Evidence map›Paper›PMID 40463651›Full record

ArticleNeuro-oncology advances

Microstructural differentiation of cerebral metastases, glioblastoma, meningioma, and primary CNS lymphoma using advanced diffusion imaging techniques.

Urs Würtemberger, Alexander Rau, Marco Reisert, Lucas Becker, Samer Elsheikh, Till-Karsten Hauser, Jürgen Grauvogel, Marc Hohenhaus, Daniel Erny, Horst Urbach and 2 more

Abstract read
In one paragraph

Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Urs WürtembergerDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-2507-9160
Alexander RauDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0001-5881-6043
Marco ReisertDepartment of Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Lucas BeckerDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Samer ElsheikhDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Till-Karsten HauserDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Tuebingen, Germany.
Jürgen GrauvogelDepartment of Neurosurgery, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
Marc HohenhausDepartment of Neurosurgery, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
Daniel ErnyInstitute of Neuropathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Horst UrbachDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Theo DemerathDepartment of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-5869-1110
Martin DieboldIMM-PACT Clinician Scientist Program, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Microstructural tumor characteristics discriminate metastases, glioblastoma, meningioma, and primary CNS lymphoma. We aimed to assess these intracranial neoplasms utilizing multiparametric diffusion imaging as a translational measure of morphology. Methods: We investigated 101 newly diagnosed intracranial tumors (35 metastases, 34 glioblastomas [GB], 21 meningiomas, 11 primary CNS lymphomas [PCNSL]) with advanced diffusion MRI including Diffusion Tensor Imaging (DTI), Neurite Orientation and Dispersion Density Imaging (NODDI), and Diffusion Microstructure Imaging (DMI). Beyond DTI-derived metrics (aD, fractional anisotropy [FA], mD, rD), we extracted the NODDI and DMI intra-axonal (NODDI intra-cellular volume fraction, DMI V-intra), extra-axonal cellular (DMI V-extra), and free water (NODDI ISO-VF, DMI V-CSF) fractions using a multi-compartment model. These metrics were read from contrast-enhancing tumor portions and compared across the entities. Results: Various microstructural parameters served as effective discriminators in pairwise comparisons: ISO-VF demonstrated high accuracy in distinguishing metastases from PCNSL (accuracy 90.13%) and meningiomas (accuracy 80.69%). aD was most accurate in discriminating GB from PCNSL (accuracy 89.57%) and meningioma from PCNSL (accuracy 74.03%), similar to MD which distinguished GB from meningiomas (accuracy 77.73%). FA performed best in discriminating GB from metastases (accuracy 83.11%). Discrimination on two axes of directionality and compartmentalization illustrate the comprehensive approach to tumor assessment. Conclusion: Advanced microstructural imaging facilitates discrimination of four common intracranial neoplasms. Features such as cell density, extent of free water, and directional cellular elements are reflected in the diffusion metrics to varying degrees. As part of a first non-invasive assessment, they may direct early diagnostic and therapeutic procedures.

Indexed as

brain tumordiffusion microstructure imagingDMIDTINODDI

Identifiers

PMID40463651
PMCPMC12130974

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.