Differential diagnostic efficacy of tumor vascular habitats based on DSC-PWI between glioblastoma and solitary metastatic brain tumors

LI Xuan; WANG Hanwei; ZENG Linlan; ZHAO Mimi; FENG Ling; XIE Huan; RAN Qisheng; MA Qiang; WANG Shunan

doi:10.16016/j.2097-0927.202509101

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Differential diagnostic efficacy of tumor vascular habitats based on DSC-PWI between glioblastoma and solitary metastatic brain tumors

Clinical Medicine | 更新时间：2025-12-30

- Differential diagnostic efficacy of tumor vascular habitats based on DSC-PWI between glioblastoma and solitary metastatic brain tumors
- Journal of Army Medical University Vol. 47, Issue 24, Pages: 3102-3111(2025)
- 作者机构：
  
  1.陆军军医大学大坪医院放射科，重庆
  2.重庆市影像学与核医学临床研究中心，重庆
  3.陆军军医大学大坪医院病理科，重庆
- 作者简介：
  
  WANG Shunan，E-mail： wangshunan@tmmu.edu.cn
- 基金信息：
  
  the Joint Medical Research Project of Chongqing Science and Technology Commission and Chongqing Health Commission(2025QNXM014)
- DOI：10.16016/j.2097-0927.202509101
  CLC： R445.2;R447;R739.41
- Received：30 September 2025，
  
  Revised：2025-12-25，
  
  Published：30 December 2025
- 稿件说明：
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李轩，王瀚苇，曾琳岚，等.基于磁共振DSC-PWI构建的肿瘤血管生境对胶质母细胞瘤和单发脑转移瘤鉴别诊断效能的研究［J］.陆军军医大学学报，2025，47（24）：3102-3111.DOI：,10.16016/j.2097-0927.202509101.

LI X，WANG H W，ZENG L L，,et al.Differential diagnostic efficacy of tumor vascular habitats based on DSC-PWI between glioblastoma and solitary metastatic brain tumors［J］.J Army Med Univ，2025，47（24）：3102-3111.DOI：,10.16016/j.2097-0927.202509101.
李轩，王瀚苇，曾琳岚，等.基于磁共振DSC-PWI构建的肿瘤血管生境对胶质母细胞瘤和单发脑转移瘤鉴别诊断效能的研究［J］.陆军军医大学学报，2025，47（24）：3102-3111.DOI：,10.16016/j.2097-0927.202509101. DOI：

LI X，WANG H W，ZENG L L，,et al.Differential diagnostic efficacy of tumor vascular habitats based on DSC-PWI between glioblastoma and solitary metastatic brain tumors［J］.J Army Med Univ，2025，47（24）：3102-3111.DOI：,10.16016/j.2097-0927.202509101. DOI：

摘要

目的

探讨基于磁共振动态磁敏感对比增强灌注加权成像（dynamic susceptibility contrast-enhanced perfusion weighted imaging，DSC-PWI）构建的肿瘤血管生境特征参数对初诊胶质母细胞瘤（Glioblastoma，GBM）和单发脑转移瘤（solitary brain metastasis，SBM）的鉴别诊断价值。

方法

采用病例对照研究方法，回顾性分析中国人民解放军陆军特色医学中心放射科2019年1月至2025年3月期间经术后病理证实或临床综合诊断的109例恶性脑肿瘤患者（其中胶质母细胞瘤57例，单发脑转移瘤52例）的影像学资料。基于DSC-PWI图像，采用血流动力学组织特征（hemodynamic tissue signature，HTS）法分割病灶并构建4种肿瘤血管生境，分别为增强区高血管生境（high angiogenic tumor，HAT）、增强区低血管生境（low angiogenic tumor，LAT）、肿瘤浸润性水肿（potentially infiltrated peripheral edema，IPE）和瘤周血管源性水肿区（vasogenic peripheral edema，VPE）。计算各生境区域体积参数和血流参数，包括各生境区域体积、肿瘤核心体积、瘤周水肿体积和相对脑血容量值（relative cerebral blood volume，rCBV），比较两组患者基线资料和生境特征参数，绘制受试者工作特征（receiver operating characteristic，ROC）曲线评估鉴别诊断效能。运用Pearson相关性分析判断各生境特征参数间的相关性以量化各生境间的空间相互作用。

