Differentiation of Primary CNS lymphoma and High-grade glioma with Dynamic Susceptibility Contrast derived metrics: A Pilot Study.

Abstract Objectives Preoperative differentiation of lymphoma from other aggressive intracranial neoplasms is important as the surgical and adjuvant therapy may be fundamentally different between the two types of tumours. The purpose of this study was to assess the ability of the dynamic susceptibility contrast (DSC) derived metrics, percentage signal recovery (PSR) ratio and relative cerebral blood volume (rCBV), to distinguish between primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG). Methods 26 patients (15 with HGG and 11 with PCNSL) with histologically confirmed diagnoses were retrospectively analysed. Mean PSR and rCBV were calculated from DSC imaging. The two groups were compared using independent samples t-test. ROC analyses were performed to determine the area under the curve (AUC) and identify threshold values to differentiate PCNSL from GBM. Results Both rCBV and PSR values were significantly different, both at the group level and at the subject level, between the PCNSL and HGG patients. The mean rCBV was significantly lower in PCNSL (1.38+/- 0.64) compared to HGG (5.19 +/- 2.21, df=11.24, p Conclusion The findings of our study show that rCBV and PSR ratio are different in HGG and PCNSL both at group level as well as at the subject level. Incorporation of perfusion in routine MR imaging of contrast enhancing lesions can have a significant impact on patient management.