Segmentation of peritumoral oedema offers a valuable radiological feature of cerebral metastasis
Chengcheng Zhou1, Zixiao Yang1, Zhengwei Yao2
1Department of Neurosurgery, Huashan Hospital, Shanghai, China.
Objective:
Peritumoral oedema (PTO) is commonly observed on MRI in malignant brain tumours including brain metastasis (bMET) and glioblastoma multiforme (GBM). This study aimed to differentiate bMET from GBM by comparing the volume ratio of PTO to tumour lesion (Rvol).
Methods:
56 patients with solitary bMET or GBM were enrolled, and MRI was analyzed by a semi-automatic methodology based on MATLAB (Mathworks, Natick, MA). The PTO volume (Voedema) was segmented for quantification using T2 fluid-attenuated inversion-recovery images, while the tumour volume was quantified with enhanced T1 images. The quantitative volume of the tumour, PTO and the ratio of PTO to tumour were interpreted using SPSS(®) (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) by considering different locations and pathologies.
Results:
The tumour volumes of supratentorial GBM, supratentorial bMET (supra-bMET) and infratentorial bMET were 32.22 ± 21.9, 18.45 ± 17.28 and 11.40 ± 5.63 ml, respectively. The corresponding Voedema were 44.08 ± 25.84, 73.20 ± 40.35 and 23.74 ± 7.78 ml, respectively. The Voedema difference between supratentorial and infratentorial lesions is significant (p-value = 0.002). Supra-bMET has a smaller tumour volume (p-value = 0.032), but a larger PTO (p-value = 0.007). The ratio of Voedema to the tumour volume in bMET is statistically higher than that in GBM (p-value = 0.015). The cut-off ratio for identifying bMET from GBM is 3.9, with a specificity and sensitivity of 90.0% and 68.8%, respectively.
Conclusion:
Segmentation is an efficient method to quantify irregular PTO. bMET possesses more extensive oedema with smaller tumour volume than does GBM. The Rvol is a valuable index to distinguish bMET from GBM.
Advances In Knowledge:
This study presents a new method for the quantitation of PTO to differentiate bMET from GBM.
Insights
Brain metastasis (bMET) shows more peritumoral oedema (PTO) relative to tumour volume than glioblastoma multiforme (GBM). The ratio of PTO to tumour volume (Rvol) can effectively differentiate bMET from GBM.
Area of Science:
- Neuro-oncology
- Radiology
- Medical Imaging Analysis
Background:
- Peritumoral oedema (PTO) is a common MRI finding in malignant brain tumors like brain metastasis (bMET) and glioblastoma multiforme (GBM).
- Differentiating between bMET and GBM is crucial for treatment planning and prognosis.
Purpose of the Study:
- To compare the volume ratio of PTO to tumour lesion (Rvol) between bMET and GBM.
- To establish Rvol as a potential imaging biomarker for distinguishing bMET from GBM.
Main Methods:
- A semi-automatic MRI analysis methodology was employed on 56 patients with solitary bMET or GBM.
- Tumour volumes were quantified using enhanced T1 images, and PTO volumes (Voedema) were segmented using T2 fluid-attenuated inversion-recovery images.
- Statistical analysis using SPSS was performed to interpret quantitative volumes and Rvol, considering lesion location and pathology.
Main Results:
- Brain metastasis (bMET) exhibited a statistically significant higher Rvol compared to glioblastoma multiforme (GBM) (p=0.015).
- Supra-bMET showed smaller tumour volumes but larger PTO compared to GBM.
- An Rvol cut-off of 3.9 demonstrated 90.0% specificity and 68.8% sensitivity in differentiating bMET from GBM.
Conclusions:
- Semi-automatic segmentation is an effective method for quantifying irregular PTO.
- bMET typically presents with more extensive oedema relative to its tumour volume when compared to GBM.
- The Rvol serves as a valuable index for distinguishing bMET from GBM on MRI.
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