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Updated: May 17, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Correlation of MRI-derived apparent diffusion coefficients in newly diagnosed gliomas with [18F]-fluoro-L-dopa PET:
1Centre for Clinical Research, Discipline of Medical Imaging, University of Queensland, St Lucia, Brisbane, Australia. Stephen.Rose@cai.uq.edu.au
Background And Purpose:
There is significant interest in whether diffusion-weighted MR imaging indices, such as the minimum apparent diffusion coefficient, may be useful clinically for preoperative tumor grading and treatment planning. To help establish the pathologic correlate of minimum ADC, we undertook a study investigating the relationship between minimum ADC and maximum FDOPA PET uptake in patients with newly diagnosed glioblastoma multiforme.
Materials And Methods:
MR imaging and FDOPA PET data were acquired preoperatively from 15 patients who were subsequently diagnosed with high-grade brain tumor (WHO grade III or IV) by histopathologic analysis. ADC and SUVR normalized FDOPA PET maps were registered to the corresponding CE MR imaging. Regions of minimum ADC within the FDOPA-defined tumor volume were anatomically correlated with areas of maximum FDOPA SUVR uptake.
Results:
Minimal anatomic overlap was found between regions exhibiting minimum ADC (a putative marker of tumor cellularity) and maximum FDOPA SUVR uptake (a marker of tumor infiltration and proliferation). FDOPA SUVR measures for tumoral regions exhibiting minimum ADC (1.36±0.22) were significantly reduced compared with those with maximum FDOPA uptake (2.45±0.88, P=.0001).
Conclusions:
There was a poor correlation between minimum ADC and the most viable/aggressive component of high-grade gliomas. This study suggests that other factors, such as tissue compression and ischemia, may be contributing to restricted diffusion in GBM. Caution should be exercised in the clinical use of minimum ADC as a marker of tumor grade and the use of this index for guiding tumor biopsies preoperatively.
Insights
Minimum apparent diffusion coefficient (ADC) does not reliably indicate aggressive tumor regions in glioblastoma. This finding suggests caution when using minimum ADC for preoperative grading or guiding biopsies in high-grade gliomas.
Area of Science:
- Neuro-oncology
- Radiology
- Medical Imaging
Background:
- Diffusion-weighted MR imaging (dWI) indices like minimum apparent diffusion coefficient (ADC) are explored for clinical utility in preoperative tumor grading and treatment planning for brain tumors.
- Establishing the pathological correlate of minimum ADC is crucial for its accurate interpretation.
Purpose of the Study:
- To investigate the relationship between minimum ADC and maximum 18F-DOPA PET uptake in patients with newly diagnosed glioblastoma multiforme (GBM).
- To determine if minimum ADC can serve as a reliable marker for the most viable or aggressive components of high-grade gliomas.
Main Methods:
- Acquired preoperative MR imaging and 18F-DOPA PET data from 15 patients with histopathologically confirmed high-grade brain tumors (WHO grade III or IV).
- Registered ADC and SUVr-normalized 18F-DOPA PET maps to corresponding contrast-enhanced MR imaging.
- Anatomically correlated regions of minimum ADC within the 18F-DOPA-defined tumor volume with areas of maximum 18F-DOPA SUVr uptake.
Main Results:
- Minimal anatomic overlap was observed between regions of minimum ADC (putative marker of tumor cellularity) and maximum 18F-DOPA SUVr uptake (marker of tumor infiltration and proliferation).
- 18F-DOPA SUVr values in regions of minimum ADC (1.36±0.22) were significantly lower than in regions of maximum 18F-DOPA uptake (2.45±0.88, P=.0001).
Conclusions:
- There is a poor correlation between minimum ADC and the most viable/aggressive components of high-grade gliomas.
- Restricted diffusion in GBM may be influenced by factors beyond cellularity, such as tissue compression and ischemia.
- Clinical use of minimum ADC for tumor grading and guiding preoperative biopsies in GBM should be approached with caution.
