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Improved conspicuity and delineation of high-grade primary and metastatic brain tumors using "restriction spectrum
N S White1, C R McDonald, N Farid
1University of California, San Diego, Department of Radiology, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA. nswhite@ucsd.edu
Background And Purpose:
Restriction spectrum imaging is a sensitive DWI technique for probing separable water diffusion compartments in tissues. Here, we evaluate RSI-CMs derived from the spherically-restricted water compartment for improved tumor conspicuity and delineation from nontumor tissue and reduced sensitivity to edema compared with high-b-value DWI and ADC.
Materials And Methods:
RSI was performed in 10 presurgical patients: 4 with glioblastoma, 3 with primary CNS lymphoma, and 3 with metastatic brain tumors. Multidirectional DWI data were collected at b = 500, 1500, and 4000 s/mm(2). Quantification of tumor conspicuity, edema conspicuity, and relative sensitivity to edema for RSI-CMs; DWI at b = 4000 (DWI-4000); and ADC were compared in manually drawn VOIs. Receiver operating characteristic curves were used to evaluate the sensitivity and specificity of each method for delineating tumor from normal-appearing WM.
Results:
Significant TC was seen with both RSI-CMs and DWI-4000, but not ADC. Significant EC was seen with ADC, but not RSI-CMs or DWI-4000. Significantly greater TC was seen with RSI-CMs compared with DWI-4000. Significantly reduced RSE was seen with RSI-CMs compared with both DWI-4000 and ADC. Greater sensitivity and specificity for delineating tumor from normal-appearing WM were seen with RSI-CMs (AUC = 0.91) compared with both DWI-4000 (AUC = 0.77) and ADC (AUC = 0.66).
Conclusions:
RSI-CMs offer improved conspicuity and delineation of high-grade primary and metastatic brain tumors and reduced sensitivity to edema compared with high-b-value DWI and ADC.
