Tumor-related Perfusion Changes in White Matter Adjacent to Brain Tumors: Pharmacodynamic Analysis of Dynamic 3T Magnetic Resonance Imaging

Anticancer Res. 2018 Jul;38(7):4149-4152. doi: 10.21873/anticanres.12707.

Abstract

Background/aim: To verify perfusion differences in white matter adjacent to glioblastomas and metastatic tumors in dynamic contrast-enhanced (DCE) 3T-magnetic resonance imaging (MRI) using gradient echo (GRE) T1 techniques.

Materials and methods: A retrospective comparative study was carried out on adults with glioblastoma (n=67) and brain metastases (n=31). In each patient, conventional 3T-MRI and DCE-MRI with 25 acquisitions of GRE-T1 were performed. The initial area under the contrast-uptake curve (iAUC) and transfer constant (Ktrans) in peritumoral regions of the white matter were evaluated using T1 pharmacodynamic modeling software.

Results: Statistically significantly higher relative iAUC (p<0.001) and Ktrans (p<0.01) values were recorded for peritumoral white matter near glioblastomas compared to that near metastases: 2.29 (SD=1.11) and 2.12 (SD=1.05) vs. 0.96 (SD=0.31) and 1.18 (SD=0.35), respectively.

Conclusion: In comparison to Ktrans, the iAUC obtained by DCE-MRI is more suitable for assessing glioblastomas because it better reflects pharmacokinetic peritumoral changes. Increased iAUC in white matter near to tumor generally indicates glioblastoma, however, a low level does not exclude it.

Keywords: Glioblastoma; brain metastases; dynamic contrast-enhanced; magnetic resonance; perfusion; white matter infiltration.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology*
  • Colorectal Neoplasms / secondary
  • Female
  • Glioblastoma / diagnostic imaging
  • Glioblastoma / pathology
  • Humans
  • Kidney Neoplasms / secondary
  • Leiomyosarcoma / secondary
  • Lung Neoplasms / secondary
  • Magnetic Resonance Imaging / methods*
  • Male
  • Melanoma / secondary
  • Middle Aged
  • Retrospective Studies
  • White Matter / diagnostic imaging*
  • White Matter / pathology*