Post Contrast-enhanced T 1 WI Histogram Analysis for Differentiating Glioblastom from Solitary Brain Metastasis / 中国医学影像学杂志

ABSTRACT

Purpose Glioblastoma and metastasis are the common and aggressive type of brain tumors in adults,and a definitive diagnosis has an important guiding significance to the clinical practice.Our purpose is to investigate the value of post contrast-enhanced T1WI-based histogram analysis in the differential diagnosis of glioblastoma and solitary brain metastasis.Materials and Methods Sixty-eight consecutive patients with glioblastoma or solitary metastasis confirmed pathologically or surgically at Meizhou People's Hospital between January 2012 and November 2015 were included in the study.Glioblastoma was diagnosed in 34 patients and solitary brain metastasis was diagnosed in the rest 34 patients.All patients had undergone routine brain MR examination before surgical resection and the imaging data were retrospectively analyzed.The ROIs were manually placed in enhanced solid parts of the tumors on the maximal cross-sectional post contrasted-enhanced T1WI by Image J.Then the mean,standard deviation (SD),minimum,maximum,skewness and kurtosis were calculated respectively.Results Kurtosis of post contrast-enhanced T1WI of metastasis (1.260 ± 1.271) was statistically higher than that of glioblastoma (0.071 ± 0.667)(P＜0.05).When the optimal threshold criterion ofkurtosis was set at 0.736,the areas under ROC curve of kurtosis was 0.792 (95％ CI0.676-0.881),and the sensitivity,specificity,positive predictive value and negative predictive value at the optimum cutoff value were 76.47％,88.24％,80.65％,78.38％,respectively.Conclusion Kurtosis of post contrastenhanced T 1 WI-based histogram is valuable in differential diagnosis of glioblastoma and brain metastasis,and thus provides reliable and objective basis for differentiating the two kinds of tumors.