Title:Dynamic Contrast-Enhanced MR Perfusion in Differentiation of Benign
and Malignant Brain Lesions
Volume: 18
Author(s): Ezra Cetinkaya, Ayse Aralasmak*, Bahar Atasoy, Sevil Tokdemir, Huseyin Toprak, Ali Toprak, Serpil Kurtcan and Alpay Alkan
Affiliation:
- Department of Radiology, Bezmialem Vakif University, 34093, Istanbul, Turkey
- Department of Radiology, Istinye University, 34010, Istanbul, Turkey
Keywords:
DCE-MR perfusion, glioblastome multiforme, cavernous malformation, developmental venous anomaly, Ktrans, subtracted Kep.
Abstract:
Background: We aimed to differentiate Glioblastoma Multiforme (GBM) from benign lesions
like Developmental Venous Anomaly (DVA) and Cavernous Malformation (CM) by Dynamic
Contrast-Enhanced MR Perfusion (DCE-MRP) markers such as Ktrans, Ve, Kep, and IAUC.
Methods: We retrospectively evaluated 20 patients; 10 GBM as the malignant group, 5 CM and 5
DVA as the benign group. Ktrans, Kep, Ve, and IAUC parameters were measured by DCE-MRP, within
the lesion, at perilesional nonenhancing white matter (PLWM) and contralateral normal appearing
white matter (CLWM).
Results: All benign and malignant lesions exhibited significantly increased Ktrans, Ve, and IAUC
values compared to PLWM and CLWM (p < 0.001, p=0.006 and p<0.001). Subtracted Kep values
between lesion and PLWM were significantly different between the benign and malignant groups, as
the malignant group exhibited higher subtracted Kep values (p 0.035). For the malignant group; Ktrans
and IAUC values at the lesion were positively correlated (r 0.911), while Kep and Ve at CLWM were
negatively and strongly correlated (r 0.798). For the benign group; Ktrans with Ve and Ktrans with
IAUC at lesion (r 0.708 and r 0.816 respectively), Ktrans and IAUC at PLWM (r 0.809), Ktrans and
IAUC at CLWM(r 0.798) were strongly and positively correlated. Ktrans, Ve, and IAUC values can be
used to restrict the lesion in both groups.
Conclusion: Ktrans strongly correlates with IAUC and they can be used instead of each other in both
benign and malignant lesions. Classical DCE-MRP parameters cannot be used in the differentiation of
malignant lesions from benign vascular lesions. However, subtracted Kep values can be used to differentiate
GBM from benign vascular lesions.
