Joint approach of diffusion- and perfusion-weighted MRI in intra-axial mass like lesions in clinical practice simulation.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read Online Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Brain/*diagnostic imaging ; Brain Neoplasms/*diagnostic imaging ; Magnetic Resonance Imaging/*methods; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity
    • 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.
      Competing Interests: The authors have declared that no competing interests exist.
    • References:
      Neuro Oncol. 2011 Apr;13(4):447-55. (PMID: 21297125)
      J Comput Assist Tomogr. 2012 Sep-Oct;36(5):577-82. (PMID: 22992609)
      Diagn Interv Radiol. 2009 Mar;15(1):3-12. (PMID: 19263367)
      Br J Radiol. 2010 Jun;83(990):466-75. (PMID: 19690076)
      AJNR Am J Neuroradiol. 2008 Mar;29(3):471-5. (PMID: 18065516)
      J Magn Reson Imaging. 2006 Oct;24(4):817-24. (PMID: 16958061)
      Radiology. 2007 May;243(2):539-50. (PMID: 17456876)
      AJNR Am J Neuroradiol. 2008 Mar;29(3):458-63. (PMID: 18065512)
      Acta Radiol. 2009 Jul;50(6):682-9. (PMID: 19449234)
      J Neuroradiol. 2002 Jun;29(2):105-13. (PMID: 12297732)
      J Am Coll Radiol. 2007 May;4(5):313-9. (PMID: 17467614)
      Mult Scler Relat Disord. 2015 Nov;4(6):555-66. (PMID: 26590662)
      Bull World Health Organ. 2010 Apr;88(4):312-20. (PMID: 20431796)
      Acad Radiol. 2008 Feb;15(2):249-59. (PMID: 18206625)
      Clin Imaging. 2002 Jul-Aug;26(4):227-36. (PMID: 12140151)
      Clin Radiol. 2010 Jan;65(1):15-20. (PMID: 20103416)
      Cancer Imaging. 2012 Oct 26;12:423-36. (PMID: 23108208)
      Lancet. 2009 Oct 31;374(9700):1512-20. (PMID: 19767089)
      Radiology. 2004 Jul;232(1):221-8. (PMID: 15220505)
      AJR Am J Roentgenol. 2014 Jul;203(1):3-9. (PMID: 24951190)
      AJNR Am J Neuroradiol. 2015 May;36(5):877-85. (PMID: 25593202)
      AJNR Am J Neuroradiol. 2006 Mar;27(3):475-87. (PMID: 16551981)
      AJNR Am J Neuroradiol. 2007 Oct;28(9):1693-9. (PMID: 17885229)
      AJNR Am J Neuroradiol. 2001 May;22(5):969-76. (PMID: 11337344)
      AJNR Am J Neuroradiol. 2011 Mar;32(3):507-14. (PMID: 21330399)
      Radiology. 2014 Dec;273(3):831-43. (PMID: 24885857)
      AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1539-47. (PMID: 15956527)
      Radiology. 2005 Jun;235(3):985-91. (PMID: 15833979)
      Eur J Radiol. 2006 Jun;58(3):394-403. (PMID: 16527438)
      Lancet Oncol. 2010 Nov;11(11):1036-47. (PMID: 20970380)
      Med Phys. 2011 Aug;38(8):4667-71. (PMID: 21928640)
    • Accession Number:
      0 (Contrast Media)
    • Publication Date:
      Date Created: 20180908 Date Completed: 20190221 Latest Revision: 20190221
    • Publication Date:
      20240104
    • Accession Number:
      PMC6128539
    • Accession Number:
      10.1371/journal.pone.0202891
    • Accession Number:
      30192785