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Edema is not a reliable diagnostic sign to exclude small brain metastases

No prior systematic study on the extent of vasogenic edema (VE) in patients with brain metastases (BM) exists. Here, we aim to determine 1) the general volumetric relationship between BM and VE, 2) a threshold diameter above which a BM shows VE, and 3) the influence of the primary tumor and location...

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Autores principales: Schneider, Tanja, Kuhne, Jan Felix, Bittrich, Paul, Schroeder, Julian, Magnus, Tim, Mohme, Malte, Grosser, Malte, Schoen, Gerhard, Fiehler, Jens, Siemonsen, Susanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426632/
https://www.ncbi.nlm.nih.gov/pubmed/28493907
http://dx.doi.org/10.1371/journal.pone.0177217
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author Schneider, Tanja
Kuhne, Jan Felix
Bittrich, Paul
Schroeder, Julian
Magnus, Tim
Mohme, Malte
Grosser, Malte
Schoen, Gerhard
Fiehler, Jens
Siemonsen, Susanne
author_facet Schneider, Tanja
Kuhne, Jan Felix
Bittrich, Paul
Schroeder, Julian
Magnus, Tim
Mohme, Malte
Grosser, Malte
Schoen, Gerhard
Fiehler, Jens
Siemonsen, Susanne
author_sort Schneider, Tanja
collection PubMed
description No prior systematic study on the extent of vasogenic edema (VE) in patients with brain metastases (BM) exists. Here, we aim to determine 1) the general volumetric relationship between BM and VE, 2) a threshold diameter above which a BM shows VE, and 3) the influence of the primary tumor and location of the BM in order to improve diagnostic processes and understanding of edema formation. This single center, retrospective study includes 173 untreated patients with histologically proven BM. Semi-manual segmentation of 1416 BM on contrast-enhanced T1-weighted images and of 865 VE on fluid-attenuated inversion recovery/T2-weighted images was conducted. Statistical analyses were performed using a paired-samples t-test, linear regression/generalized mixed-effects model, and receiver-operating characteristic (ROC) curve controlling for the possible effect of non-uniformly distributed metastases among patients. For BM with non-confluent edema (n = 545), there was a statistically significant positive correlation between the volumes of the BM and the VE (P < 0.001). The optimal threshold for edema formation was a diameter of 9.4 mm for all BM. The primary tumors as interaction term in multivariate analysis had a significant influence on VE formation whereas location had not. Hence VE development is dependent on the volume of the underlying BM and the site of the primary neoplasm, but not from the location of the BM.
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spelling pubmed-54266322017-05-25 Edema is not a reliable diagnostic sign to exclude small brain metastases Schneider, Tanja Kuhne, Jan Felix Bittrich, Paul Schroeder, Julian Magnus, Tim Mohme, Malte Grosser, Malte Schoen, Gerhard Fiehler, Jens Siemonsen, Susanne PLoS One Research Article No prior systematic study on the extent of vasogenic edema (VE) in patients with brain metastases (BM) exists. Here, we aim to determine 1) the general volumetric relationship between BM and VE, 2) a threshold diameter above which a BM shows VE, and 3) the influence of the primary tumor and location of the BM in order to improve diagnostic processes and understanding of edema formation. This single center, retrospective study includes 173 untreated patients with histologically proven BM. Semi-manual segmentation of 1416 BM on contrast-enhanced T1-weighted images and of 865 VE on fluid-attenuated inversion recovery/T2-weighted images was conducted. Statistical analyses were performed using a paired-samples t-test, linear regression/generalized mixed-effects model, and receiver-operating characteristic (ROC) curve controlling for the possible effect of non-uniformly distributed metastases among patients. For BM with non-confluent edema (n = 545), there was a statistically significant positive correlation between the volumes of the BM and the VE (P < 0.001). The optimal threshold for edema formation was a diameter of 9.4 mm for all BM. The primary tumors as interaction term in multivariate analysis had a significant influence on VE formation whereas location had not. Hence VE development is dependent on the volume of the underlying BM and the site of the primary neoplasm, but not from the location of the BM. Public Library of Science 2017-05-11 /pmc/articles/PMC5426632/ /pubmed/28493907 http://dx.doi.org/10.1371/journal.pone.0177217 Text en © 2017 Schneider et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schneider, Tanja
Kuhne, Jan Felix
Bittrich, Paul
Schroeder, Julian
Magnus, Tim
Mohme, Malte
Grosser, Malte
Schoen, Gerhard
Fiehler, Jens
Siemonsen, Susanne
Edema is not a reliable diagnostic sign to exclude small brain metastases
title Edema is not a reliable diagnostic sign to exclude small brain metastases
title_full Edema is not a reliable diagnostic sign to exclude small brain metastases
title_fullStr Edema is not a reliable diagnostic sign to exclude small brain metastases
title_full_unstemmed Edema is not a reliable diagnostic sign to exclude small brain metastases
title_short Edema is not a reliable diagnostic sign to exclude small brain metastases
title_sort edema is not a reliable diagnostic sign to exclude small brain metastases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426632/
https://www.ncbi.nlm.nih.gov/pubmed/28493907
http://dx.doi.org/10.1371/journal.pone.0177217
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