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It is always a great challenge to distinguish high-grade glioma (HGG) from primary central nervous system lymphoma (PCNSL). We conducted a meta-analysis to assess the performance of MR perfusion-weighted imaging (PWI) in differentiating HGG from PCNSL. The heterogeneity and threshold effect were evaluated, and the sensitivity (SEN), specificity (SPE) and areas under summary receiver operating characteristic curve (SROC) were calculated. Fourteen studies with a total of 598 participants were included in this meta-analysis. The results indicated that PWI had a high level of accuracy (area under the curve (AUC) = 0.9415) for differentiating HGG from PCNSL by using the best parameter from each study. The dynamic susceptibility-contrast (DSC) technique might be an optimal index for distinguishing HGGs from PCNSLs (AUC = 0.9812). Furthermore, the DSC had the best sensitivity 0.963 (95%CI: 0.924, 0.986), whereas the arterial spin-labeling (ASL) displayed the best specificity 0.896 (95% CI: 0.781, 0.963) among those techniques. However, the variability of the optimal thresholds from the included studies suggests that further evaluation and standardization are needed before the techniques can be extensively clinically used. [ABSTRACT FROM AUTHOR]

Background: Locating the pyramidal tract (PT) is difficult in patients with thalamic or basal ganglia tumors, especially when the surrounding anatomical structures cannot be identified using computed tomography or magnetic resonance images. Hence, we objected to find a way to predict the location of the PT in patients with thalamic and basal ganglia tumors, Methodology/principal Findings: In 59 patents with thalamic or basal ganglia tumors, the PTs were constructed by with diffusion tensor imaging (DTI)-based fiber tracking (FT). In axial slices crossing the foramen of Monro, the tumor position was classified according to three lines. Line 1 was vertical and crossed the vertex point of the anterior limbs of the internal capsule. Lines 2 and line 3 were horizontal and crossed the foramen of Monro and joint of the middle and lateral thirds of the posterior limbs, respectively. Six (10.17%) patients were diagnosed with type 1 tumor, six (10.17%) with type 2, seven (11.86%) with type 3a, five (8.47%) with type 3b, 17 (28.81%) with type 4a, six (10.17%) with type 4b, three (5.08%) with type 5, and nine (15.25%) with type 6. In type 1 tumors, the PTs were located at the 12 o'clock position of the tumor, type 2 at six o'clock, type 3a between nine and 12 o'clock, type 3 between six and nine o'clock, type 4a between 12 and three o'clock, type 4b at three o'clock, type 5 between six and nine o'clock, and type 6 between three and six o'clock., Conclusions/significance: The position of the PT relative to the tumor could be determined according to the tumor location. These results could prove helpful in determining the location of the PT preoperatively.