Histogram analysis of apparent diffusion coefficient maps for differentiating primary CNS lymphomas from tumefactive...

Area of Science:

• Radiology
• Neuroimaging
• Oncology

Background:

• Primary CNS lymphomas (PCNSLs) and tumefactive demyelinating lesions (TDLs) can present with similar imaging characteristics.
• Accurate differentiation is crucial for appropriate patient management and treatment.

Purpose of the Study:

• To evaluate the utility of apparent diffusion coefficient (ADC) histogram analysis in differentiating PCNSLs from TDLs.
• To specifically assess its effectiveness in distinguishing atypical PCNSLs from TDLs.

Main Methods:

• ADC maps were analyzed using histogram analysis in 47 PCNSL patients and 18 TDL patients.
• Regions of interest (ROIs) were defined on T2-weighted images and transferred to ADC maps.
• ADC histogram parameters were compared between groups, and ROC curves were generated to determine diagnostic performance.

Main Results:

• Minimum ADC values (ADCmin) and 5th/10th percentiles (ADC5%, ADC10%) differed significantly between PCNSLs and TDLs.
• These parameters were also lower in atypical PCNSLs compared to TDLs.
• ADCmin demonstrated the highest diagnostic performance for differentiating atypical PCNSLs from TDLs (AUC 81.3%, specificity 88.9% at a threshold of 556×10(-6) mm2/s).

Conclusions:

• ADC histogram analysis is a valuable tool for differentiating PCNSLs from TDLs.
• This technique shows particular promise for distinguishing atypical PCNSLs from TDLs, aiding in diagnosis.