Ondokuz Mayis University, Turkey
Posters & Accepted Abstracts: J Cancer Sci Ther
Purpose: The purpose of this study is to determine the utility of diffusion weighted imaging (DWI), MR spectroscopy (MRS) and dynamic susceptibility contrast imaging (DSCI) at peritumoral area and contrasted tumor on the basis of cellularity, vascularity and metabolite levels in distinguishing high-grade gliomas (HGG) from solitary metastasis (SM). Method: MRS, DSCI and DWI were applied on 56 patients with solitary brain tumor (39 HGG, 17 SM). ADCMIN, ADCMAX, ADCMEAN, rCBVMax rates, Cho/Cr, Cho/NAA and NAA/Cr metabolite rates were measured from contrasted tumor and peritumoral area. In terms of the distinction between SM and HGT, Mann Whitney U test and independent samples T test were used to find out whether all these parameters had statistical difference and receiver operating characteristic (ROC) curve analysis was conducted to find out the cutoff values of these parameters. Results: In the distinction between SM and HGG, the differences in all ADC rates in the peritumoral area, rCBVMAX rate and differences between Cho/Cr, Cho/NAA and NAA/Cr metabolite rates were statistically significant (NAA/Cr p<0.009 other parameters p<0.0001). However, in the distinction between the two groups, all these parameters were shown to have no statistical difference in the contrasted tumor (p>0.05). According to ROC curve analysis, in distinguishing SM lesions from HGGs, cutoff values for ADCMIN, ADCMAX, ADCMEAN, rCBVMAX, Cho/Cr, Cho/NAA and NAA/Cr were 1,327, 1,483, 1,439, 0,61, 1,29, 1,16, 1,33, respectively in the peritumoral area, while sensitivity, specificity and AUC values were 82,4%, 89,7%, 0,920; 82,4%, 83,1%, 0,863; 82,4%, 87,2%, 0,888; 94.1%, 87,2%, 0,949; 88,2%, 82,1%, 0,897; 94,1%, 79,5%, 0,952; 82,4%, 74,4%, 0,762, respectively. Conclusion: DWI, MRS and DSCI can show the tumor infiltration around the contrasted area and provide diagnostic information in the distinction between SM and HGG. In addition, the highest sensitivity and specificity was found in the peritumoral rCBVMAX rates in the distinction between tumors.
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