结果，沿着与ADC减少在此体积内的复发性肿瘤的患者，提供支持这种方法被用来协助后续患者的管理策略。
BACKGROUND AND PURPOSE: The accurate delineation of tumor recurrence presents a significant problem in neuro-oncology. Our aim was to improve the identification of brain tumor recurrence from chemoradiation injury by using CE-SWI, a technique that provides improved visualization of the heterogeneous patterns of brain tumor pathology, to guide the analysis of ADC measures within the peritumoral territory.MATERIALS AND METHODS: Seventeen patients who were being treated for high-grade glial neoplasms took part in the study. All patients presented with new enhancing lesions on follow-up CE-T1. Recurrence or chemoradiation injury was confirmed from either histologic analysis or extensive clinical follow-up. Regions of enhancement on registered CE-SWI and CE-T1 images were extracted in a semiautomated fashion and transferred to coregistered ADC maps. Significant differences in ADC measures defined within the enhancement volumes on serial MR images were analyzed by using a nonparametric Kolmogorov-Smirnov approach and correlated with clinical follow-up diagnoses.RESULTS: Analysis of the serial data revealed that patients with a diagnosis of tumor recurrence had significantly reduced ADC measures within the enhancement volume delineated on CE-SWI. In contrast, patients with SD had significantly elevated ADC within the CE-SWI enhancement volume.CONCLUSIONS: The findings of an increase in enhancement volume delineated on serial CE-SWI maps, along with a concomitant reduction in ADC within this volume for patients with recurrent tumor, provide support for such an approach to be used to assist in follow-up patient management strategies.