Differentiation among Glioblastoma Multiforme, Solitary Metastatic Tumor, and Lymphoma Using Whole-Tumor Histogram Analysis of the Normalized Cerebral Blood Volume in Enhancing and Perienhancing Lesions

BACKGROUND AND PURPOSE: The histogram method has been shown to demonstrate heterogeneous morphologic features of tumor vascularity. This study aimed to determine whether whole-tumor histogram analysis of the normalized CBV for contrast-enhancing lesions and perienhancing lesions can differentiate among GBMs, SMTs, and lymphomas.

MATERIALS AND METHODS: Fifty-nine patients with histopathologically confirmed GBMs (n = 28), SMTs (n = 22), or lymphomas (n = 12) underwent conventional MR imaging and dynamic susceptibility contrast-enhanced imaging before surgery. Histogram distribution of the normalized CBV was obtained from whole-tumor voxels in contrast-enhancing lesions and perienhancing lesions. The HW, PHP, and MV were determined from histograms. One-way ANOVA was used initially to test the overall equality of mean values for each type of tumor. Subsequently, posttest multiple comparisons were performed.

RESULTS: For whole-tumor histogram analyses for contrast-enhancing lesions, only PHP could differentiate among GBMs (4.79 ± 1.31), SMTs (3.32 ± 1.10), and lymphomas (2.08 ± 0.54). The parameters HW and MV were not significantly different between GBMs and SMTs, whereas the 2 histogram parameters were significantly higher in GBMs and SMTs compared with lymphomas. For the analyses of perienhancing lesions, only MV could differentiate among GBMs (1.90 ± 0.26), SMTs (0.80 ± 0.21), and lymphomas (1.27 ± 0.34). HW and PHP were not significantly different between SMTs and lymphomas.

CONCLUSIONS: Using a whole-tumor histogram analysis of normalized CBV for contrast-enhancing lesions and perienhancing lesions facilitates differentiation of GBMs, SMTs and lymphomas.