Related Experiment Video
Updated: Jul 6, 2026
Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
Published on: June 7, 2020
Differentiation of infective from neoplastic brain lesions by dynamic contrast-enhanced MRI
Mohammad Haris1, Rakesh Kumar Gupta, Anup Singh
1Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India 226014.
Introduction:
It is not always possible to differentiate infective from neoplastic brain lesions with conventional MR imaging. In this study, we assessed the utility of various perfusion indices in the differentiation of infective from neoplastic brain lesions.
Methods:
A total of 103 patients with infective brain lesions (group I, n=26) and neoplastic brain lesions (high-grade glioma, HGG, group II, n=52; low-grade glioma, LGG, group III, n=25) underwent dynamic contrast-enhanced MR imaging. The perfusion indices, including relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (k(trans)) and leakage (v(e)), were calculated and their degree of correlation with immunohistologically obtained microvessel density (MVD) and vascular endothelial growth factor (VEGF) determined. The rCBV was corrected for the leakage effect. Discriminant analysis for rCBV, rCBF, k(trans) and v(e) was performed to predict the group membership of each case and post hoc analysis was performed to look for group differences.
Results:
The rCBV, rCBF, k(trans), v(e), MVD and VEGF were significantly different (P<0.001) between the three groups. Discriminant analysis showed that rCBV predicted 73.1% of the infective lesions, 84.6% of the HGG and 72.0% of the LGG. The rCBF classified 86.5% of the HGG, 80.0% of the LGG and 65.4% of the infective lesions. The k(trans) discriminated 98.1% of the HGG, 76.0% of the LGG and 88.5% of the infective lesions correctly. The v(e) classified 98.1% of the HGG, 76.0% of the LGG and 84.6% the infective lesions. The rCBV was correlated significantly with MVD and VEGF, while the correlation between k(trans) and MVD was not significant.
Conclusion:
Physiological perfusion indices such as k(trans) and v(e) appear to be useful in differentiating infective from neoplastic brain lesions. Adding these indices to the current imaging protocol is likely to improve tissue characterization of these focal brain mass lesions.
Insights
Perfusion indices like k(trans) and v(e) from dynamic contrast-enhanced MR imaging can help distinguish between infective and neoplastic brain lesions. These advanced metrics improve tissue characterization for better diagnosis.
Area of Science:
- Neuroimaging
- Radiology
- Oncology
Background:
- Conventional MRI often struggles to differentiate between infective and neoplastic brain lesions.
- Accurate differentiation is crucial for appropriate patient management and treatment.
Purpose of the Study:
- To evaluate the effectiveness of various perfusion indices in distinguishing between infective and neoplastic brain lesions.
- To assess the correlation between perfusion indices and microvessel density (MVD) and vascular endothelial growth factor (VEGF).
Main Methods:
- Dynamic contrast-enhanced MR imaging was performed on 103 patients with infective or neoplastic brain lesions (high-grade glioma [HGG] and low-grade glioma [LGG]).
- Perfusion indices including relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (k(trans)), and leakage (v(e)) were calculated.
- Discriminant analysis was used to predict group membership, and correlations with MVD and VEGF were determined.
Main Results:
- Significant differences in rCBV, rCBF, k(trans), v(e), MVD, and VEGF were observed between the groups (P<0.001).
- Discriminant analysis showed high accuracy for k(trans) (98.1% for HGG, 88.5% for infective lesions) and v(e) (98.1% for HGG, 84.6% for infective lesions) in differentiating lesion types.
- rCBV showed significant correlation with MVD and VEGF.
Conclusions:
- Physiological perfusion indices, specifically k(trans) and v(e), demonstrate significant utility in differentiating infective from neoplastic brain lesions.
- Incorporating these perfusion indices into MRI protocols can enhance the tissue characterization of focal brain mass lesions, aiding in diagnosis.
