Open AccessDynamic contrast‐enhanced MRI perfusion for differentiating between melanoma and lung cancer brain metastases
Author(s) -
Hatzoglou Vaios,
Tisnado Jamie,
Mehta Alpesh,
Peck Kyung K.,
Daras Mariza,
Omuro Antonio M.,
Beal Kathryn,
Holodny Andrei I.
Publication year - 2017
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1046
Subject(s) - medicine , melanoma , brain metastasis , lung cancer , receiver operating characteristic , perfusion , cancer , perfusion scanning , mann–whitney u test , nuclear medicine , radiology , pathology , metastasis , cancer research
Brain metastases originating from different primary sites overlap in appearance and are difficult to differentiate with conventional MRI . Dynamic contrast‐enhanced ( DCE )‐ MRI can assess tumor microvasculature and has demonstrated utility in characterizing primary brain tumors. Our aim was to evaluate the performance of plasma volume ( V p) and volume transfer coefficient ( K trans ) derived from DCE ‐ MRI in distinguishing between melanoma and nonsmall cell lung cancer ( NSCLC ) brain metastases. Forty‐seven NSCLC and 23 melanoma brain metastases were retrospectively assessed with DCE ‐ MRI . Regions of interest were manually drawn around the metastases to calculate V p mean and K mean trans . The Mann–Whitney U test and receiver operating characteristic analysis ( ROC ) were performed to compare perfusion parameters between the two groups. The V p mean of melanoma brain metastases (4.35, standard deviation [ SD ] = 1.31) was significantly higher ( P = 0.03) than V p mean of NSCLC brain metastases (2.27, SD = 0.96). The K mean trans values were higher in melanoma brain metastases, but the difference between the two groups was not significant ( P = 0.12). Based on ROC analysis, a cut‐off value of 3.02 for V p mean (area under curve = 0.659 with SD = 0.074) distinguished between melanoma brain metastases and NSCLC brain metastases ( P < 0.01) with 72% specificity. Our data show the DCE ‐ MRI parameter V p mean can differentiate between melanoma and NSCLC brain metastases. The ability to noninvasively predict tumor histology of brain metastases in patients with multiple malignancies can have important clinical implications.