Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

Paul C. Schroeder, M. Judith Post, Elizabeth Oschatz, Alfred Stadler, Jocelyn Bruce-Gregorios, Majda M. Thurnher

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Introduction: Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. Methods: The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. Results: There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Conclusion: Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma.

Original languageEnglish
Pages (from-to)715-720
Number of pages6
JournalNeuroradiology
Volume48
Issue number10
DOIs
StatePublished - Oct 1 2006

Fingerprint

Cerebral Toxoplasmosis
Diffusion Magnetic Resonance Imaging
Lymphoma
Toxoplasmosis
Acquired Immunodeficiency Syndrome
Toxoplasma
Abscess

Keywords

  • Diffusion
  • Lymphoma
  • Toxoplasmosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Radiological and Ultrasound Technology

Cite this

Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma. / Schroeder, Paul C.; Judith Post, M.; Oschatz, Elizabeth; Stadler, Alfred; Bruce-Gregorios, Jocelyn; Thurnher, Majda M.

In: Neuroradiology, Vol. 48, No. 10, 01.10.2006, p. 715-720.

Research output: Contribution to journalArticle

Schroeder, Paul C. ; Judith Post, M. ; Oschatz, Elizabeth ; Stadler, Alfred ; Bruce-Gregorios, Jocelyn ; Thurnher, Majda M. / Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma. In: Neuroradiology. 2006 ; Vol. 48, No. 10. pp. 715-720.
@article{7bb46b6ea58445f4a1276db9a2784879,
title = "Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma",
abstract = "Introduction: Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. Methods: The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. Results: There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Conclusion: Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma.",
keywords = "Diffusion, Lymphoma, Toxoplasmosis",
author = "Schroeder, {Paul C.} and {Judith Post}, M. and Elizabeth Oschatz and Alfred Stadler and Jocelyn Bruce-Gregorios and Thurnher, {Majda M.}",
year = "2006",
month = "10",
day = "1",
doi = "10.1007/s00234-006-0123-y",
language = "English",
volume = "48",
pages = "715--720",
journal = "Neuroradiology",
issn = "0028-3940",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

AU - Schroeder, Paul C.

AU - Judith Post, M.

AU - Oschatz, Elizabeth

AU - Stadler, Alfred

AU - Bruce-Gregorios, Jocelyn

AU - Thurnher, Majda M.

PY - 2006/10/1

Y1 - 2006/10/1

N2 - Introduction: Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. Methods: The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. Results: There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Conclusion: Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma.

AB - Introduction: Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. Methods: The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. Results: There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Conclusion: Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma.

KW - Diffusion

KW - Lymphoma

KW - Toxoplasmosis

UR - http://www.scopus.com/inward/record.url?scp=33749338141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33749338141&partnerID=8YFLogxK

U2 - 10.1007/s00234-006-0123-y

DO - 10.1007/s00234-006-0123-y

M3 - Article

C2 - 16947010

AN - SCOPUS:33749338141

VL - 48

SP - 715

EP - 720

JO - Neuroradiology

JF - Neuroradiology

SN - 0028-3940

IS - 10

ER -