{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:50Z","timestamp":1789448570617,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG) may share overlapping conventional MRI appearances. We developed and internally validated a parsimonious model combining tumor apparent diffusion coefficient (ADC) and the lipid-to-creatine ratio (Lip\/Cr), compared it with every single predictor, and evaluated the secondary contribution of proximal peritumoral ADC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective, availability-based cohort included 83 consecutive eligible patients with pathologically confirmed PCNSL (n = 38) or HGG (n = 45) who underwent pretreatment 3.0-T MRI with diffusion-weighted imaging and proton magnetic resonance spectroscopy. Four prespecified logistic models were evaluated. Internal validation used 2,000 stratified bootstrap resamples with standardization repeated within each resample. Distribution-appropriate summaries, paired incremental performance, empirical calibration, sensitivity analyses, and exploratory decision-curve analysis were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Tumor ADC was lower and Lip\/Cr was higher in PCNSL than in HGG (both P &amp;lt; 0.001). The tumor ADC plus Lip\/Cr model achieved an apparent AUC of 0.925 and an optimism-corrected AUC of 0.918 (95% CI, 0.868\u20130.980); the corrected Brier score was 0.114 (95% CI, 0.073\u20130.160). Relative to Lip\/Cr alone, the corrected changes were small and uncertain (\u0394AUC, 0.021; 95% CI, \u22120.039 to 0.055; \u0394Brier, \u22120.020; 95% CI, \u22120.044 to 0.023). Adding proximal peritumoral ADC also produced small and uncertain changes (\u0394AUC, 0.004; 95% CI, \u22120.039 to 0.023; \u0394Brier, \u22120.005; 95% CI, \u22120.018 to 0.027). Findings were directionally stable after log transformation of Lip\/Cr and restriction of the HGG comparator to IDH-wildtype glioblastoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tumor ADC plus Lip\/Cr showed favorable exploratory internal-validation performance, but superiority over Lip\/Cr alone was not established. The model requires multicenter external validation with prespecified MRS quality control and should support, rather than replace, expert interpretation and histopathologic confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1941153","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:24Z","timestamp":1789446384000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tumor apparent diffusion coefficient combined with the lipid-to-creatine ratio for preoperative differentiation of primary central nervous system lymphoma from high-grade glioma: a single-center diagnostic model development and internal validation study"],"prefix":"10.3389","volume":"16","author":[{"given":"Lei","family":"Geng","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, The Second People\u2019s Hospital of Lianyungang (The Oncology Hospital of 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