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Diffusion-Weighted Imaging of Brain Metastasis: Correlation of MRI Parameters with Histologic Type
Esra Ulu1, Bahadir Ozturk, Koksal Atalay
1Medicalpark Samsun Hospital, Department of Radiology, Samsun, Turkey.
Aim:
To compare the diffusion properties of brain metastases as imaging biomarkers in various types of tumours, to determine their histology and origin.
Material And Methods:
Magnetic Resonance Imaging (MRI) and diffusion-weighted imaging (DWI) were used to retrospectively study the data of 143 patients suffering from brain metastases. Four categories of primary tumours with metastases to the brain were included: lung carcinoma (n=102, 71.3%); breast carcinoma (n=27, 18.8%); colon carcinoma (n=8, 5.6%); and others (n=6, 4.2%). The Apparent Diffusion Coefficient (ADCmin ) values, as well as the normalised ADC ratio (nADC), were determined. The lesions on the DWI were categorised as follows: type 1, with negative findings on DWI; type 2, which were isointense with the normal cortical grey matter; type 3, which were hyperintense compared to the normal cortical grey matter.
Results:
The diffusion type, mean ADCmin, and mean nADC showed statistically significant differences in different types of metastases. In the subgroup analysis, it was found that type 3 was the diffusion type found most extensively in the brain metastases of small cell carcinoma (SCLC) (n=52, 65.8%, p < 0.000). Furthermore, the mean ADCmin and nADC values were the least for the brain metastases of the SCLC (552.0 ± 134.2 and nADC = 0.8 ± 0.1, p < 0.000, respectively). The value of the mean ADCmin was low in the human epidermal growth factor receptor 2 (HER-2) negative groups than in the HER-2 positive groups at 786.8 ± 299.1 vs 844.8 ± 141.3 (p < 0.006).
Conclusion:
Our findings indicated that there is a correlation between diffusion parameters as imaging biomarkers of the solid component of brain metastases of primary tumours and the tumour histology.
Insights
Diffusion MRI can help identify brain metastases origin. Different tumor types show distinct diffusion patterns, with small cell lung cancer exhibiting specific characteristics. This aids in understanding tumor histology and origin.
Area of Science:
- Radiology
- Oncology
- Neuroscience
Background:
- Brain metastases are a significant challenge in cancer care.
- Distinguishing the origin of brain metastases is crucial for treatment planning.
- Diffusion-weighted imaging (DWI) offers insights into tissue microstructure.
Purpose of the Study:
- To compare diffusion properties of brain metastases across various tumor types.
- To utilize diffusion parameters as imaging biomarkers for tumor histology and origin determination.
Main Methods:
- Retrospective analysis of 143 patients with brain metastases.
- Magnetic Resonance Imaging (MRI) and diffusion-weighted imaging (DWI) were employed.
- Apparent Diffusion Coefficient (ADCmin) and normalized ADC ratio (nADC) were calculated.
- Lesions were categorized into three diffusion types based on DWI signal intensity.
Main Results:
- Statistically significant differences in diffusion types, mean ADCmin, and mean nADC were observed among different metastases.
- Type 3 diffusion pattern was most prevalent in small cell lung cancer (SCLC) metastases (65.8%).
- SCLC brain metastases showed the lowest mean ADCmin and nADC values.
- Lower mean ADCmin values were found in human epidermal growth factor receptor 2 (HER-2) negative groups compared to HER-2 positive groups.
Conclusions:
- Diffusion parameters serve as valuable imaging biomarkers for the solid component of brain metastases.
- A correlation exists between diffusion characteristics and the histology/origin of primary tumors.
- DWI can aid in differentiating the origin of brain metastases based on their diffusion properties.
