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Updated: May 8, 2025
Co-analysis of Brain Structure and Function using fMRI and Diffusion-weighted Imaging
Published on: November 8, 2012
Glioma-white matter tract interactions: A diffusion magnetic resonance imaging-based 3-tier classification and its
Jie Hu1, Hongbo Bao1,2, Xing Liu3
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background:
This study proposed a classification system for the interaction between gliomas and white matter tracts, exploring its potential associations with clinical characteristics, tumor pathological subtypes, and patient outcomes.
Methods:
Clinical data and diffusion magnetic resonance imageing (dMRI) from 360 glioma patients who underwent craniotomy were analyzed. Using automatic fiber tractography, glioma-tract relationships were categorized into 3 types: displacement, infiltration, and disruption. Double immunohistochemical staining for isocitrate dehydrogenase (IDH) and myelin basic protein was performed on neuronavigation-guided tissue samples to validate the imaging-based classifications. The clinical implications of these classifications on the extent of tumor resection, postoperative motor function, and survival outcomes were evaluated.
Results:
Among the patients, 35 (9.7%) were categorized as displacement type, 283 (78.6%) as infiltration type, and 42 (11.7%) as disruption type. Disruption-type tracts were predominantly associated with IDH wild-type gliomas (87.2%), significantly higher than infiltration (28.5%) and displacement types (23.5%) (P < .001). Displacement and infiltration types were more common in IDH-mutant gliomas (P < .001). Displacement-type tracts were significantly associated with higher rates of gross tumor resection compared to infiltration types (P = .015). In corticospinal tract involved cases, displacement-type tumors demonstrated no significant postoperative motor strength changes, whereas infiltration (P < .001) and disruption types (P = .013) were highly associated with postoperative motor deficits. Histological results aligned with dMRI-based classifications.
Conclusions:
This dMRI-based classification of glioma-tract interactions is significantly associated with tumor pathology, resection outcomes, functional prognosis, and survival, providing a valuable tool for personalized and precise surgical planning.
