ArticleEuropean radiology2023
Improved performance of non-preloaded and high flip-angle dynamic susceptibility contrast perfusion-weighted imaging sequences in the presurgical differentiation of brain lymphoma and glioblastoma.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Percentage of signal recovery (PSR): a more accurate marker than rCBV for differentiating radiation necrosis from tumor progression in brain metastases treated with stereotactic radiosurgery.Journal of neuro-oncology · 2025Article
- Engineered iron oxide nanoplatforms: reprogramming immunosuppressive niches for precision cancer theranostics.Molecular cancer · 2025Review
- Multiparametric MRI for differential diagnosis of primary central nervous system lymphoma and atypical glioblastoma: an analysis incorporating DWI, DCE-MRI, and contrast agent preload DSC-PWI.BMC medical imaging · 2025Article
- "Synthetic" DSC Perfusion MRI with Adjustable Acquisition Parameters in Brain Tumors Using Dynamic Spin-and-Gradient-Echo Echoplanar Imaging.AJNR. American journal of neuroradiology · 2025Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThis study aimed to compare the accuracy of relative cerebral blood volume (rCBV) and percentage signal recovery (PSR) obtained from high flip-angle dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) sequences with and without contrast agent (CA) preload for presurgical discrimination of brain glioblastoma and lymphoma.
methodsConsecutive 336 patients (glioblastoma, 236; PCNSL, 100) were included. All the patients underwent DSC-PWI on 3.0-T magnetic resonance units before surgery. The rCBV and PSR with preloaded and non-preloaded CA were measured. The means of the continuous variables were compared using Welch's t-test. The diagnostic accuracies of the individual parameters were compared using the receiver operating characteristic curve analysis.
resultsThe rCBV was higher with preloaded CA than with non-preloaded CA (glioblastoma, 10.20 vs. 8.90, p = 0.020; PCNSL, 3.88 vs. 3.27, p = 0.020). The PSR was lower with preloaded CA than with non-preloaded CA (glioblastoma, 0.59 vs. 0.90; PCNSL, 0.70 vs. 1.63; all p < 0.001). Regarding the differentiation of glioblastoma and PCNSL, the AUC of rCBV with preloaded CA was indistinguishable from that of non-preloaded CA (0.940 vs. 0.949, p = 0.703), whereas the area under the curve of PSR with preloaded CA was lower than non-preloaded CA (0.529 vs. 0.884, p < 0.001).
conclusionWith preloaded CA, diagnostic performance in differentiating glioblastoma and PCNSL did not improve for rCBV and it was decreased for PSR. Therefore, high flip-angle non-preload DSC-PWI sequences offer excellent accuracy and may be of choice sequence for presurgical discrimination of brain lymphoma and glioblastoma. CLINICAL RELEVANCE STATEMENT: High flip-angle DSC-PWI using non-preloaded CA may be an excellent diagnostic method for distinguishing glioblastoma from PCNSL. KEY POINTS: • Differentiating primary central nervous system lymphoma and glioblastoma accurately is critical for their management. • DSC-PWI sequences optimised for the most accurate CBV calculations may not be the optimal sequences for presurgical brain tumour diagnosis as they could be masquerading leakage phenomena that may provide interesting information in terms of differential diagnosis. • High flip-angle non-preloaded DSC-PWI sequences render the best accuracy in the presurgical differentiation of brain lymphoma and glioblastoma.
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