结果

胶质母细胞瘤组HAT、LAT、IPE、VPE四种生境区域的rCBV中位值（rCBV

median

）分别为6.143±1.687（95%

：5.695~6.591）、3.249±0.988（95%

：2.987~3.511）、1.913（1.578，2.588）（95%

：1.794~2.110）、0.836（0.676，1.110）（95%

：0.710~0.949）。均高于单发脑转移瘤组的rCBV

median

值［4.634±1.647（95%

：4.175~5.092）、2.255±0.807（95%

：2.031~2.480）、1.291（1.022，1.767）（95%

：1.125~1.677）、0.600（0.459，0.742）（95%

：0.519~0.682）］（

0.001）。经ROC曲线分析，LAT中rCBV

median

值具有良好的鉴别诊断效能，其AUC值为0.792（95%

：0.704~0.864），最佳截断值为2.660（敏感性：75.44%，特异性：78.85%），（

0.001）。胶质母细胞瘤组IPE体积与瘤周体积比（

（IPE）

（P）

）为0.216（0.101，0.351）（95%

：0.165~0.267），高于单发脑转移瘤组0.079（0.055，0.153）（95%

：0.066~0.102）（

0.001）。经ROC曲线分析，

（IPE）

（P）

具有良好的鉴别诊断效能，AUC值为0.765（95%

：0.674~0.840），最佳截断值为0.122（敏感性：71.93%，特异性：73.08%），（

0.001）。Pearson相关性分析显示，GBM组IPE-rCBV

median

和VPE-rCBV

median

与HAT-rCBV

median

间的相关系数分别为0.620（

0.01）、0.283（

=0.033），呈显著正相关。

结论

基于磁共振DSC-PWI构建的肿瘤血管生境特征参数在初诊GBM和SBM中差异明显，其体积特征参数

（IPE）

（P）

和血流特征参数LAT-rCBV

median

均具有较好的鉴别诊断效能，可作为两者鉴别诊断的影像学标记。

Abstract

Objective

To investigate the value of tumor vascular habitat characteristic parameters constructed based on dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) in differentiating between newly diagnosed glioblastoma (GBM) and solitary brain metastasis (SBM).

Methods

A case-control study design was adopted to analyze the imaging data of 109 patients with malignant brain tumors (including 57 cases of GBM and 52 cases of SBM) confirmed by postoperative pathology or comprehensive clinical diagnosis retrospectively collected from Department of Radiology of Daping Hospital between January 2019 and March 2025. Based on DSC-PWI images

hemodynamic tissue signature (HTS) was used to segment the lesions and construct 4 tumor vascular habitats

that is

high angiogenic tumor (HAT)

low angiogenic tumor (LAT)

potentially infiltrated peripheral edema (IPE)

and vasogenic peripheral edema (VPE). Volume parameters and blood flow parameters for each habitat region were calculated

including volume of each habitat region

tumor core volume

peritumoral edema volume

and relative cerebral blood volume (rCBV). Baseline data and habitat characteristic parameters were compared between the 2 groups. Receiver operating characteristic (ROC) curves were drawn to evaluate the differential diagnostic efficacy. Pearson correlation analysis was performed to assess the correlations among habitat characteristic parameters to quantify the spatial interactions between habitats.

Results

In the GBM group

the median rCBV (rCBV

median

) at HAT

LAT

IPE

and VPE habitats were 6.143±1.687 (95%

: 5.695~6.591)

3.249±0.988 (95%

: 2.987~3.511)

1.913 (1.578

2.588) (95%

: 1.794~2.110) and 0.836 (0.676

1.110) (95%

: 0.710~0.949)

respectively. These values were all significantly higher than the rCBV

median

at above habitats in the SBM group [4.634±1.647 (95%

: 4.175~5.092)

2.255±0.807 (95%

: 2.031~2.480)

1.291 (1.022

1.767) (95%

: 1.125~1.677)

0.600 (0.459

0.742) (95%

: 0.519~0.682);

0.001

]

. ROC curve analysis showed that the rCBV

median

at LAT habitat had good diagnostic efficacy for differentiation

with an AUC value of 0.792 (95%

: 0.704~0.864) (

0.001). The optimal cutoff value of rCBV

median

at LAT habitat was 2.660 (sensitivity: 75.44%

specificity: 78.85%). The ratio of IPE volume to peritumoral volume (

(IPE)

(P)

) in the GBM group was 0.216 (0.101

0.351) (95%

: 0.165~0.267)

notably higher than that in the SBM group [0.079 (0.055

0.153) (95%

: 0.066~0.102)

0.001

]

. ROC curve analy

sis indicated that

(IPE)

(P)

ratio had good diagnostic efficacy

with an AUC value of 0.765 (95%

: 0.674~0.840). The optimal cutoff value of the ratio was 0.122 (sensitivity: 71.93%

specificity: 73.08%). Pearson correlation analysis suggested that in the GBM group

the correlation coefficients between IPE-rCBV

median

and HAT-rCBV

median

and between VPE-rCBV

median

and HAT-rCBV

median

were 0.620 (

0.01) and 0.283 (

=0.033)

respectively

indicating significant positive correlations.

Conclusion

DSC-PWI-based vascular habitat characteristic parameters show significant differences between newly diagnosed GBM and SBM. Both the volumetric parameter

(IPE)

(P)

ratio and the hemodynamic parameter LAT-rCBV

median

have good differential diagnostic efficacy

and can serve as imaging markers for distinguishing between GBM and SBM.

关键词

Keywords

references

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