Role of susceptibility-weighted imaging in characterisation of solitary intra-axial-enhancing lesions of brain

Abstract

Background: To evaluate the role of susceptibility-weighted imaging (SWI) using intratumoural susceptibility signals (ITSSs) in characterising and grading intra-axial lesions of the brain. Methods: We prospectively studied 37 consecutive patients with solitary enhancing intra-axial brain lesions on contrast-enhanced magnetic resonance imaging (MRI) who underwent surgery followed by histopathological examination of the specimen at our tertiary care teaching hospital during the period January 2015–August 2016. Results: The mean age was 43.3 ± 15.7 years; there were 21 female. ITSS was detected in glioblastoma multiforme (GBM) (16/16), metastasis (2/6), high-grade glioma (2/2) and low-grade glioma (4/6). ITSS was not detected in granulomas. In semi-quantitative analysis, Grade 3 ITSS was able to differentiate GBM from other lesions (sensitivity = 87.5%; specificity = 86.4%; P < 0.0001). Grade 3 ITSS was able to differentiate GBM and metastasis (sensitivity = 87.5; specificity = 100; P < 0.0001). Conclusion: SWI using ITSSs is useful MRI sequence in characteristing and grading intra-axial bram lessions.

Keywords

• glioblastoma multiforme
• metastasis
• solitary-enhancing lesion
• susceptibility-weighted imaging