Dynamic Imaging of Intracranial Lesions Using Fast Spin-Echo Imaging: Differentiation of Brain Tumors and Treatment Effects

J Magn Reson Imaging. Nov-Dec 1997;7(6):1084-93. doi: 10.1002/jmri.1880070622.

Abstract

The purpose of this study was to develop a technique for differentiating between recurrent brain tumors and treatment-related changes, such as radiation necrosis, using dynamic MRI. Ninety-five patients with intracranial mass lesions were evaluated using T1-weighted fast spin-echo (FSE) MRI at 1.5 T. Pathologies included treatment-related changes (n = 32), primary tumors (n = 41), metastatic tumors (n = 5), meningiomas (n = 4), and mixed primary/treatment related changes (n = 13). Signal enhancement-time curves were analyzed by fitting to a sigmoidal-exponential function. Maximal enhancement rates were calculated as the first derivative of the fitted curve. Based on the maximal enhancement rates, treatment-related changes could be differentiated from primary tumors, metastatic tumors, and meningiomas at the P < .05 confidence level. Lesions of mixed tumor and treatment-related change had intermediate values. Dynamic MRI can be used to differentiate treatment-related changes from primary tumors in previously treated patient populations based on maximal enhancement rates. Individual case studies demonstrate the clinical significance of these findings.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Astrocytoma / diagnosis
  • Astrocytoma / therapy
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy*
  • Child
  • Female
  • Glioblastoma / diagnosis
  • Glioblastoma / therapy
  • Glioma / diagnosis
  • Glioma / therapy
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meningioma / diagnosis
  • Meningioma / therapy
  • Middle Aged
  • Pilot Projects
  • Prospective Studies