DIFFERENTIATION BETWEEN BRAIN TUMOR RECURRENCE AND RADIATION INJURY USING DIFFUSION-WEIGHTED IMAGING AND PERFUSION MAGNETIC RESONANCE IMAGING: THE COMPARATIVE STUDY

The aim of the study was to compare the diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) and T2* MR-perfusion in differential diagnosis between recurrent brain tumor (RT) and post-radiation injury (PRI). We retrospectively reviewed 33 patients with brain tumors after radiation therapy (male - 16, female - 17, mean age = 40±16 years). Entry criteria included new or progressive MR imaging enhancing lesions after treatment. Conventional MRI (T1, T2, FLAIR, post-gadolinium T1-weighted images) DWI and T2* MR-perfusion were performed.The lesions were grouped according to MR enhancement that was due either TR (n=29) or PRI (n=26).The data analysis included calculation of the apperent diffusion coeficient (ADC) and rCVB values in the enhancing lesions. The rCBV values were normalized to the normal appearing grey matter. Recurrence and nonrecurrence groups were compared by means of Mann-Whitney U-test. The level of P<0,05 was set as significant. The total count of 55 enhancing lesions was analased. The recurrence group showed statistically significant lower ADC values and higher rCBV values than group with PRI. ADC threshold ratio equal to 1056 provided a distinction between the RT and the PRI with 69% sensitivity and 92% specificity. rCBV threshold ratio equal to 0,8 provided a distinction between the RT and the PRI with 92% sensitivity and 95% specificity. Thus, DWI has lower sensitivity in distinction RT from PRI than T2* MR-perfusion.

опухоль головного мозга, лучевая терапия, диффузионно-взвешенная МРТ, Т2* МР-перфузия, лучевое поражение, brain tumor, radiation therapy, diffusion-weighted magnetic resonance imaging, Т2* МR-perfusion, post-radiation injury

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