Brain Tumor Res Treat.
2016 Oct;4(2):100-106. 10.14791/btrt.2016.4.2.100.
White Matter Change Revealed by Diffusion Tensor Imaging in Gliomas
- Affiliations
-
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea. chungc@snu.ac.kr
- 2Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
- 3Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
- 4Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
- KMID: 2356977
- DOI: http://doi.org/10.14791/btrt.2016.4.2.100
Abstract
- BACKGROUND
Tumor-related white matter change is detected at late stages with magnetic resonance imaging (MRI), when mass effect or prominent edema is present. We analyzed if diffusion tensor imaging (DTI) white matter change earlier than conventional MRI.
METHODS
Twenty-six patients with gliomas (World Health Organization grade II, 5; grade III, 12; and grade IV, 9) within 2 cm from the posterior limb of the internal capsule (IC) were studied. Fifteen normal adults were enrolled as controls. Fluid attenuation inversion recovery MRI showed a high signal change at the posterior limb of the IC (HSIC) in 9 patients with grade III or IV gliomas. We classified the gliomas as WHO grade II (gliomas II), grade III or IV without HSIC [gliomas III/IV(-)] and grade III or IV with HSIC [gliomas III/IV(+)], as an indicator of the increase in the severity of the white matter changes. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) were calculated for the pyramidal tract. Tumor progression along pyramidal tract was evaluated by follow-up MRI in 16 patients at 40±18 months.
RESULTS
FA showed no significant difference between gliomas II and control (p=0.694), but was lower in gliomas III/IV(-) and gliomas III/IV(+) (p<0.001). ADCs were higher in gliomas II, gliomas III/IV(-) and gliomas III/IV(+) than control (p<0.001). Tumor progression was detected in 2/16 patients.
CONCLUSION
DTI detected white matter changes that appeared to be normal in MRI. ADC changed even in low grade glioma, indicating ADC may be a better parameter for the early detection of white matter change.
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