Peculiarities of the Application of Diffusion-Curtosis MRI in the Differential Diagnosis of Glial Brain Tumors and Solitary Metastasis

Purpose: To improve  the  differential diagnosis of high-grade gliomas  and solitary  metastases by introducing the diffusion-kurtosis magnetic resonance imaging technique into the MRI scan protocol.

Material and methods: The study included 43 patients who underwent examination and treatment at the N.N. Blokhin  National Research Medical  Center of Oncology from  October 2019 to March  2022, in which, according to magnetic resonance imaging, solitary  formations in the brain  substance were detected. A total of 43 neoplasms were found  in the substance of the brain,  of which:  17 glioblastomas in 17 patients (40 %), 25 solitary  metastatic tumors of lung,  breast, melanoma and kidney  cancer  (60 %). We evaluated the  tumor size, diffusion and kurtosis parameters, such as mean kurtosis (MK), axial kurtosis (AK), radial  kurtosis (RK), kurtosis anisotropy (KA), radial  diffusion (RD), fractional anisotropy (FA), relative  anisotropy (RA), tortuosity of the trajectory (TTD).

Results:  Statistically significant differences (р < 0.05) in  such  parameters of diffusion and  kurtosis in the  tumor as kurtosis anisotropy (KA), fractional anisotropy (FA) and tortuosity of the  trajectory (TT) were revealed.  Significant differences between solitary  metastases and malignant glial tumors based  on diffusion and kurtosis values such as mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), radial diffusion (RD), and relative  anisotropy (RA) (criteria where р > 0.05) was not detected.

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