Analysis of fractional anisotropy facilitates differentiation of glioblastoma and brain metastases in a clinical setting

Stefanie Bette, Thomas Huber, Benedikt Wiestler, Tobias Boeckh-Behrens, Jens Gempt, Florian Ringel, Bernhard Meyer, Claus Zimmer, Jan S. Kirschke

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Purpose Differentiating glioblastoma from brain metastases is important for therapy planning. Diffusion tensor imaging (DTI) was described as a promising tool, however with conflicting results. Aim of this study was to analyze the clinical utility of DTI for the differentiation of brain metastases and glioblastoma. Methods 294 patients (165 glioblastoma, 129 brain metastases) with preoperative DTI were included in this retrospective study. Fractional anisotropy (FA) was measured via regions of interest (ROIs) in the contrast-enhancing tumor, the necrosis and the FLAIR-hyperintense non-enhancing peritumoral region (NEPTR). Two neuroradiologists classified patient cases as glioblastoma or brain metastases without and with knowledge of FA values. Results Glioblastoma showed significantly higher FAcontrast (median glioblastoma = 0.33, metastases = 0.23; P < 0.001) whereas no significant difference was observed for FANEPTR (0.21 vs. 0.22; P = 0.28) and for FAnecrosis (0.17 vs. 0.18, P = 0.37). FA improved diagnostic accuracy of the neuroradiologists significantly from an AUC of 0.84/0.85 (Reader1/Reader2) to 0.89/0.92. Conclusions Glioblastoma show significantly higher FA values in the contrast enhancing tumor part than brain metastases. Implementation of a ROI-based measurement of FA values and FA color maps in clinical routine helps to differentiate between glioblastoma and brain metastases.

Original languageEnglish
Pages (from-to)2182-2187
Number of pages6
JournalEuropean Journal of Radiology
Volume85
Issue number12
DOIs
StatePublished - 1 Dec 2016

Keywords

  • Brain metastases
  • Diffusion tensor imaging
  • Fractional anisotropy
  • Glioblastoma

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