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. 2018 May 24;8:161. doi: 10.3389/fonc.2018.00161

Table 1.

Comparison of neuroimaging techniques in diagnosis of BMs.

Technique Advantages Disadvantages
CT
  • –

    First-line approach

  • –

    Fast information on intracranial hemorrhage, herniation, mass effect, and hydrocephalus

  • –

    Useful in non compliant patients
  • –

    Low resolution and low sensibility for differential diagnosis
MRI (T1/T2/FLAIR sequences)
  • –

    Major resolution

  • –

    Better lesion characterization and localization (cortical/subcortical)
  • –

    Difficult resolution of calcifications

  • –

    Longer time for image acquisition and processing
MRI with Gad Better characterization
  • –

    Longer time

  • –

    Allergic reactions to Gad
Advanced MRI Spectroscopy Useful in DD glioma vs BM
  • –

    Longer time
Perfusion Useful in DD HGG vs BM (rCBV value in peritumoral FLAIR hyperintense region)
  • –

    Longer time

  • –

    Variable target definition for measurement

  • –

    Unclear rCBV cutoff values in DD HGG vs BM
DTI images
  • –

    Evaluate the structural organization of white matter tracts and spatial relationships with brain lesions

  • –

    Useful in surgical planning
  • –

    Low specificity
DWI and ADC images
  • –

    DD HGG/BM and abscesses (restricted diffusion with DWI+ is more typical in abscesses)

  • –

    DD HGG/BM edema in peritumoral region (higher ADC signal in BM)

  • –

    DD PCNSL/HGG and BM (DWI + ADC maps)
  • –

    Longer time
PET-CT 18F-FDG PET
  • –

    Metabolic and functional information
  • –

    Low specificity in DD with others brain lesions (inflammatory disease, abscesses, and granulomatous lesions) and other tumors (HGG)
Amino acids PET
  • –

    More useful for the differentiation of tumor and non-tumoral processes, as tumors have significantly higher uptake
  • –

    Increased uptake in acute inflammatory lesions

  • –

    Not sufficient discrimination from HGG and some non-neoplastic lesions

CT, computed tomography; MRI, magnetic resonance imaging; Gad, gadolinium; DTI, diffusion tensor imaging; DWI diffusion-weighted imaging; DD, differential diagnosis; BMs, brain metastases; HGG, high-grade glioma; rCBV, relative cerebral blood volume; ADC, apparent diffusion coefficient; PET, positron emission tomography; 18F FDG, 18F-fluorodeoxyglucose; FLAIR, fluid attenuated inversion recovery.