Oncotarget

Research Papers:

The value of whole lesion ADC histogram profiling to differentiate between morphologically indistinguishable ring enhancing lesions–comparison of glioblastomas and brain abscesses

Diana Horvath-Rizea, Alexey Surov, Karl-Titus Hoffmann, Nikita Garnov, Cathrin Vörkel, Patricia Kohlhof-Meinecke, Oliver Ganslandt, Hansjörg Bäzner, Georg Alexander Gihr, Marcell Kalman, Elina Henkes, Hans Henkes and Stefan Schob _

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Oncotarget. 2018; 9:18148-18159. https://doi.org/10.18632/oncotarget.24454

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Abstract

Diana Horvath-Rizea1,*, Alexey Surov2,*, Karl-Titus Hoffmann3, Nikita Garnov4, Cathrin Vörkel2, Patricia Kohlhof-Meinecke5, Oliver Ganslandt6, Hansjörg Bäzner7, Georg Alexander Gihr1, Marcell Kalman1, Elina Henkes1, Hans Henkes1 and Stefan Schob3

1Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany

2Clinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany

3Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany

4Eichamt Leipzig, Leipzig, Germany

5Department for Pathology, Katharinenhospital Stuttgart, Stuttgart, Germany

6Clinic for Neurosurgery, Katharinenhospital Stuttgart, Stuttgart, Germany

7Clinic for Neurology, Katherinenhospital Stuttgart, Stuttgart, Germany

*These authors contributed equally to this work

Correspondence to:

Stefan Schob, email: [email protected]

Keywords: ring enhancing lesion; glioblastoma, brain abscess; diffusion weighted imaging; histogram analysis

Received: December 26, 2017     Accepted: January 30, 2018     Published: April 06, 2018

ABSTRACT

Background: Morphologically similar appearing ring enhancing lesions in the brain parenchyma can be caused by a number of distinct pathologies, however, they consistently represent life-threatening conditions. The two most frequently encountered diseases manifesting as such are glioblastoma multiforme (GBM) and brain abscess (BA), each requiring disparate therapeutical approaches. As a result of their morphological resemblance, essential treatment might be significantly delayed or even ommited, in case results of conventional imaging remain inconclusive. Therefore, our study aimed to investigate, whether ADC histogram profiling reliably can distinguish between both entities, thus enhancing the differential diagnostic process and preventing treatment failure in this highly critical context.

Methods: 103 patients (51 BA, 52 GBM) with histopathologically confirmed diagnosis were enrolled. Pretreatment diffusion weighted imaging (DWI) was obtained in a 1.5T system using b values of 0, 500, and 1000 s/mm2. Whole lesion ADC volumes were analyzed using a histogram-based approach. Statistical analysis was performed using SPSS version 23.

Results: All investigated parameters were statistically different in comparison of both groups. Most importantly, ADCp10 was able to differentiate reliably between BA and GBM with excellent accuracy (0.948) using a cutpoint value of 70 x 10-5 mm2 × s-1.

Conclusions: ADC whole lesion histogram profiling provides a valuable tool to differentiate between morphologically indistinguishable mass lesions. Among the investigated parameters, the 10th percentile of the ADC volume distinguished best between GBM and BA.


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