THE ROLE OF DIFFUSION-WEIGHTED MRI IN DIFFERENTIAL DIAGNOSIS AND PREDICTION OF SURVIVAL IN PATIENTS WITH BRAIN METASTASES

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Abstract

Background: Brain metastases are observed in up to 40% of all intracranial tumors. Some types of metastatic tumors cause difficulties in differential diagnosis, since they have similar signal characteristics with other pathological entities in neuroimaging. Obviously, the additional diagnostic methods to determine the prognosis and tactics of further management of this group of patients should be implemented.

Aim: To study the role of diffusion-weighted magnetic resonance imaging (MRI) in differential diagnostics and predicting the survival rate in patients with brain metastases. Materials and methods: The study included data from MRI and morphological studies of 23 patients with brain metastases. The obtained values of the apparent diffusion coefficient (ADC) of tumors were compared with their histological type, cell density, and the index of proliferative activity Ki-67. In addition, the influence of ADC values on the overall survival rate was assessed.

Results: A reliable inverse correlation of ADC values and the index of proliferative activity for various types of brain metastases (r=-0.74, p=0.014) was established. The dependence of ADC values and overall survival rate of patients with metastases in the brain is presented. The overall survival rate in patients with an ADC value greater than 947.2 mm2/sec was 9.8 months (95% CI: 8.6−11.3), and with ADC value less than 947.2 mm2/sec ― 6.4 months (95% CI: 3.7−9.1).

Conclusion: The technique of diffusion-weighted MRI plays an important role in the differential diagnosis of brain metastases; it can be used as a tool of comprehensive preoperative assessment when planning the surgery and as a prognostic factor of overall survival rate for this group of patients. 

About the authors

V. A. Byvaltsev

Irkutsk State Medical University; Railway Clinical Hospital on the station Irkutsk-Passazhirskiy of Russian Railways Ltd.; Irkutsk Scientifi c Center of Surgery and Traumatology; Irkutsk State Academy of Postgraduate Education; Institute of Nuclear Physics n.a. G.I. Budker of the SB RAS

Email: byval75vadim@yandex.ru
ORCID iD: 0000-0003-4349-7101

Доктор медицинских наук, главный нейрохирург Дирекции здравоохранения ОАО «РЖД»; руководитель Центра нейрохирургии ДКБ на ст. Иркутск-Пассажирский ОАО «РЖД-Медицина»; заведующий курсом нейрохирургии ИГМУ; заведующий научно-клиническим отделом нейрохирургии и ортопедии ИНЦХТ; профессор кафедры травматологии, ортопедии и нейрохирургии ИГМАПО; ведущий научный сотрудник ИЯФ им. Г.И. Будкера.

664082, Иркутск, ул. Боткина, д. 10, тел.: +7 (3952) 63-85-28, SPIN-код: 5996-6477

Россия

I. A. Stepanov

Irkutsk State Medical University

Author for correspondence.
Email: edmoilers@mail.ru
ORCID iD: 0000-0001-9039-9147

Аспирант курса нейрохирургии ИГМУ.

664003, Иркутск, ул. Красного Восстания, д. 14, тел.: +7 (3952) 63-88-30, SPIN-код: 5485-5316

Россия

A. I. Kichigin

Irkutsk State Medical University; Institute of Nuclear Physics n.a. G.I. Budker of the SB RAS

Email: sam@211.ru
ORCID iD: 0000-0001-8763-2905

аспирант курса нейрохирургии Иркутского медицинского университета, стажер-исследователь Института ядерной физики им. Г.И. Будкера СО РАН, SPIN-код: 4321-2422

Россия

V. V. Kanigin

Institute of Nuclear Physics n.a. G.I. Budker of the SB RAS; Novosibirsk State Medical University

Email: kanigin@mail.ru
ORCID iD: 0000-0003-3533-6076

Врач-нейрохирург, кандидат медицинских наук, доцент, заведующий лабораторией медико-биологических проблем бор-нейтронзахватной терапии НГУ.

 

630090, Новосибирск, ул. Пирогова, д. 2, тел.: +7 (3833) 63-43-33, SPIN-код: 4211-2417

Россия

V. V. Stupak

Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya. L. Tsivyan

Email: vstupak@niito.ru
ORCID iD: 0000-0002-6074-6248

Доктор медицинских наук, профессор, руководитель клиники нейрохирургии ННИИТО им. Я.Л. Цивьяна.

 

630091, Новосибирск, ул. Фрунзе, д. 17, тел.: +7 (3833) 63-31-31, SPIN-код: 4111-2527

Россия

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