Performance of Apparent Diffusion Coefficient Values and Conventional MRI Features in Differentiating Tumefactive Demyelinating Lesions From XXXX .

@entity1 @entity706 @entity1313 @entity75 @entity11
OBJECTIVE: Tumefactive demyelinating lesions (TDLs) remain one of the most common @entity75 to mimic a @entity1313 , particularly primary @entity706 (PCNSL) and high-grade @entity11 . The purpose of our study was to evaluate the ability of apparent diffusion coefficient (ADC) values and conventional MRI features to differentiate TDLs from PCNSLs and high-grade @entity11 . MATERIALS AND METHODS: Seventy-five @entity1 (24 @entity1 with TDLs, 28 with PCNSLs, and 23 with high-grade @entity11 ) with 168 @entity75 (70 TDLs, 68 PCNSLs, and 30 high-grade @entity11 ) who underwent DWI before surgery or therapy were included in the study. Minimum ADC (ADCmin) and average ADC (ADCavg) values were calculated for each lesion. ANOVA and ROC analyses were performed. ROC analyses were also performed for the presence of incomplete rim enhancement and for the number of lesions. Multiple-variable logistic regression with ROC analysis was then performed to evaluate performance in multiple-variable models. RESULTS: ADCmin was statistically significantly higher (p < 0.01) in TDLs (mean, 0.886; 95% CI, 0.802-0.931) than in PCNSLs (0.547; 95% CI, 0.496-0.598) and high-grade @entity11 (0.470; 95% CI, 0.385-0.555). (All ADC values in this article are reported in units of * 10(-3) mm(2)/s.) ADCavg was statistically significantly higher (p < 0.01) in TDLs (mean, 1.362; 95% CI, 1.268-1.456) than in PCNSLs (0.990; 95% CI, 0.919-1.061) but not in high-grade @entity11 (1.216; 95% CI, 1.074-1.356). Multiple-variable models showed statistically significant individual effects and superior diagnostic performance on ROC analysis. CONCLUSION: TDLs can be diagnosed on preoperative MRI with a high degree of specificity; MRI features of incomplete rim enhancement, high ADC values, and a large number of lesions individually increase the probability and diagnostic confidence that a lesion is a TDL.
