Multiple diffusion metrics in differentiating solid glioma from brain inflammation
Kai Zhao, Ankang Gao, Eryuan Gao, Jinbo Qi, Ting Chen, Guohua Zhao, Gaoyang Zhao, Peipei Wang, Weijian Wang, Jie Bai, Yong Zhang, Huiting Zhang, Guang Yang, Xiaoyue Ma, Jingliang Cheng
Abstract
Background and purpose: The differential diagnosis between solid glioma and brain inflammation is necessary but sometimes difficult. We assessed the effectiveness of multiple diffusion metrics of diffusion-weighted imaging (DWI) in differentiating solid glioma from brain inflammation and compared the diagnostic performance of different DWI models. Materials and methods: ) in 30 directions for each b value, and one b value of 0 was included. The mean values of multiple diffusion metrics based on diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), mean apparent propagator (MAP), and neurite orientation dispersion and density imaging (NODDI) in the abnormal signal area were calculated. Comparisons between glioma and inflammation were performed. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) of diffusion metrics were calculated. Results: 57 patients (39 patients with glioma and 18 patients with inflammation) were finally included. MAP model, with its metric non-Gaussianity (NG), shows the greatest diagnostic performance (AUC = 0.879) for differentiation of inflammation and glioma with atypical MRI manifestation. The AUC of DKI model, with its metric mean kurtosis (MK) are comparable to NG (AUC = 0.855), followed by NODDI model with intracellular volume fraction (ICVF) (AUC = 0.825). The lowest value was obtained in DTI with mean diffusivity (MD) (AUC = 0.758). Conclusion: Multiple diffusion metrics can be used in differentiation of inflammation and solid glioma. Non-Gaussianity (NG) from mean apparent propagator (MAP) model shows the greatest diagnostic performance for differentiation of inflammation and glioma.