The Mount Sinai Hospital
Radiology & Neurosurgery
•The
integrated algorithmic MR imaging strategy described by al-Okaili was 65.6% (21/32) accurate in distinguishing diffusely
infiltrating astrocytomas within our patient
population (examples 1,2). The single factor that most affected accuracy appears to be Question 5, which incorrectly identified up to 27.7% (4/15) of
high grade astrocytomas as
metastases (example 3). Overall this
question had an accuracy of
73.3% (11/15). If Question 5 is
omitted, and one considers only low-grade
versus high-grade neoplasms, the accuracy of the algorithm increased to 78.1% (25/32).
•The
Al-Okaili et al.4 study included 40
patients with high- and
low-grade neoplasms,
lymphomas, tumefactive demyelinating lesions, abscesses, and encephalitis. Of those patients, only 19 had
high-grade or low-grade neoplasms. Their study showed that the overall accuracy in
distinguishing between high-grade and
low-grade neoplasms was 90%, which was higher than our results, possibly because their series included not only astrocytomas, but
also metastases and lymphomas.
Discussion (1)