Ces radiol. 2007, 61(3):279-289

Diffusion tensor magnetic resonance imaging of glial brain tumorsOriginal article

Jiří Ferda, Jan Kastner, Boris Kreuzberg, Petr Mukenšnabl1
1 Radiodiagnostická klinika LF UK a FN, Plzeň
2 Šiklův ústav patologické anatomie LF UK a FN, Plzeň

Aim: To evaluate the author's experience with the use of diffusion tensor magnetic resonance imaging (DTI) on patients with glial tumours.

Methods: A retrospective evaluation of a group of 24 patients with glial tumours was performed. There were eight patients with grade II, eight patients with grade III and eight patients with grade IV tumours with a histologically proven diagnosis. All the patients underwent routine imaging including T2 weighted images, multidirectional diffusion weighted imaging (measured in 60 non-collinear directions) and T1 weighted non-enhanced and contrast enhanced images. The imaging sequence and evaluation software were produced by Massachusetts General Hospital Corporation (Boston, USA, Ma). Fractional anisotropy (FA) maps were calculated in all patients. The white matter FA changes were assessed within the tumourous tissue, on the tumourous borderline and in the normally appearing white matter adjacent to the tumour. A three-dimensional model of the white matter tract was created to demonstrate the space relationship of the tumour and the capsula interna or corpus callosum in each case using the following fibre tracing parameters: FA step 0.25 and a tensor declination angle of 45 gr. An additional assessment of the tumourous tissue enhancement was performed.

Results: A uniform homogenous structure and sharp demargination of the grade II tumours and the wide rim of the intermedial FA in all grade III tumours respectively, were found during the evaluation of the FA maps. In grade IV tumours a variable demargination was noted on the FA maps. The sensitivity and specificity for the discrimination of low and high grade glial tumours using FA maps was revealed to be 81% and 87% respectively. If the evaluation of the contrast enhancement was combined with the evaluation of the FA maps, both sensitivity and specificity were 100%.

Conclusion: Although the evaluation of the fractional anisotropy maps is not sufficient for glioma grading, the combination of the contrast enhancement pattern and fractional anisotropy maps evaluation improves the possibility of distinguishing low and high grade glial tumours. Three-dimensional models of the white matter fibres in the corpus callosum and the internal capsule may be used in the presurgical planning.

Keywords: diffusion tensor imaging (DTI), glial tumors, intracranial neoplasms, tractography

Accepted: June 15, 2007; Published: September 1, 2007  Show citation

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Ferda J, Kastner J, Kreuzberg B, Mukenšnabl P. Diffusion tensor magnetic resonance imaging of glial brain tumors. Ces radiol. 2007;61(3):279-289.
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