Differentiation of True Recurrence from Delayed Radiation Therapy-related Changes in Primary Brain Tumors Using Diffusion-weighted Imaging, Dynamic Susceptibility Contrast Perfusion Imaging, and Susce

서지정보

· 발행기관 : 대한자기공명의과학회
· 수록지 정보 : Investigative Magnetic Resonance Imaging / 18권 / 2호 / 120 ~ 132페이지
· 저자명 : 김동현, 최승홍, 류인선, 윤태진, 김태민, 이세훈, 박철기, 손철호, 박성혜, 김일한

초록

Purpose : To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weightedimaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patientstreated with RT for primary brain tumors.
Materials and Methods: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newlyappearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions wereconfirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume(nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for theenhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regressionmodel was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtainedfrom receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy forthe diagnosis.
Results: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004),and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference wasobserved in the mean ADC values between the two groups. A multivariable logistic regression analysis showed thatproSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively.
Conclusion: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesionsmore than one year after RT completion in brain tumor patients.

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