Evidence map›Paper›PMID 40861571›Full record

ArticleCureus2025

The Role of Percentage Signal Recovery (PSR) in MRI Perfusion for the Diagnosis of Primary Central Nervous System Lymphoma.

Eliezer Villanueva-Castro, Marco Antonio Muñuzuri-Camacho, Luis A Rodríguez-Hernández, Bernardo Cacho-Díaz, Vicente Guerrero-Juarez, Rebeca Hernández Reséndiz, Tomas Moncada-Habib, Rodolfo Villalobos-Díaz, José Guillermo Flores-Vázquez, Domingo J Coutinho-Thomas and 3 more

Abstract read
In one paragraph

Article in Cureus, 2025. 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. Article
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

13 authors.

Eliezer Villanueva-CastroNeurosurgery, University of Arkansas for Medical Sciences, Little Rock, USA.
Marco Antonio Muñuzuri-CamachoNeurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Luis A Rodríguez-HernándezNeurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Bernardo Cacho-DíazNeuro-oncology, Instituto Nacional de Cancerología, Mexico City, MEX.
Vicente Guerrero-JuarezNeurology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Rebeca Hernández ReséndizPediatric Neurology, Hospital Angeles Universidad, Mexico City, MEX.
Tomas Moncada-HabibNeurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Rodolfo Villalobos-DíazNeurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
José Guillermo Flores-VázquezNeurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Domingo J Coutinho-ThomasDemyelinating Diseases, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Jorge Omar Garcia-GutierrezRadiology, Angeles del Pedregal Hospital, Mexico City, MEX.
Guillermo A Gutierrez-AcevesRadioneurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Alberto González-AguilarNeuro-oncology, Centro Oncologico Internacional, Mexico City, MEX.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Primary central nervous system lymphoma (PCNSL) is a rare type of malignancy confined to the central nervous system. While histopathological analysis remains the gold standard for diagnosis, it is invasive and not always feasible. Percentage signal recovery (PSR) derived from perfusion-weighted magnetic resonance imaging (MRI) has emerged as a promising non-invasive biomarker for PCNSL. Objective This study aims to evaluate the diagnostic accuracy of PSR and relative cerebral blood volume (rCBV) in distinguishing PCNSL from other CNS mass lesions using perfusion MRI. Methods We conducted a retrospective study using the neuro-oncology database of a national referral center in Mexico. Patients with histopathological confirmation and available perfusion MRI were included in the analysis. Results From a total of 16,198 patients, 700 met the inclusion criteria and were classified as follows: PCNSL (n = 86), high-grade gliomas (HGGs; n = 435), metastases (n = 80), neuroinfections (n = 80), and pseudotumoral demyelinating disorders (PDDs) (n = 19). Mean rCBV for PCNSL was 1.1, HGGs 3.9, metastases 3.0, neuroinfections 0.5, and PDDs 0.9, while mean PSR for PCNSL was 176%, HGGs 92%, metastases 81%, neuroinfections 95%, and PDDs 91%, with a statistically significant difference for PCNSL (p ≤ 0.0003). Receiver operating characteristic (ROC) curve analysis showed that PSR was the only parameter with robust diagnostic performance. A PSR threshold of >110 yielded 98% sensitivity (95% CI: 90.7-100) and 99% specificity (95% CI: 91.3-100) for the diagnosis of PCNSL. Conclusion PSR demonstrated high diagnostic accuracy in differentiating PCNSL from other enhancing brain lesions and may be particularly valuable in patients with atypical presentations, multiple comorbidities, or nondiagnostic or contraindicated biopsies. PSR is a promising non-invasive imaging biomarker that warrants further prospective validation.

Indexed as

cerebral blood volumediagnostic accuracymri perfusionneuroimaging biomarkerspercentage signal recoveryprimary cns lymphoma

Identifiers

PMID40861571
PMCPMC12372564

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