Predicting brain tumor histology: change of effective atomic number with contrast enhancement

Thirty-eight enhancing intracranial neoplasms were evaluated with a dual kilovoltage technique to measure the change of effective atomic number (delta Z), and linear attenuation coefficients with the use of iodinated contrast material. The change of effective atomic number was found to separate intracranial neoplasms into three major groups: gliomas, meningiomas, and metastases. Other parameters, including linear attenuation coefficients and CT numbers, varied from less accurate to inaccurate. The change of effective atomic number with contrast enhancement not only predicted the appropriate histologic group of the neoplasm, but also aided in the differential diagnosis of neoplasms without a characteristic delta Z value.