Differentiation of brain tumors from brain infections and
abscesses
Brain abscesses caused by aerobic bacteria can mimic GBM tumors in MRI
image appearance and single voxel proton MR spectroscopy, leading to
misdiagnosis. Based on the hypothesis that metabolite levels of choline
would be decreased in the ring-enhancing portion of abscesses compared
to GBM, one study using MR spectroscopic imaging found that metabolite
ratios and maximum choline/choline-n, choline/creatine, and choline/
N-acetylaspartate ratios of the contrast-enhancing rim could be useful
differentiating aerobic abscesses from GBM. In MRI procedures, the
apparent diffusion coefficient (APC) may be useful in differentiating
GBM from brain fungal abscess. Combining diffusion tensor imaging (DTI)
and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI)
provides better results in differentiating lesions from brain infections
than each technique used alone [54-56].