New MR perfusion features in primary central nervous system lymphomas: pattern and prognostic impact

Area of Science:

• Neuroimaging
• Oncology
• Radiology

Background:

• Glioblastomas show MR perfusion features predicting survival.
• The prognostic value of MR perfusion in primary CNS lymphomas (PCNSL) is unknown.

Purpose of the Study:

• To investigate the prognostic value of MR perfusion in PCNSL.
• To correlate MR perfusion features with overall survival (OS) and progression-free survival (PFS).

Main Methods:

• Retrospective analysis of 3Tesla dynamic susceptibility contrast MR perfusion in 37 pre-surgical PCNSL.
• Evaluation of normalized regional cerebral blood volume (rCBVmean and rCBVmax) and time-signal intensity curve (TSIC) shoulder.
• Correlation of MR perfusion features with tumor size, edema, lesion number, and patient characteristics.

Main Results:

• Only patient age was prognostic for OS and PFS (p < 0.009).
• Most PCNSL (23/37) exhibited a TSIC-shoulder with moderate rCBV.
• Larger, unifocal PCNSL with TSIC-shoulder showed a "rCBV-sun" pattern and more edema compared to smaller, multifocal PCNSL.

Conclusions:

• Patient age is the sole predictor of OS and PFS in PCNSL.
• MR perfusion parameters and features did not show prognostic value.
• Distinct MR perfusion patterns (TSIC-shoulder, rCBV-sun) correlate with tumor size, multiplicity, and edema, suggesting different underlying vascular characteristics.