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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Centrally Reduced Diffusion Sign for Differentiation between Treatment-Related Lesions and Glioma Progression: A
P Alcaide-Leon1, J Cluceru2, J M Lupo2
1From the Department of Medical Imaging (P.A.-L.), University Health Network, Toronto, Ontario, Canada.
AJNR. American Journal of Neuroradiology
|October 16, 2020
Summary
The centrally reduced diffusion sign on MRI helps distinguish treatment effects from tumor progression in glioma recurrence. Absence of this sign suggests a low probability of treatment-related lesions, aiding neuro-oncology diagnosis.
Area of Science:
- Neuroradiology
- Neuro-oncology
- Medical Imaging
Background:
- Differentiating treatment-related lesions from tumor progression is challenging in neuro-oncology.
- Diffusion Magnetic Resonance (MR) imaging may offer insights for this distinction.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the centrally reduced diffusion sign for differentiating treatment-related lesions from true tumor progression in patients with suspected glioma recurrence.
Main Methods:
- Review of preoperative MR images from 231 patients with suspected glioma recurrence.
- Classification of diffusion patterns into five categories by two neuroradiologists.
- Histopathology reports used for final diagnosis.
Main Results:
- 103 patients were included (22 treatment-related lesions, 81 tumor progression).
- The centrally reduced diffusion pattern showed 64% sensitivity and 84% specificity for treatment-related lesions.
- Positive predictive value was 52% and negative predictive value was 89%.
Conclusions:
- The centrally reduced diffusion sign is linked to treatment effects.
- A low probability (11%) of treatment-related lesions exists when this sign is absent.
