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MR dynamic-susceptibility-contrast perfusion metrics in the presurgical discrimination of adult solitary intra-axial cerebellar tumors.

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Title: MR dynamic-susceptibility-contrast perfusion metrics in the presurgical discrimination of adult solitary intra-axial cerebellar tumors.
Authors: Pons-Escoda, Albert1,2 (AUTHOR) albert.pons@bellvitgehospital.cat, Garcia-Ruiz, Alonso3 (AUTHOR), Garcia-Hidalgo, Clemente4 (AUTHOR), Gil-Solsona, Ruben5 (AUTHOR), Naval-Baudin, Pablo1 (AUTHOR), Martin-Noguerol, Teodoro6 (AUTHOR), Fernandez-Coello, Alejandro2,7,8 (AUTHOR), Flores-Casaperalta, Susanie1 (AUTHOR), Fernandez-Viñas, Montserrat1 (AUTHOR), Gago-Ferrero, Pablo5 (AUTHOR), Oleaga, Laura9 (AUTHOR), Perez-Lopez, Raquel3 (AUTHOR), Majos, Carles1,2 (AUTHOR)
Source: European Radiology. Dec2023, Vol. 33 Issue 12, p9120-9129. 10p.
Subjects: Magnetic resonance angiography, Cerebellar tumors, Perfusion, Blood volume, Central nervous system tumors
Abstract: Objectives: Adult solitary intra-axial cerebellar tumors are uncommon. Their presurgical differentiation based on neuroimaging is crucial, since management differs substantially. Comprehensive full assessment of MR dynamic-susceptibility-contrast perfusion-weighted imaging (DSC-PWI) may reveal key differences between entities. This study aims to provide new insights on perfusion patterns of these tumors and to explore the potential of DSC-PWI in their presurgical discrimination. Methods: Adult patients with a solitary cerebellar tumor on presurgical MR and confirmed histological diagnosis of metastasis, medulloblastoma, hemangioblastoma, or pilocytic astrocytoma were retrospectively retrieved (2008–2023). Volumetric segmentation of tumors and normal-appearing white matter (for normalization) was semi-automatically performed on CE-T1WI and coregistered with DSC-PWI. Mean normalized values per patient tumor-mask of relative cerebral blood volume (rCBV), percentage of signal recovery (PSR), peak height (PH), and normalized time-intensity curves (nTIC) were extracted. Statistical comparisons were done. Then, the dataset was split into training (75%) and test (25%) cohorts and a classifier was created considering nTIC, rCBV, PSR, and PH in the model. Results: Sixty-eight patients (31 metastases, 13 medulloblastomas, 13 hemangioblastomas, and 11 pilocytic astrocytomas) were included. Relevant differences between tumor types' nTICs were demonstrated. Hemangioblastoma showed the highest rCBV and PH, pilocytic astrocytoma the highest PSR. All parameters showed significant differences on the Kruskal–Wallis tests (p < 0.001). The classifier yielded an accuracy of 98% (47/48) in the training and 85% (17/20) in the test sets. Conclusions: Intra-axial cerebellar tumors in adults have singular and significantly different DSC-PWI signatures. The combination of perfusion metrics through data-analysis rendered excellent accuracies in discriminating these entities. Clinical relevance statement: In this study, the authors constructed a classifier for the non-invasive imaging presurgical diagnosis of adult intra-axial cerebellar tumors. The resultant tool can be a support for decision-making in the clinical practice and enables optimal personalized patient management. Key Points: • Adult intra-axial cerebellar tumors exhibit specific, singular, and statistically significant different MR dynamic-susceptibility-contrast perfusion-weighted imaging (DSC-PWI) signatures. • Data-analysis, applied to MR DSC-PWI, could provide added value in the presurgical diagnosis of solitary cerebellar metastasis, medulloblastoma, hemangioblastoma, and pilocytic astrocytoma. • A classifier based on DSC-PWI metrics yields excellent accuracy rates and could be used as a support tool for radiologic diagnosis with clinician-friendly displays. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: MR dynamic-susceptibility-contrast perfusion metrics in the presurgical discrimination of adult solitary intra-axial cerebellar tumors.