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White Matter Change Revealed by Diffusion Tensor Imaging in Gliomas
Young Il Won1, Chun Kee Chung2, Chi Heon Kim2
1Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Brain Tumor Research and Treatment
|November 22, 2016
Summary
Diffusion tensor imaging (DTI) detects white matter changes in gliomas earlier than conventional MRI. Apparent diffusion coefficients (ADC) show changes even in low-grade gliomas, suggesting ADC is a superior early detection parameter.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- White matter changes in gliomas are typically detected late using conventional MRI when significant edema or mass effect is present.
- Diffusion tensor imaging (DTI) offers potential for earlier detection of these changes.
Purpose of the Study:
- To investigate if DTI can detect white matter changes associated with gliomas earlier than conventional MRI.
- To evaluate the utility of DTI parameters, fractional anisotropy (FA) and apparent diffusion coefficients (ADC), in assessing white matter integrity in gliomas.
Main Methods:
- Twenty-six glioma patients (WHO grades II-IV) and 15 controls were studied, focusing on the posterior limb of the internal capsule.
- Gliomas were classified based on WHO grade and presence/absence of high signal change on fluid attenuation inversion recovery MRI.
- DTI metrics (FA, ADC) were calculated for the pyramidal tract, and tumor progression was monitored via follow-up MRI.
Main Results:
- Fractional anisotropy (FA) was significantly lower in high-grade gliomas (WHO III/IV) compared to controls.
- Apparent diffusion coefficients (ADC) were elevated in all glioma groups (WHO II-IV) compared to controls, indicating early white matter changes.
- Tumor progression was observed in 2 out of 16 patients during the follow-up period.
Conclusions:
- DTI can detect white matter abnormalities in gliomas that may appear normal on conventional MRI.
- Apparent diffusion coefficients (ADC) show early alterations even in low-grade gliomas, positioning ADC as a promising biomarker for early detection of white matter changes.
