Frontiers in Neuroscience (Jan 2024)

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

DOI
https://doi.org/10.3389/fnins.2023.1320296
Journal volume & issue
Vol. 17

Abstract

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Background and purposeThe 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 methodsParticipants diagnosed with either glioma or brain inflammation with a solid lesion on MRI were enrolled in this prospective study from May 2016 to April 2023. Diffusion-weighted imaging was performed using a spin-echo echo-planar imaging sequence with five b values (500, 1,000, 1,500, 2000, and 2,500 s/mm2) 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.Results57 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).ConclusionMultiple 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.

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