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pons-Escoda%2C+Albert%22&quot;&gt;Pons-Escoda, Albert&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; albert.pons@bellvitgehospital.cat&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Garcia-Ruiz%2C+Alonso%22&quot;&gt;Garcia-Ruiz, Alonso&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Garcia-Hidalgo%2C+Clemente%22&quot;&gt;Garcia-Hidalgo, Clemente&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gil-Solsona%2C+Ruben%22&quot;&gt;Gil-Solsona, Ruben&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Naval-Baudin%2C+Pablo%22&quot;&gt;Naval-Baudin, Pablo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Martin-Noguerol%2C+Teodoro%22&quot;&gt;Martin-Noguerol, Teodoro&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fernandez-Coello%2C+Alejandro%22&quot;&gt;Fernandez-Coello, Alejandro&lt;/searchLink&gt;&lt;relatesTo&gt;2,7,8&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Flores-Casaperalta%2C+Susanie%22&quot;&gt;Flores-Casaperalta, Susanie&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fernandez-Vi&#241;as%2C+Montserrat%22&quot;&gt;Fernandez-Vi&#241;as, Montserrat&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gago-Ferrero%2C+Pablo%22&quot;&gt;Gago-Ferrero, Pablo&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oleaga%2C+Laura%22&quot;&gt;Oleaga, Laura&lt;/searchLink&gt;&lt;relatesTo&gt;9&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Perez-Lopez%2C+Raquel%22&quot;&gt;Perez-Lopez, Raquel&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Majos%2C+Carles%22&quot;&gt;Majos, Carles&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Dec2023, Vol. 33 Issue 12, p9120-9129. 10p.
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  Data: Objectives: Adult solitary intra-axial cerebellar tumors are uncommon. Their presurgical differentiation based on neuroimaging is crucial, since management differs substantially. Comprehensive full assessment of MR dynamic-susceptibility-contrast perfusion-weighted imaging (DSC-PWI) may reveal key differences between entities. This study aims to provide new insights on perfusion patterns of these tumors and to explore the potential of DSC-PWI in their presurgical discrimination. Methods: Adult patients with a solitary cerebellar tumor on presurgical MR and confirmed histological diagnosis of metastasis, medulloblastoma, hemangioblastoma, or pilocytic astrocytoma were retrospectively retrieved (2008–2023). Volumetric segmentation of tumors and normal-appearing white matter (for normalization) was semi-automatically performed on CE-T1WI and coregistered with DSC-PWI. Mean normalized values per patient tumor-mask of relative cerebral blood volume (rCBV), percentage of signal recovery (PSR), peak height (PH), and normalized time-intensity curves (nTIC) were extracted. Statistical comparisons were done. Then, the dataset was split into training (75%) and test (25%) cohorts and a classifier was created considering nTIC, rCBV, PSR, and PH in the model. Results: Sixty-eight patients (31 metastases, 13 medulloblastomas, 13 hemangioblastomas, and 11 pilocytic astrocytomas) were included. Relevant differences between tumor types&#39; nTICs were demonstrated. Hemangioblastoma showed the highest rCBV and PH, pilocytic astrocytoma the highest PSR. All parameters showed significant differences on the Kruskal–Wallis tests (p &lt; 0.001). The classifier yielded an accuracy of 98% (47/48) in the training and 85% (17/20) in the test sets. Conclusions: Intra-axial cerebellar tumors in adults have singular and significantly different DSC-PWI signatures. The combination of perfusion metrics through data-analysis rendered excellent accuracies in discriminating these entities. Clinical relevance statement: In this study, the authors constructed a classifier for the non-invasive imaging presurgical diagnosis of adult intra-axial cerebellar tumors. The resultant tool can be a support for decision-making in the clinical practice and enables optimal personalized patient management. Key Points: • Adult intra-axial cerebellar tumors exhibit specific, singular, and statistically significant different MR dynamic-susceptibility-contrast perfusion-weighted imaging (DSC-PWI) signatures. • Data-analysis, applied to MR DSC-PWI, could provide added value in the presurgical diagnosis of solitary cerebellar metastasis, medulloblastoma, hemangioblastoma, and pilocytic astrocytoma. • A classifier based on DSC-PWI metrics yields excellent accuracy rates and could be used as a support tool for radiologic diagnosis with clinician-friendly displays. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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              Text: Dec2023
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