Intracerebral metastasis showing restricted diffusion: Correlation with histopathologic findings
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Date
2010
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Abstract
Objective: We aimed to detect the frequency of restricted diffusion in intracerebral metastases and to find whether there is correlation between the primary tumor pathology and diffusion-weighted MR imaging (DWI) findings of these metastases. Material and methods: 87 patients with intracerebral metastases were examined with routine MR imaging and DWI. 11 hemorrhagic metastatic lesions were excluded. The routine MR imaging included three plans before and after contrast enhancement. The DWI was performed with spin-echo EPI sequence with three b values (0, 500 and 1000), and ADC maps were calculated. 76 patients with metastases were grouped according to primary tumor histology and the ratios of restricted diffusion were calculated according to these groups. ADCmin values were measured within the solid components of the tumors and the ratio of metastases with restricted diffusion to that which do not show restricted diffusion were calculated. Fisher's exact and Mann-Whitney U tests were used for the statistical analysis. Results: Restricted diffusion was observed in a total of 15 metastatic lesions (19, 7%). Primary malignancy was lung carcinoma in 10 of these cases (66, 6%) (5 small cell carcinoma, 5 non-small cell carcinoma), and breast carcinoma in three cases (20%). Colon carcinoma and testicular teratocarcinoma were the other two primary tumors in which restricted diffusion in metastasis was detected. There was no statistical significant difference between the primary pathology groups which showed restricted diffusion (p > 0.05). ADCmin values of solid components of the metastasis with restricted diffusion and other metastasis without restricted diffusion also showed no significant statistical difference (0.72 ± 0.16 × 10-3 mm2/s and 0.78 ± 21 × 10-3 mm2/s respectively) (p = 0.325). Conclusion: Detection of restricted diffusion on DWI in intracerebral metastasis is not rare, particularly if the primary tumor is lung or breast cancer. However we found that there is no correlation between the metastasis showing restricted diffusion and primary pathology. Prospective studies with larger groups and more information are necessary regarding the correlation between the primary tumor histopathology and the ADC values of metastasis with restricted diffusion. © 2009 Elsevier Ireland Ltd. All rights reserved.
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Brain Neoplasms , Diffusion Magnetic Resonance Imaging , Humans , Biological organs , Diffusion , Magnetic resonance , Magnetic resonance imaging , Medical imaging , Multicarrier modulation , Statistical tests , Tumors , B value , Before and after , Breast Cancer , Breast carcinomas , Cell carcinoma , Colon carcinoma , Contrast Enhancement , Lung carcinoma , Mann-Whitney U test , Metastatic lesions , MR imaging , Prospective study , Restricted diffusion , Solid components , Spin echo , Statistical analysis , Statistical differences , adolescent , adult , aged , article , brain metastasis , breast carcinoma , colon carcinoma , contrast enhancement , diffusion weighted imaging , female , histopathology , human , human tissue , lung non small cell cancer , lung small cell cancer , major clinical study , male , primary tumor , priority journal , testis teratoma , Pathology