Intravoxel incoherent motion (IVIM) for distinguishing glioma and solitary brain metastasis: A pilot multi-parameter magnetic resonance imaging histogram and texture analysis

Abstract Background: To investigate the value of diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and amide proton transfer-weighted (APTW) imaging in differentiating the primary glioma from solitary brain metastases (SBM) with the histogram and texture features. Methods: A total of 65 patients with newly diagnosed glioma or metastases were enrolled. All patients underwent DWI, IVIM, and APTW imaging, as well as the T1W, T2W, T2FLAIR, and enhanced T1W imaging. The first-order texture and histogram features of apparent diffusion coefficient (ADC) from DWI, diffusion coefficient (D), perfusion fraction (f), pseudo-diffusion coefficient (D*) from IVIM, and MTRasym (3.5 ppm) from APTW were extracted from the tumor parenchyma and compared between glioma and SBM. Parameters with significant differences were analyzed with the logistics regression and receiver operator curves to explore the optimal model and compare the differentiation performance. Results: Higher ADCkurtosis (p=0.02), f90 (p＜0.01), and fkurtosis (p=0.01) were found for glioma, while higher MTRasym (3.5ppm)10 (p= 0.05), fentropy (p＜0.01), and fmean (p＜0.01) were observed for SBM. fkurtosis (OR =0.66, 95%CI 0.48-0.92, p=0.02), and fmean (OR=1.44, 95%CI 1.16-1.18, p<0.01) were independent factors for SBM differentiation. The model combining age, fkurtosis, and fmean showed an AUC of 0.83, while the model combined with fkurtosis and fmean with improved sensitivity had an AUC of 0.81. Conclusion: The fmean and fkurtosis in enhanced tumor region could be used to differentiate glioma and SBM.