Characterization of normal brain and brain tumor pathology by chisquares parameter maps of diffusion-weighted image...

To characterize normal and pathologic brain tissue by quantifying the deviation of diffusion-related signal from a simple monoexponential decay, when measured over a wider than usual range of b-factors.

Line scan diffusion imaging (LSDI), with diffusion weighting at multiple b-factors between 100 and 5000 s/mm(2), was performed on 1.5 T clinical scanners. Diffusion data of single slice sections were acquired in five healthy subjects and 19 brain tumor patients. In-patients, conventional T2-weighted and contrast-enhanced T1-weighted images were obtained for reference purposes. The chisquare (chi(2)) error parameter associated with the monoexponential fits of the measured tissue water signals was then used to quantify the departure from a simple monoexponential signal decay on a pixel-by-pixel basis.

Diffusion-weighted images over a wider b-factor range than typically used were successfully obtained in all healthy subjects and patients. Normal and pathologic tissues demonstrated signal decays, which clearly deviate from a simple monoexponential behavior. The chi(2) of cortical and deep grey matter was considerably lower than in white matter. In peritumoral edema, however, chi(2) was 68% higher than in normal white matter. In highly malignant brain tumors, such as glioblastoma multiforme (GBM) or anaplastic astrocytoma, chi(2) values were on average almost 400% higher than in normal white matter, while for one low grade astrocytoma and two cases of metastasis, chi(2) was not profoundly different from the chi(2) value of white matter. Maps of the chi(2) values provide good visualization of spatial details. However, the tumor tissue contrast generated appeared in many cases to be different from the enhancement produced by paramagnetic contrast agents. For example, in cases where the contrast agent only highlighted the rim of the tumor, chi(2) enhancement was present within the solid part of the tumor.

The deviation from a purely monoexponential diffusion signal decay becomes evident as diffusion encoding is extended well beyond the normal range. The chi(2) error parameter as a measure of this deviation seems to provide sufficient lesion contrast to permit differentiation of malignant brain tumors from normal brain tissue.