DTI Analysis of the Peritumoral Zone of Diffuse Low-grade Gliomas in Progressing Patients

Dylan Chiche ¹, Luc Taillandier ², Marie Blonski ²

⁰Université de Lorraine, CHRU-Nancy, Service de Neuroradiologie diagnostique et thérapeutique, Nancy, France.

World Neurosurgery +

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November 3, 2024

View abstract on PubMed

Summary

Diffusion tensor imaging (DTI) shows abnormalities in brain areas where diffuse low-grade gliomas will progress within a year. These early DTI changes may help predict tumor growth and guide treatment strategies.

Area Of Science

Neuro-oncology
Radiology
Medical Imaging

Background

Diffuse low-grade gliomas (LGGs) infiltrate white matter tracts, complicating treatment planning and response monitoring.
Standard imaging like FLAIR may not detect early tumor infiltration beyond visible boundaries.
Diffusion tensor imaging (DTI) offers potential to identify subtle white matter changes indicative of tumor spread.

Purpose Of The Study

To investigate if DTI signal changes in the peritumoral zone can predict future tumor progression in LGGs.
To assess DTI abnormalities in areas that show progression on FLAIR imaging one year later.

Main Methods

Retrospective analysis of 5 patients with LGGs.
Acquisition of DTI, T1, and FLAIR MRI sequences at baseline and FLAIR at 1-year follow-up.
Comparison of DTI signal within the 1-year progression mask to the contralateral healthy white matter.

Main Results

All 5 patients demonstrated tumor progression at 1 year.
Pre-existing DTI signal abnormalities were observed in all progression areas.
Significantly lower fractional anisotropy and higher mean, axial, and radial diffusivity were found in progression areas compared to healthy tissue.

Conclusions

Early DTI signal abnormalities can indicate tumor infiltration not yet visible on FLAIR.
DTI may serve as a valuable tool for predicting tumor progression in LGGs.
Identifying these early changes could enable timely adaptation of therapeutic strategies.

Keywords:

Diffuse low-grade glioma Tensor diffusion imaging Tumor progression