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PT  - JOURNAL ARTICLE
AU  - She, D.
AU  - Yang, X.
AU  - Xing, Z.
AU  - Cao, D.
TI  - Differentiating Hemangioblastomas from Brain Metastases Using Diffusion-Weighted Imaging and Dynamic Susceptibility Contrast-Enhanced Perfusion-Weighted MR Imaging
AID  - 10.3174/ajnr.A4809
DP  - 2016 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1844--1850
VI  - 37
IP  - 10
4099  - http://www.ajnr.org/content/37/10/1844.short
4100  - http://www.ajnr.org/content/37/10/1844.full
SO  - Am. J. Neuroradiol.2016 Oct 01; 37
AB  - BACKGROUND AND PURPOSE: On DWI and DSC-PWI, hemangioblastomas and brain metastases may exhibit different signal intensities depending on their cellularity and angiogenesis. The purpose of this study was to evaluate whether a hemangioblastoma can be differentiated from a single brain metastasis with DWI and DSC-PWI.MATERIALS AND METHODS: We retrospectively reviewed DWI, DSC-PWI, and conventional MR imaging of 21 patients with hemangioblastomas and 30 patients with a single brain metastasis. Variables of minimum ADC and relative ADC were acquired by DWI and the parameter of relative maximum CBV, by DSC-PWI. Minimum ADC, relative ADC, and relative maximum CBV values were compared between hemangioblastomas and brain metastases by using the nonparametric Mann-Whitney test. The sensitivity, specificity, positive and negative predictive values, accuracy, and the area under the receiver operating characteristic curve were determined.RESULTS: Both the minimum ADC values and relative ADC ratios were significantly higher in hemangioblastomas compared with brain metastases (P &amp;lt; .001 for both minimum ADC values and relative ADC ratios). The same was true for the relative maximum CBV ratio (P &amp;lt; .002). The threshold value of ≥6.59 for relative maximum CBV provided sensitivity, specificity, and accuracy of 95.24%, 53.33%, and 70.59%, respectively, for differentiating hemangioblastomas from brain metastases. Compared with relative maximum CBV, relative ADC had high sensitivity (95.24%), specificity (96.67%), and accuracy (96.08%) using the threshold value of ≥1.54. The optimal threshold value for minimum ADC was ≥1.1 × 10−3 mm2/s.CONCLUSIONS: DWI and DSC-PWI are helpful in the characterization and differentiation of hemangioblastomas from brain metastases. DWI appears to be the most efficient MR imaging technique for providing a distinct differentiation of the 2 tumor types.ADCminminimum ADCrADCrelative ADCrCBVrelative CBVrCBVmaxrelative maximum CBVROCreceiver operating characteristicAUCarea under the curve